Medical residency program fills first 10 slots

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The Family Medicine Residency of Western Montana has filled all 10 of its positions.

The program starts in Missoula in July. Then three residents go to Kalispell training sites — Kalispell Regional Medical Center and Flathead Community Health Center — in 2014 and three more in 2015 for their second and third years of training.

Dr. Ned Vasquez, director of the program, told the Flathead City-County Board of Health on Thursday that about 100 medical students applied for the first year’s 10 spaces and 50 were interviewed. 

The first year starts with four women and six men, including one each from Kalispell, Great Falls, Livingston and Frenchtown. Four others have “strong connections” to the state.

He said the program did a great job of bringing students back to the state.

“We’re very pleased last week to find out that all 10 were filled in the first round,” Vasquez said.

He described the new residents as “a good core” of people who understand Montana and are likely to stay here and practice. Students came from a variety of medical schools including the University of Washington, the University of Vermont, Dartmouth and Brown.

According to Vasquez, planning for the Missoula/Kalispell residency program began in 2009 to address the projected national shortage of 150,000 physicians anticipated by 2025.

“A big chunk of that is family medicine,” he said. 

Aggravating factors in the shortage include population growth, the aging population, numbers of newly insured patients, more treatments for diseases, unhealthy lifestyles and chronic diseases. Montana faces an acute shortage: Almost all its counties have too few primary-care physicians.

“Almost a quarter of Montana physicians are 60 or older and they said in a survey they plan to retire in the next five years,” Vasquez said.

Vasquez said this program — a partnership involving the University of Montana and hospitals and community health centers in Kalispell and Missoula — was developed to provide a pipeline of family medicine physicians to fill these shortages.

“Physicians tend to reside where they do their training,” he said. “The Billings program has a great track record of keeping people in the state.”

 About 70 percent of the physicians who finish their residency in Billings practice somewhere in Montana. 

The bulk of the money to pay for the program comes through the Centers for Medicare and Medicaid Services. Vasquez said the money flows through the hospitals but they aren’t “skimming money off the top” and keeping it in the hospitals.

“It’s coming through to the program to fund the program,” he said. 

The three hospitals — Community Medical Center, Providence St. Patrick Hospital and Kalispell Regional Medical Center — agreed to accept fiscal liability and cover any deficits. Vasquez said the program expects to run a deficit in year one, approach or break even in year two and maintain that in year three with some potential for a surplus. 

Community health centers won’t have any financial liability for the residency training, nor will the Frontier Family Medicine Program. A joint effort involving Ronan, Superior and Plains, the Frontier Family Medicine Program was formed separately with a grant to create a family residency program for osteopathic physicians but has merged with this program.

“We’re bringing these two efforts together,” Vasquez said. “I think there’s lots of synergies there, especially for the rural communities.” 

He said that facilities such as Flathead Community Health Center make good training locations for residents because they have a wide variety of patients with acute problems and they have the needed clinical resources.

“By bringing more providers into that institution, it increases the number of patients that can be seen,” he said. “I’m talking about faculty and residents being the additional providers.” 

In both Kalispell and Missoula, he said, many people will function as “faculty affiliates” working with medical residents in hospital or office settings. 

“The challenge has been to move them from a student who was not taking on a lot of responsibility to a student who must take on a lot of responsibility to become trained,” he said. “That is our biggest challenge as we get going in July.”

Reporter Candace Chase may be reached at 758-4436 or by email at   

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