Idaho pushes residency expansion: psychiatry, internal medicine and family medicine funding debated at JFAC

Legislators on the Joint Finance‑Appropriations Committee heard presentations on funding requests for several Idaho medical residency programs as part of a multi‑year plan to increase the state's physician workforce.

Legislative analyst Kevin Campbell opened the segment with an overview of residency funding and structure, describing East Idaho, Boise and family medicine residency programs and explaining that many residency positions are paid through three‑way partnerships among the sponsoring institution, health systems and the state. "To create a doctor takes at a minimum, three additional years longer for some specialties," Campbell said, adding that the state typically pays a portion of the annual per‑resident cost.

Eastern Idaho Medical Residency

Doctor Matt Larson, psychiatry program director at Eastern Idaho, outlined a request to fund psychiatric residency slots. Eastern Idaho Medical Residency sought $240,000 to fund four additional psychiatric resident positions for FY2026, which the analyst said would bring the total number of psychiatry residents in that program to 12. Larson told the committee that training physicians in Idaho increases the chance they remain in the state: "Training people here gets people to stay here."

Boise Internal Medicine and Family Medicine

Analysts and program directors explained that Boise Internal Medicine and the Family Medicine Residency (FMR) programs also requested modest increases for additional residents or fellowships. Boise Internal Medicine requested $60,000 ongoing for one additional resident in FY2026. Family Medicine Residency requested funding tied to a new St. Alphonsus‑Nampa program and other expansions; family medicine programs statewide currently include Full Circle Health, ISU family medicine and Kootenai Clinic sites and collectively account for more than 130 residents.

Funding model and costs

Presenters said the cost to train a single resident has risen and that a commonly cited figure in testimony is roughly $210,000 per resident per year; historically the state’s share was about one‑third of that amount. Program directors urged continued state support to maintain and grow residency capacity. As one program director summarized: the three‑way partnership of sponsoring institution, local health system and the state made many of Idaho’s residency programs possible.

Retention and immediate clinical capacity

Campbell cited an American Medical Association finding that about 55% of Idaho residency graduates remain in the state, placing Idaho among the top 10 states for retention. Program directors and clinicians emphasized that residents provide immediate clinical capacity while in training: "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 told the committee.

Committee follow‑up

Legislators asked for additional details about residency counts, the relative costs and how residency growth fits into broader workforce strategy, including rural physician loan‑repayment efforts. Several committee members asked how residency growth compares with neighboring states; presenters said Idaho has increased residencies significantly under a 10‑year expansion plan and has moved from near the bottom of the region to parity or better with many nearby states.

Why it matters

Residency training is a critical part of the physician pipeline: residents deliver care while training and many remain to practice in the communities where they trained. Committee members said continued state investment in residencies aims to expand access to primary care, mental‑health care and other specialties in rural and urban Idaho.

No formal appropriation votes were recorded in the hearing transcript; committee staff asked analysts and program directors to supply follow‑up budget and capacity details.