Lawmakers hear requests to expand residency slots as state seeks more doctors

Legislative analysts and medical educators asked the Joint Finance Appropriations Committee on Thursday to approve modest FY2027 enhancements to graduate medical education that they say will expand Idaho’s physician workforce and reduce patient wait times.

Kevin Campbell of the Legislative Services Office presented the family medicine residency (FMR) budget and said FMR now encompasses 153 residents and 25.3 FTP. The FY2027 request for family medicine totals $480,000 and includes a family‑medicine obstetrics fellowship (Pocatello), one additional resident in Burley and six family‑medicine residents in Nampa; the governor recommended those requests.

Dr. Brandon Mickelson, program director at Idaho State University, told lawmakers that Idaho State’s family medicine residents are state employees and that ISU’s program was subject to the recent 3% holdback; other residency sites have different funding arrangements. "We are state employees ... and so ... we are very much ... subject to the 3%," Mickelson said, explaining why holdbacks affect some programs differently. Dr. Melissa "Moe" Hagman, representing other residency programs, emphasized the "three‑legged stool" of residency financing (federal funds, state support and patient‑care revenue) and said programs have adjusted to statewide budget constraints.

Committee members asked about clinical placement capacity, medicaid impacts and whether adding seats would create sufficient training sites. Mickelson responded that placing residents is less problematic than undergraduate medical‑school clinical placements and said family medicine residents already provide substantial care — last year the family medicine group saw more than 100,000 patients, including about 4,000 babies delivered — and that the program expects to maintain or grow resident numbers if enhancements are approved.

Campbell then described Eastern Idaho Medical Residency (EIMR) and a University of Utah psychiatry collaboration; the University of Utah program requested three child‑psychiatry resident slots (total $180,000). Dr. Jesse Hinckley and Dr. Beth Botts said training psychiatry residents in Idaho improves regional retention: approximately 58–60% of residents remain in the region where they train. Botts said the addition of outpatient psychiatry residents in Pocatello has dramatically shortened wait times — "we're able to get people in within a month, and that was unheard of before" — and that new child‑psychiatry training spots will further increase access.

No formal votes were taken; committee members asked for follow‑up information on funding mixes, rainy‑day balances, medicaid exposure and how private partnerships (hospitals and systems) might supplement state support. Presenters said some residency sponsors are hospital systems (for example, Eastern Idaho Regional Medical Center, part of HCA) and that private backing and clinical revenue are an important part of the financing model for many programs.