Lawmakers hear reports on residency expansion; state funding counted as one‑third of training costs

Legislative staff and program directors told the Joint Finance‑Appropriations Committee that Idaho’s multi‑year effort to expand graduate medical education (GME) is increasing the number of residents training in the state, providing immediate clinical capacity while aiming to boost long‑term retention of physicians.

Kevin Campbell, a Legislative Services Office analyst, presented an overview of several residency programs — Eastern Idaho Medical Residency (EIMR), Boise Internal Medicine and multiple family medicine residency (FMR) campuses — describing both base budgets and the FY2026 funding requests. Campbell reported that residency programs typically operate under a three‑way funding model (sponsoring institution, healthcare system partner(s), and state support) and that the current estimated cost per resident has risen to about $210,000 per year.

Why it matters: increasing residency slots expands the physician workforce in the short term (residents provide patient care while training) and improves long‑term retention: Campbell noted an American Medical Association figure that 55% of Idaho residency graduates remain to practice in the state.

Key details from testimony

- Program scale and growth: Speakers said the state has grown residency capacity as part of a 10‑year expansion plan. Program directors reported increases in training slots across specialties: family medicine, internal medicine and psychiatry were emphasized. Program directors said Idaho’s residency capacity grew from roughly 134 residents several years ago to about 262 residents in the most recent counts presented.

- Cost and state share: Campbell and program directors said the state’s typical share to fund a residency slot has historically been roughly one‑third of the per‑resident cost; at $210,000 per resident that equates to roughly $60,000–$70,000 per resident per year. Cost pressures have increased since earlier years, when $60,000 represented the state third for lower per‑resident totals.

- Specific FY2026 requests discussed on the record: - Eastern Idaho Medical Residency requested $240,000 for four additional psychiatric residents (to complete psychiatry’s four‑year cycle); the program has 56 residents and noted strong applicant interest. - Boise Internal Medicine requested $60,000 ongoing for one additional internal medicine resident; its program had 41 residents and two addiction medicine fellows described in testimony. - Family Medicine Residency (FMR) network requested multiple increases, including a FY2026 request tied to a new St. Alphonsus‑Nampa program (six residents and related fellowships) and additional slots at Eastern Idaho campuses; testimony referenced a $420,000 ongoing request tied to six new residents and 1 fellowship in the FMR submission.

Immediate clinical impact

Program directors emphasized that residents are licensed clinicians who deliver care while training. Psychiatrist Matthew Larson said his psychiatry residents see patients daily and that the program immediately increases access in Eastern Idaho: “It takes 3 and a half months to get into me,” Larson said when describing wait times before the residency expansion; he added that residents provide direct services during training and that even if retention were imperfect, the immediate clinical capacity is substantial.

Retention and evaluation

Campbell told the committee the AMA found 55% of Idaho residency graduates remain in state practice — a retention rate that places Idaho among the top 10 states for retention. Division and program directors described higher retention numbers for several programs (family medicine programs cited retention rates as high as about 65%). Program directors said retention varies by specialty and maturity of the residency program; psychiatry’s first full graduating classes are still in progress, so retention figures for psychiatry are not yet mature.

Committee questions and readiness to expand

Lawmakers pressed program directors on where additional funding could be used immediately; directors identified a child psychiatry track and a sports medicine fellowship as programs with infrastructure ready to begin if funding is provided. Program directors and physicians emphasized residency programs’ role in increasing physician counts statewide and described Idaho’s model as an example for neighboring states seeking to expand GME.

Ending

Program directors and analysts asked the committee to sustain the long‑term expansion plan. “Please continue the 10 year plan. Don't cut it short and let us finish,” psychiatrist Matthew Larson told the committee. Analysts and program directors said they would provide follow‑up details on costs, capacity and the timing of slot additions.