Idaho medical school director to budget committee: Residencies still a challenge for students

The director of the University of Idaho’s medical school program told members of the Idaho Legislature’s budget-setting committee Friday that it continues to struggle with too few in-state residency options for graduating students, contributing to Idaho’s longtime problem of having the lowest number of physicians per 100,000 people.

The Washington, Wyoming, Alaska, Montana and Idaho Regional Medical Education Program, better known as WWAMI, is Idaho’s only medical school that is partially funded by state dollars. The medical school produces the most rural physicians for the state, with incentives available for those who decide to practice in a rural area of Idaho.

The program is part of the University of Washington’s School of Medicine, but every applicant who joins the Idaho branch is an Idaho resident. The school admits about 40 students per year, some of which are reserved for Idaho students at the University of Utah. Tuition costs about $80,000 per year, with state support covering roughly half of that amount.

A March 2022 report from the Association of American Medical Colleges showed Idaho has the fewest active physicians in the entire country, ranking 50th with 196 physicians per 100,000 people. Massachusetts ranks highest with 466 physicians per 100,000, and West Virginia, which has nearly the same population as Idaho as of 2021, has 274 physicians per 100,000 people.

Idaho WWAMI Regional Dean and Director Jeff Seegmiller told legislators as of today, the program has trained 800 physicians in Idaho and 51% have returned from clinical studies to practice in Idaho, which is above the national average of 40%. Seegmiller expects that percentage to increase after the Legislature passed a bill in 2022 requiring repayment of tuition for students who decline to return to practice in Idaho.

Along with funding for the tuition subsidies, the Idaho Legislature can choose to fund more seats for students within the program. The Legislature passed a resolution in the 2022 session stating it would fund 10 more seats for WWAMI students beginning in 2025.  

“The challenge is that we have … a physician shortage throughout Idaho, and it’s exacerbated within the rural parts of our state,” Seegmiller said. “To add on top of that, our workforce is aging much faster than other states.”

Seegmiller said the program is doing its best to match students with Idaho residencies after they graduate but said there is a shortage of residency spots in the state that makes it likely that a student will have no choice but to find a residency out of state.

“We lack residencies in surgery, in pediatrics, in (obstetrics and gynecology), emergency medicine. Those are just a few of the residencies that our state should have so our students can decide to stay in Idaho,” Seegmiller said.

Senator questions Seattle-based electives for abortion care, race considerations in medicine

Echoing an article published by the Idaho Freedom Foundation on Thursday, Sen. Scott Herndon, R-Sagle, asked Seegmiller about two elective courses offered for fourth-year medical students in western Washington at the University of Washington School of Medicine. One elective is for gynecology specialties about first trimester abortion care.

“Since that is now a felony in the state of Idaho, do we know the Idaho student participation rate in that program?” Herndon asked.

Idaho has a near-total ban on abortions at any stage of pregnancy, but it does include affirmative defenses for instances of rape and incest with an accompanying police report and situations when an abortion is necessary to save the pregnant person’s life.

Seegmiller said Idaho students in the program are enrolled with the University of Idaho for the first 18 months, and during the remaining portion of the four years, they are enrolled only at the University of Washington for clinical study.

“Students are not required to take elective courses,” Seegmiller said. “Even if they’re required to take the elective courses, they have the ability to opt out of any training. We are 100% compliant with the law in the state of Idaho.”

Herndon also asked about an elective called Critical Race Theory and Medicine, which covers the topic of race and racism and its applicability to medicine and effects on marginalized communities, according to the course description. The course aims to eliminate bias and decrease health disparities as a practicing physician.

Herndon asked if there was a possibility that students were taking the course using Idaho taxpayer dollars since the tuition for the school is subsidized by public funds. Seegmiller said he wasn’t sure and would look into an answer to that question.

“We don’t track what students take outside of state-required curriculum … but we do track the training that does occur in the state of Idaho, and we are making sure that is compliant with state law,” Seegmiller said.

The budget committee will continue to hear from publicly funded agencies across the state until late February, when budget setting is scheduled to begin.