Residency programs ask JFAC to sustain expansion; directors say trainees increase access now and boost long‑term retention

Legislative analysts and residency program directors told the Joint Finance‑Appropriations Committee that state financial support remains critical to expanding graduate medical education (GME) seats and to keeping more newly trained physicians practicing in Idaho.

Who spoke and why it matters. Kevin Campbell, analyst for the Legislative Services Office, and program leaders from Eastern Idaho Medical Residency, Boise Internal Medicine and family medicine residencies described requests for modest state dollars that fund portions of resident salaries and training costs in partnership with hospitals and sponsoring institutions. Committee members heard that residents both provide care during training and are more likely to remain in state when trained here.

Requests and program details. Analysts and program directors listed FY2026 funding requests and program‑level details:

- Eastern Idaho Medical Residency (EIMR): requested $240,000 to support four additional psychiatry residents, bringing psychiatry slots to a total of 12 in that program. - Boise Internal Medicine: requested $60,000 ongoing to add one internal medicine resident. - Family Medicine Residency (statewide consortium): requested $420,000 ongoing for six new residents and one fellowship tied to a new St. Alphonsus‑Nampa program; the family medicine portfolio also asked for $120,500 and 2 FTP for new family medicine residents in Eastern Idaho and described additional new seats planned in Nampa and other locations.

Analysts said Idaho’s model is commonly a three‑way partnership: the sponsoring institution (medical center or university), health‑system partners, and the state share residency costs; Campbell said the minimum per‑resident cost in 2026 was about $210,000 per year to cover salary, training, liability and attending‑physician supervision.

Retention and capacity. Campbell cited a 2022 American Medical Association finding that about 55 percent of graduates from Idaho residencies stay and practice in Idaho. Program directors emphasized that residents deliver care during training: Dr. Matthew Larson, psychiatry program director in Idaho Falls, said, “It takes 3 and a half months to get into me,” illustrating long waits for psychiatric care and the immediate service residents provide while training. Directors also described retention and pipeline gains from the state’s 10‑year expansion plan: programs have grown from about nine residencies with 134 residents to 16 programs with roughly 262 residents in training.

Geographic and specialty needs. Directors and legislators stressed rural and mental‑health shortages. Boise and Pocatello program leaders described substantial obstetric training in family medicine residencies: Brandon Mickelson said many family‑medicine graduates complete 150 to 250 deliveries—well above the national average—and that family physicians provide obstetrical care in many Idaho counties that lack OB‑GYNs.

Cost, partnership, and risks. Program leaders and analysts said loss of state funding would likely force a reduction in slots rather than program elimination, which would shrink the pipeline and reduce the number of residents providing care while they train. Directors said the state’s investment has yielded measurable growth in residency slots and improved the state’s position among neighboring states.

Next steps. The committee did not vote on appropriations at the session. Analysts and program directors asked JFAC members to sustain the multi‑year expansion through the planned 10‑year horizon, and to consider modest per‑resident increases to account for rising costs; staff said they would include the requests in budget deliberations.

Ending: Program directors asked legislators to complete funding that allows newly established programs to reach full capacity so the pipeline and retention effects can materialize over the coming years.