Doctor shortage impacted by limited residency slots; Idaho ranks 49th per capita for doctors and residencies

Doctor shortage impacted by limited residency slots; Idaho ranks 49th per capita for doctors and residencies

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BLACKFOOT — A steady thrum fills the room, each beep mimicking a potential patient’s heartbeat. Medical residents gather around a medical manikin lying on a gurney in the middle of a classroom.

The residents check the patient’s vitals, symptoms and ask for a medical history, studying how to save the patient’s life in this scenario.

This mock setup helps prepare the young doctors for their future as internists in the hospitals where they’ll work.

Suddenly, the beeping escalates, signaling the patient is in distress.

The residents start to shout out directions to each other, mimicking what would happen in a real-life event.

“Pulse check.”

“No pulse.”

“OK, let’s do another shock set at 300.”

“Still charging, still charging.”

“Let’s clear everybody.”

As the beeping starts to become steady again, their teamwork saved the mock patient’s life.

In this practice scenario the “patient” was lucky. They were able to access skilled physicians who knew what to do and when to do it. Not all Idahoans are as fortunate.

Idaho ranks 49th in the U.S. for residents and doctors per capita, according to the Association of American Medical Colleges. This is problematic because where a doctor does their residency is a good indication of where they’ll stay and practice, said Kelli Christensen, assistant director of the Family Residency Program at Idaho State University.

Idaho, as a state, can be mostly categorized as rural, making access to physicians already difficult.

“Unfortunately, patients are having to travel to receive health care,” Christensen said. “Some patients don’t have the resources to be able to do that.”

Patients are experiencing longer wait times and traveling longer distances just to receive basic care because of the doctor shortage. The lack of access to doctors causes patients to live sicker and experience more complications from illnesses that could have been avoided if there were more doctors to go around.

“It’s mainly a problem of access for patients to the care they need in a prompt manner,” said William Woodhouse, family physician faculty with Idaho State University’s family medicine residency. “The problem is one of both numbers and distribution. There are some communities where access to a physician is very, very difficult.”

Christensen has experienced firsthand what it’s like to not have the care she needed close by. Growing up as a sick kid in rural California she had to travel five hours to get the specialist care she needed.

A large part of the problem for Idaho has been a lack of graduate medical education and a medical school.

The Idaho College of Osteopathic Medicine is slated to open this fall in Meridian to help remedy this problem, but there also needs to be an increase in residency slots.

Christensen said there are more medical students graduating nationwide each year than there are residency slots. This leaves potential doctors stuck waiting to start residencies when the need for doctors only grows.

Because of the low number of residencies, medical students scramble to try and find a residency slot. This happened to Bingham Memorial Hospital resident Amie Woody, and many of her classmates.

Woody originally wanted to go into a residency for anesthesia, but couldn’t find an opening. She quickly found a last-minute slot in her internal medicine residency at Bingham.

“I think it’s challenging in this day and age and it’s getting harder because a lot of it’s government controlled,” Woody said, referring to the residency accreditation process.

Other residents said it was increasingly difficult to get residencies in certain specialty fields such as neurology, dermatology and orthopedics.

Christensen said today’s medical students are encouraged to schedule far more interviews than when Christensen was a resident 11 years ago.

ISU’s family residency program gets about 800 applicants for seven residency slots. Shane Robinson, the outreach director at Bingham Memorial Hospital’s internal residency program, said it gets about 1,200 applicants for four slots.

Eastern Idaho Regional Medical Center received more than 800 applications for its 10 residency slots, said Coleen Niemann, director of marketing and community relations at the hospital. EIRMC will have 30 residents by 2020 for its new internal medicine residency program. The first batch of 10 residents will begin in late June.

Niemann said EIRMC was motivated to start its residency program to help recruit doctors to the state and with the creation of Idaho’s first medical school.

“We know (it’s) a lot easier to grow our own physicians than try to recruit people from other parts of the country,” Niemann said. “Our partnership with ICOM is a critical component of the residency program.”

The high demand is spurring state officials into action. Idaho created a 10-year graduate medical education plan in December. The plan targets the state’s doctor and residency shortage and aims to expand the residency programs from nine to 21.

Existing programs also are trying to expand the number of residency slots they offer.

ISU’s family program is creating an additional rural training track slot that should become available in 2019 and Dr. Shields Stutts, residency director at Bingham Memorial, said he wants to increase the program’s residents from 12 to 15.

Stutts said part of the obstacle with creating new residency slots is it takes a lot of resources. This is exacerbated in Idaho because there are fewer doctors in the state to help teach residents and run programs.

To start a residency program, institutions must get accredited with the Accreditation Council for Graduate Medical Education, a process that can take years. In addition, programs also must go through state licensing boards and resident programs are extremely costly.

But once programs get accredited they can start combating the shortage that is literally life or death. With an increase in residency slots, an increase of doctors in Idaho will soon follow.

Increasing the number of residents in the state will also increase care quality for patients.

“(Residencies) literally means more eyes, more hands on our patients and that’s a good thing for quality,” Niemann said. “When they’re more people as part of the care (it) elevates physician and nursing care across the board. You have new physicians who are asking questions of more experienced physicians, and that transfer of knowledge to a newer physicians (keeps) the more experienced physician on their toes about evidence-based practice.”

“I think it’s challenging in this day and age and it’s getting harder because a lot of it’s government controlled.” Amie Woody, Bingham Memorial Hospital resident, referring to the residency accreditation process

“I think it’s challenging in this day and age and it’s getting harder because a lot of it’s government controlled.”

Amie Woody, Bingham Memorial Hospital resident, referring to the residency accreditation process

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