BOISE, ID – Idaho has for years ranked near or at the bottom of all states in the number of doctors per capita.

To solve this physician shortage issue, the state in 2017 crafted a 10-year roadmap for increasing the number of medical residencies in the state with the goal of increasing the number of doctors. But these efforts are now in jeopardy under the budget cuts approved by the state budget-writing committee last week.

“It’s frustrating,” said Dr. Ted Epperly, the Idaho State Board of Education Graduate Medical Education coordinator. “I recognize the legislators have a job to do with constitutionally balancing the budget, but there has to be a prioritization then of what becomes important for the state long-term, to solve major problems. And physician workforce is one of those problems.”

Potential budget cuts may cause the state to freeze a planned new obstetrics training program in Pocatello and compromise the ability to fulfill current obligations to Idaho’s existing physician residents.

The budget-writers of the Joint Finance-Appropriation Committee on Friday approved sweeping, across-the-board cuts to most state agencies, the Idaho Capital Sun reported. The cuts would amount to 1% of the budgets — a $131 million total reduction – for what is left of the 2026 fiscal year, and 2% – or a $143 million reduction – from fiscal year 2027.

The cuts are in addition to 3% cuts already made at the direction of the governor’s office over the summer.

The co-chairs of the budget committee have said the new cuts are necessary to make room to comply with the tax cuts President Donald Trump championed in the federal One Big Beautiful Bill Act.

The budget cuts will go before the full Legislature for consideration before being enacted.

Why is graduate medical education a focus in Idaho? 

Upon graduation from medical school, newly minted doctors must complete a residency, also called graduate medical education or GME. This supervised clinical education involves practicing as a real-world doctor.

Most of those doctors tend to stay in Idaho after they finish their program, Idaho Medical Association CEO Susie Keller said, and the Gem State ranks fourth in the nation for retention of physicians who train in the state.

The 2017 “Idaho Ten Year GME Strategic Plan” has been a success, Epperly and Keller told the Idaho Capital Sun in separate interviews.

The plan calls for the state to pay about a third of the cost to train a resident. However, costs for training have increased in recent years while the state’s share of the cost has remained fairly stagnant.

It now costs about $250,000 per resident per year for training, Keller said. The state chips in about $60,000 per resident per year, or around a quarter of the cost.

Idaho increased its physician residency and fellowship programs since 2017 by 250% and more than doubled the number of residents training in Idaho. However, the state’s population growth rate has outpaced that residency growth. This issue has been compounded by physician departures from the state and retirements.

Idaho’s physician workforce is older than the national average, Keller said.

“It’s kind of hard when we have this acknowledgement of, ‘we want to grow this,’ but then the state has to turn around and cut funding for those things that could help our workforce problem,” Keller said.

The Legislature last year created a Medical Education Working Group that met over the interim to look at ways to boost medical education, both graduate and undergraduate, with a goal of increasing the number of total physicians practicing in Idaho.

Working group co-Chairman Rep. Dustin Manwaring, R-Pocatello, said he has “serious concerns” about the proposed cuts to medical education.

“It’s going to be a lot of work this year, given the budget situation, but I’m going to try everything that I can to get my colleagues to preserve and not go backwards on medical education,” Manwaring told the Sun.

Planned Pocatello obstetrics fellowship may be on chopping block 

Women’s health is an acute shortage area in Idaho, with more than a third of the state’s obstetrician doctors having left since Idaho enacted its felony abortion ban, the Idaho Capital Sun previously reported.

To address this, lawmakers in a budget bill approved last year directed the GME committee to use funding to prioritize a new obstetric/gynecology fellowship for family medicine residents in the state.

Thus, a new fellowship in Pocatello for family medicine doctors to receive advanced obstetrics training — so they may perform surgical Caesarean-sections — was slated to go online July 1, 2027.

Epperly and fellow GME Committee members, Drs. Moe Hagman and Lisa Nelson, wrote to budget-writers in a Jan. 30 memo that additional cuts to their budget would halt the program.

Epperly told the Sun in an interview that the program would need a highly trained family medicine doctor, with training in obstetrics, to serve as director of the new fellowship for it to receive accreditation. Amid the proposed cuts, there wouldn’t be a director, Epperly said.

The state is more than halfway through its fiscal year, and the contracts for residents and for the faculty that teach them are already in place. There is almost no flexibility in the current budget to make additional cuts, Epperly said.

“Those positions are already obligated, and that’s why this becomes a real problem,” Epperly said. “Because the promises have been made, and it gets to be extremely frustrating to be cut to the bone and then be cut further.”

Some of the budget request was to continue to fund residencies that are already underway, as some programs last multiple years.

“The impacts of cuts like these would kind of stop that progress and momentum,” Keller said, “and would call into question if Idaho will sustain its obligations to those residents that are in the middle of their training, and what implications that may have for the future.”

This story first appeared on Idaho Capital Sun.