Residency directors urge continued state support as Idaho expands graduate medical education

Legislative analysts and program directors told the Joint Finance‑Appropriations Committee on Monday that continued state funding for graduate medical education is crucial to expanding the physician pipeline in Idaho, increasing the number of residency slots and helping retain clinicians in the state after training.

Kevin Campbell, a budget and policy analyst with the Legislative Services Office, said the state’s residency programs play a key role in producing clinicians who remain in Idaho. “The American Medical Association noted in 2022 that 55 percent of graduates of Idaho residencies and fellowships stay in Idaho,” Campbell said. He added that many programs consistently spend their appropriations in full to pay training costs and trustee payments to sponsoring hospitals.

Program directors described high demand and cited retention and service benefits. Doctor Matt Larson, psychiatry program director in Idaho Falls, said psychiatry positions are heavily oversubscribed and that residents provide daily clinical care while training. “It takes 3 and a half months to get into me,” Larson told the committee when describing access challenges for psychiatric care; he noted that residents add immediate clinical capacity while they train.

Key numbers and requests presented to the committee included:

- Eastern Idaho Medical Residency (EIMR): EIMR reported 56 residents and requested $240,000 to fund four additional psychiatric resident positions (the request represents the state portion of a three‑way funding model). The analyst said psychiatry positions receive outsize interest, citing about 95 applicants per psychiatric slot in some programs. - Boise Internal Medicine: the program has 41 residents and requested $60,000 ongoing for one additional internal medicine resident for FY2026. The state’s payment is part of a three‑way partnership with sponsoring institutions and health systems. - Family Medicine Residency programs (Full Circle Health, ISU family medicine, Kootenai Clinic and others): combined, family medicine programs reported about 130 residents. The family medicine group requested $420,000 ongoing for six new residents and one fellowship at St. Alphonsus Nampa (the request was described in presentation slides), and additional requests for residents in Eastern Idaho including $120,500 and two FTP for new ISU slots.

Analysts and directors explained the funding model that has supported expansion: historically the cost of training a resident has been covered roughly by a three‑way partnership among the sponsoring institution, clinical partners and the state. Presenters said the per‑resident cost has risen to about $210,000 per year; earlier state shares were about $60,000 per resident but program leaders said that figure has not kept pace with rising costs.

Program directors emphasized that residency training increases immediate clinical capacity. Doctor Mo Hagman, program director for Boise Internal Medicine, said a program’s residents are active in hospital and clinic care; he told the committee programs would likely reduce slots if state funding were removed. Ted Epperly, a family medicine physician, said the state’s “Idaho solution” — a three‑way funding model — has become a regional example and helped the state move from near the bottom of the nation in residents trained to a stronger position.

Committee members asked about evaluation and measuring success. Directors and analysts said different programs address different points of the workforce lifecycle — loans, residencies and graduate medical education — and that success metrics should reflect those distinct objectives (for example, retention rates, time to appointment, and the number of physicians practicing in shortage areas). Several speakers described retention for established programs above 50% and family‑medicine programs as high as about 65%.

Directors also identified ready‑to‑launch expansions contingent on funding: a child psychiatry program with a Utah partnership that would spend initial years in Salt Lake City and later years in Idaho, and a sports‑medicine fellowship identified as ready to start, subject to appropriation.

There were no votes recorded in the hearing. Committee members asked analysts for follow‑up materials and were advised to consult the Legislative Services Office for additional line‑by‑line cost detail and retention metrics.