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Residency Training Slots May Evaporate

Friday is the day medical school graduates find out where they’re going for residency programs — the training years between medical school and practice. It’s called Match Day.

In California, there are 140 residency training slots every year in the family practice specialty. That number may diminish, given the pending loss of four funding sources designed to encourage California medical students to join family-practice residencies, particularly in underserved areas of the state.

According to Del Morris, president of the California Academy of Family Physicians, California faces a pending loss of $50 million from the end of these four programs:

  • The Teaching Health Center graduate medical education grant program is set to expire this year;
  • The primary care residency expansion program also is ending. It awarded about $18 million in grants last year to create new resident positions in primary care residency programs in California;
  • A California Endowment grant supporting the Song-Brown workforce training program — providing $21 million over the past three years — ends in 2016; and
  • $4 million appropriated last year by the Legislature to add into the Song-Brown fund was a one-time infusion of funds.

Those programs helped fund residency slots and encouraged California medical school graduates to remain in the state for residency. Many people set up practices near their residency program, Morris said.

No one knows how many residency slots in California might be lost because of dried-up funding, but the Sierra Vista Family Medicine Residency Program in Fresno won’t be enrolling a class of residents this year because they can’t afford it, given that federal funding is expected to end.

According to Norma Forbes, executive director of Fresno Healthy Communities Access Partners, “it is estimated 66% (of California’s Teaching Health Center primary care residency programs) are unlikely to be able to support current residency positions in the future without continued federal funding.” That statistic came from a survey of 60 Teaching Health Center residency programs  reported by the American Association of Teaching Health Centers.

Even the status quo of 140 residency slots won’t nearly approach the need for primary care physicians in California, Morris said, especially in rural and urban underserved areas.

“That’s just not enough,” Morris said. “One-third of physicians in the state will retire by 2030, our population is growing and millions more Californians have gained coverage under health care reform.”

California can’t afford to lose more med students to other states, he said.

On the state level, Morris said his association is working with the Legislature on budget language that could appropriate an additional $8 million to put into the Song-Brown Fund.

On the national front, California Rep. Doug LaMalfa (R-Redding) is leading a bipartisan effort to fund the Teaching Health Center program.

“Californians’ health depends in part on a sufficient number of primary care physicians to treat them,” Morris said. “Our state must increase its family medicine training capacity.”

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