Proposal Would Expand Physician Residencies, Senator Says

Arkansas leaders and health care experts today addressed the shortage of physician residency positions in the state and how legislation proposed by U.S. Sen. John Boozman can help.

The Resident Physician Shortage Reduction Act would provide new opportunities for medical school graduates to complete residency training, something they must do before practicing medicine. A 1997 cap on Medicare support for Graduate Medical Education (GME) has stymied increases in residency training, creating a blockage in the physician workforce pipeline.

Dr. Mikaila Calcagni, a resident physician in Northwest Arkansas, talked today during a roundtable discussion about her desire to stay in the region to practice medicine.

Dr. Mikaila Calcagni, a resident physician in Northwest Arkansas, talked today during a roundtable discussion about her desire to stay in the region to practice medicine.

The GME Summit, co-sponsored by the University of Arkansas for Medical Sciences (UAMS) and Northwest Arkansas Council and held in Springdale, enabled policy makers and health care, education, community and business stakeholders to start a statewide dialogue focused on solutions to the residency shortage in Arkansas.

“The number of available physicians per population in the Natural State is among the lowest in the nation and providers of all specialties are facing a serious shortfall, especially in Arkansas’s rural communities,” Boozman said. “This isn’t just a problem we are facing in Arkansas. There is a physician shortage in hospitals across the nation, and every state is struggling to fill the void. The bill Senator Bob Menendez and I introduced will lift the antiquated cap on Medicare-supported doctor training slots, creating 15,000 residency-training slots across the country over a five-year period. It is a small step, but one that will go a long way to addressing this dire need in Arkansas and at the national level.”

UAMS Chancellor Cam Patterson said a nationwide physician shortage remains significant.

“The latest data indicates a shortfall of up to 122,000 physicians by 2032, including significant shortages in both primary care and specialty categories,” Patterson said. “If action is not taken, Arkansas will soon have more medical school graduates than residency positions, forcing graduates to pursue residency training outside of the state.”

He said that adding residency positions would improve the chances for physicians to stay in Arkansas after completing residency because data shows physicians are more likely to practice within 50 miles of their final residency training location.

The Northwest Arkansas Council worked with UAMS, the University of Arkansas, Northwest Arkansas medical systems and a medical research firm throughout 2018 to fully understand the region’s health care needs. The research showed more physician residency positions was among the top needs. The Council made the full report available on its website when it was made public in January 2019.

“Northwest Arkansas loses nearly $1 billion each year in economic impact due to the outmigration of health care services,” said Nelson Peacock, president and CEO of the Northwest Arkansas Council. “To reverse that trend, regional health care leaders developed a comprehensive plan to increase Graduate Medical Education, expand interdisciplinary research and establish a four-year medical school. In fast-growing regions such as Northwest Arkansas, federal funding restrictions prevent the health care sector from keeping pace with demand. 

“Regional leaders are working collaboratively to address these challenges, and changes to federal policy that expand GME, such as those proposed by Senator Boozman, are critical. Increasing GME would allow us to train more doctors here and give us a better chance of retaining them in the long term.”

Dr. Christopher Westfall, dean of the UAMS College of Medicine, told attendees it will take multiple strategies to address the shortage. 

Len Marquez, senior director of governmental relations for the Association of American Medical Colleges, gave an overview of the nation’s GME policy and how it impacts the number of doctors who can practice medicine in the U.S. Marquez emphasized the importance of federal funding support, which would increase if Boozman’s bill gains legislative approval.

Those who joined today’s roundtable discussion included  Arkansas State Sen. Missy Irvin; Dr. Drake Rippelmeyer, a physician at the Veterans Health Care System of the Ozarks and faculty member in the Internal Medicine Residency Program, UAMS Northwest Regional Campus; Marquez; Pearl McElfish, vice chancellor for the UAMS Northwest Regional Campus; Lashannon Spencer, CEO of Community Health Centers of Arkansas; Dr. Mikaila Calcagni, a resident physician in Northwest Arkansas; and Peacock.

Pictured at the top: Len Marquez and Pearl McElfish listen as Lashannon Spencer, the CEO of Community Health Centers of Arkansas, talks about Dr. Mikaila Calcagni, a Bentonville High School, University of Arkansas and UAMS graduate and resident physician who wants to stay in Northwest Arkansas throughout her career.