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Lt. Gov. Janice McGeachin cast a tie-breaking vote on Wednesday morning in the Idaho Senate to pass a bill that will require 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.

Under Senate rules, Idaho’s lieutenant governor acts as president of the Senate and can cast a vote in the event of a tie.

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. Idaho also has a for-profit, private osteopathic medical school in Meridian.

WWAMI students
An Idaho bill would require graduates of the state’s WWAMI program to practice in the state after completing medical school and residency, or pay back any tuition that was subsidized by public dollars. (Courtesy of the University of Idaho)

WWAMI 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 seats are reserved for Idaho students at the University of Utah.

The Idaho Legislature has also passed a resolution stating its intentions to fund  10 more seats for Idaho students in the WWAMI program beginning in 2025. 

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

Most physicians settle to practice in the place where they completed their residency after medical school. After medical school, students apply to “match” with residency programs, and may not be able to choose the location of their program. Idaho has very few residency seats — a fact that Rep. Mike Moyle, R-Star, acknowledged and said they are working on when he presented the bill to the House earlier this month.


Dr. Mary Barinaga, assistant dean for regional affairs and a graduate of the WWAMI program, said in a statement sent to the Idaho Capital Sun that the residency question is not a small factor.

“A big piece of this puzzle is adding residency spots, as well as more specialties, to Idaho. Graduating physicians must complete an additional residency of three to seven years to be able to practice, and these young adults may have a harder time coming back to Idaho if they do their residencies elsewhere,” Barinaga said.

The new bill would mean a graduate could have to pay back roughly $120,000 if they don’t match with an Idaho residency program, or if they don’t return to Idaho to practice after completing their post-graduate training elsewhere.

The Senate held the bill for one day after starting debate during Tuesday’s floor session, saying there were questions that needed time to be answered. Debate was fairly short on Wednesday.

Sen. Robert Blair, R-Kendrick, sponsored the bill on the Senate floor and said other states in the WWAMI program, including Alaska, Wyoming and Montana, have existing laws that are similar to House Bill 718.

During a House committee meeting on a bill earlier this month, Moyle said he doesn’t know how long those contracts have been in place in other states 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.”

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.

“It’s no secret that Idaho needs more doctors,” said University of Idaho WWAMI Director Jeff Seegmiller in a statement to the Idaho Capital Sun. “Idaho WWAMI exposes students to practicing in rural or underserved communities through all four years of medical school. With a required service payback, we hope to see those same students applying that experience to improve patient outcomes across the Gem State.”


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