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The Senate Education Committee easily passed a bill requiring graduates of Idaho’s medical school to practice in the state for at least four years or pay back any tuition subsidized by public dollars, along with a resolution to add 10 more seats to the school’s enrollment capacity.

House Bill 718 outlines contract requirements for students who are accepted into the Washington, Wyoming, Alaska, Montana and Idaho Regional Medical Education Program, better known as WWAMI, at the University of Idaho or the University of Utah. WWAMI is Idaho’s only medical school that is partially funded by state dollars, and the medical school that 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.

The program costs about $80,000 per year at the University of Idaho, with state support covering roughly half of tuition.


Idaho Democratic senator worries about chilling effect

The bill’s sponsor, House Majority Leader Mike Moyle, R-Star, said he has heard from WWAMI students in the past whose future plans did not include practicing in Idaho, and the intention of the legislation is to provide incentive for students to give back to the state.

House Majority Leader Mike Moyle (R, Star) during a Ways & Means Committee hearing at the Idaho Capitol on April 6, 2021. (Otto Kitsinger for Idaho Capital Sun)

Moyle said he worked with the University of Idaho to develop the bill.

“I know it’s probably nothing they’re jumping up and down about and saying, ‘We love this bill,’ but they also know it’s a concern,” Moyle told the committee. “They also know it’s good for the state of Idaho.”

Students in the program would commit to entering active, full-time professional practice in Idaho within one year of obtaining a license to practice medicine or finishing a residency or fellowship. The reimbursement obligation would not be subject to interest and could be suspended or waived based on hardship or other specific circumstances related to military service. The obligation would apply to students who enroll in the WWAMI program at the University of Idaho or University of Utah in fall 2023 and beyond.

Idaho ranks near the bottom of states in the country for number of active primary care physicians, and 49th for active physicians overall. According to the Idaho Department of Health and Welfare, nearly every corner of Idaho, or 98%, has a shortage of primary care physicians.

Only Sen. David Nelson, D-Moscow, voted against sending the bill to the floor, but Sen. Janie Ward-Engelking, D-Boise, said she had reservations as well and might change her vote.

“I know we offer scholarships to many of our students to attend our public universities, and we don’t require that they stay in Idaho when they graduate,” Ward-Engelking said. “And I don’t believe we do this for pharmacy or dentistry or the veterinarian program, so it seems like we’re singling out one group and requiring them to do it. And I’m worried this might actually disincentivize them to come here.”

Nelson said he heard from many WWAMI students who were unaware of the proposal and thought it was unfair.

“If I had a child that wanted to be a doctor, I would be uncomfortable that in-state tuition came with a contract that they had to come back,” Nelson said. “And I guess I also think this could have a chilling effect on people applying.”

Other states in WWAMI have similar provision to proposed Idaho law

Montana, Wyoming and Alaska have a similar contract with medical students, but Moyle said he doesn’t know how long those contracts have been in place or if it has produced the desired results of more students staying in state to practice medicine.

“I do know one started it, then the next, and it snowballed through all of them,” Moyle said. “They must think it’s working, or they wouldn’t all be doing it.”

No other individuals testified about the idea at the committee meeting. The bill has already passed the House of Representatives and should receive a vote by the full Senate in the coming days of the session.


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