Lawmakers hear requests to expand residency slots, citing long waits for care and retention gains

Idaho residency program directors and Legislative Services analysts told the Joint Finance Appropriations Committee that continued and expanded state funding for graduate medical education is needed to address physician shortages, increase the number of practicing specialists in rural areas and relieve long patient wait times.

Why it matters: Program directors said residents provide hands-on clinical care while they train and that graduates often remain in-state. Committee members pressed for retention metrics and asked how new slots compare to other workforce strategies such as loan repayment, scholarships and increased residency capacity at medical schools.

Analyst Kevin Campbell (Legislative Services Office) summarized program requests and spending patterns for Eastern Idaho Medical Residency (EIMR), Boise Internal Medicine and the state’s consolidated family medicine residency programs. EIMR asked for $240,000 to fund four additional psychiatry resident positions for FY 2026; Campbell said the program has no FTE because residents are employees of the sponsoring hospital and that in recent years the legislature has funded incremental resident increases. EIMR and other programs consistently spend nearly all of their appropriations, Campbell said.

Psychiatry program director Matthew Larson told the committee Idaho faces long waits for psychiatric care: "It takes 3 and a half months to get into me," he said, and added that waits for psychological testing and other specialty services are often longer. "It takes about a year to get into a psychologist for testing for a kid," he told the committee. Larson said the psychiatry residency will expand to 16 residents in July and that training more psychiatrists in-state is a key strategy to increase local capacity.

Kevin Campbell cited a 2022 American Medical Association statistic saying about 55% of graduates from Idaho residencies stay in the state; residency directors and university partners said retention rates vary by program but have been strong enough to justify continued investment. Program directors reported that training slots are oversubscribed (for example, Larson described 30 applicants per family-medicine position and 95 applicants per psychiatry slot) and that residencies provide immediate clinical capacity: "Even if no one stayed in the state afterwards, you still have 16 additional doctors practicing psychiatry in Idaho Falls and the surrounding areas just from my program," Larson said.

Cost and requests: Analysts said the current estimated cost per resident is about $210,000 per year. Specific FY 2026 requests discussed included EIMR’s $240,000 for four psychiatric residents; Boise Internal Medicine’s request for $60,000 for one additional internal-medicine resident; and Family Medicine Residency’s larger package that included a $420,000 ongoing ask for six residents and one fellowship tied to a new St. Alphonsus Nampa program (the family-medicine package also included additional requests for ISU sites and other rural expansions). Committee members and directors noted that funding is typically structured as three-way partnerships (sponsoring hospital/institution, health system partner and state contribution) and that the state’s portion historically approximated a third of per-resident costs.

Legislators asked about alternatives and evaluation. Director Alex Adams and committee members described the physician pipeline as requiring a "yes, and" approach: scholarships, residencies and loan-repayment incentives address different parts of the recruitment and retention problem. Vice Chair Miller and others asked for measurable outcomes; directors cited retention percentages and year-over-year slot growth as primary metrics and asked the committee to continue the 10-year expansion plan that has increased resident numbers across Idaho.

What was not decided: No appropriation votes were taken during the hearing. Directors asked the committee to consider funding the last increments of multi-year expansions so new psychiatry and other resident classes can be sustained.