NWA hospital, med school to add residency slots for specialty care

The University of Arkansas for Medical Sciences Northwest Regional Campus and Washington Regional Medical Center will increase the size of their residency programs in order to train more doctors locally, including in specialty care.

What's happening: The Arkansas Legislative Council approved $12.5 million for startup costs, such as recruiting faculty. The federal government will pay for long-term costs, such as resident salaries, Nelson Peacock, Northwest Arkansas Council CEO and president, tells Axios.

Why it matters: A 2019 report by the Northwest Arkansas Council found that while the region has enough primary care or family practice doctors, the number of specialty care doctors is not keeping up with the growing population.

• All existing residencies in the area are for family practice or internal medicine.

State of play: There's no pipeline for specialty care doctors in NWA, Larry Shackelford, Washington Regional CEO and president, tells Axios. The only specialty residency slots in the state are in Little Rock, meaning hospitals must recruit all specialty doctors from Little Rock or out of state.

• Arkansas loses about 200 medical school graduates a year to out-of-state residencies and then has to try to recruit them back to work in Arkansas later, Shackelford says.
• Without more in-state residency slots, the situation will only get worse, as the new and growing medical school in Fort Smith and the planned Bentonville medical school graduate more doctors who need residencies before they can practice.
• Most doctors practice in the state where they completed their residencies.

Details: The 82 residency slots will include 24 in emergency medicine, 24 in internal medicine, 20 in general surgery, eight in neurology and six in family practice, Shackelford says.

• Ten residency slots, including eight in internal medicine and two in rural track family practice, will be added by 2023.

• Post-residency fellowship programs in cardiology, infectious disease, nephrology and pulmonary critical care will also be added by 2028. The hospital will have a total of four fellows the first year, eight the second year and ten the third year, as programs differ in length.

Context: Federal law caps federal funding for residency programs at however many slots they had in 1996. Any additional slots have to be paid for by the hospital, state or philanthropy. But new hospitals or new programs have five years to add slots until they're capped.

• Hospitals can also change their slot limit through "geographic wage classification," which is what Washington Regional did, Peacock says. Basically, hospitals are can be reclassified based on the size of the area they serve.

Go deeper: Read more about the recent push for more residency slots here and here.