Lawmakers hear residency expansion requests as Idaho funds part of graduate medical education

Legislators on the Joint Finance‑Appropriations Committee on Monday reviewed requests to expand graduate medical education across Idaho, including psychiatry slots in eastern Idaho and additional family and internal medicine positions statewide. Department analysts and residency directors said state support for residency slots is a key strategy to increase the number of physicians practicing in Idaho.

Why it matters: Idaho has fewer physicians per capita than most states. Residency positions are widely seen by program leaders and analysts as a crucial retention point: physicians who train in the state are more likely to remain and practice here. Several programs asked for incremental funding to add residents and complete multi‑year residency cohorts.

Legislative analysts from the Legislative Services Office summarized the request and noted the funding model used in Idaho: most residency programs operate as three‑way partnerships among sponsoring institutions (hospitals or universities), health systems, and the state. Kevin Campbell, presenting the budget overview, said the annual cost per resident is currently presented at a minimum of about $210,000 and described the state’s share patterns in several programs.

Key requests and program details presented to JFAC included: - Eastern Idaho Medical Residency (EIMR): Analyst materials showed EIMR requested $240,000 to fund four additional psychiatry residents, bringing psychiatry capacity in eastern Idaho to a four‑year psychiatry program that program directors said will take multiple classes to show retention results. EIMR currently reported about 56 residents across specialties; the program described strong applicant demand for family medicine and psychiatry slots. - Boise Internal Medicine: The Boise internal medicine residency asked for $60,000 ongoing to fund one additional internal‑medicine resident. The program has about 41 residents and spent prior appropriations fully to pay sponsoring hospitals; residents are employees of sponsoring institutions. - Family Medicine Residencies (FMR): The state supports several family‑medicine programs (Full Circle Health, Idaho State University programs, Kootenai Clinic and others). FMR-related budget slides showed recent appropriations for new residents and fellowships and a FY2026 request that included funding previously approved for new family medicine residencies in Nampa (six residents/fellowship partnerships) and additional positions in eastern Idaho.

Program directors emphasized two points: residents provide clinical care while training, increasing access immediately, and training more residents in Idaho raises the likelihood they will remain and practice in the state. Psychiatrist Matthew Larson told the committee his psychiatry training program in Idaho Falls already adds clinical capacity while residents train and that wait times for psychiatric care remain long; he said early cohorts of psychiatry residents will take time before retention data are available. Family‑medicine and internal‑medicine directors cited retention rates for residency graduates above 50 percent in programs with longer track records; Campbell noted an American Medical Association figure that 55 percent of graduates of Idaho residencies remain in Idaho.

Several lawmakers asked about how to evaluate the different interventions — residency slots, loan‑repayment programs and scholarship or residency‑expansion efforts — and whether they should be treated as complementary. Director Alex Adams and program directors described them as “yes‑and” solutions: residencies address in‑state training capacity while loan repayment and rural incentives attract clinicians to underserved communities. Elke Shaw Tullock, the division administrator, separately cited a 91 percent retention figure for the medical education loan‑repayment program (staff‑reported retention rate for that incentive) while noting residency retention for newer psychiatry cohorts will not be clear until the programs mature.

Officials also described how the state’s contribution typically operates: historically the sponsoring institution, health system and state each covered roughly one‑third of the annual cost. Directors noted the per‑resident cost has grown (Campbell and directors cited the current minimum of about $210,000 per resident per year) and suggested the legislature consider the state’s share per resident at a higher per‑slot level to sustain growth.

Committee members agreed residencies are a high‑priority strategy for increasing physician supply in Idaho and asked analysts for further cost detail on proposed new slots. No formal votes or motions were recorded at the hearing.