Two years after Congress extended a funding source for training family physicians, Stanislaus County’s residency program is again facing a fiscal cliff.
The Valley Consortium for Medical Education in Modesto could lose millions in federal funding in October if legislation is not passed to continue the Teaching Health Centers program. The Valley consortium oversees a family practice residency that trains about 35 new physicians at Doctors Medical Center and the county health clinics. It graduates a dozen primary care doctors a year.
Supporters of the Teaching Health Centers program, a product of former President Barack Obama’s Affordable Care Act, say it’s been successful in encouraging medical school graduates to work in rural areas like the San Joaquin Valley, which suffers from a shortage of primary care doctors.
Dr. Kate Kearns, director of the Modesto program, said a third of the young doctors who complete the three-year training program remain in the Central Valley to practice medicine, and most of the other graduates stay in California. The local program is one of the half dozen Teaching Health Centers in the state and among the 57 centers across the country that receive the federal funding.
Without the supplemental funding, Kearns said, the Modesto consortium would have to shift to a smaller teaching program starting next year and would train fewer physicians. In 2017, when there was a stalemate in Congress over continued funding, a smaller cohort of nine first-year residents was enrolled in the local program, which usually has 12 in each class.
“They did extend it again for two years,” Kearns said, adding that it’s nerve-racking being on a two-year funding cycle.
Proposed bills in the Senate and House of Representatives would reauthorize the Teaching Health Centers for more than five years and increase the funding to upward of $151 million a year.
The American Academy of Family Physicians is lobbying for the legislation and says it would increase funding for training medical residents. In the past year, 728 residents were trained in family practice, internal medicine, pediatrics, geriatrics, obstetrics-gynecology and psychiatry at teaching health centers in 23 states and the District of Columbia.
The Stanislaus Family Medicine Residency trained physicians for 35 years until its future was threatened by an interpretation of federal law. That residency was replaced in 2010 by the Valley Family Medicine Residency, the first Training Health Center established and funded through the ACA in California.
The training grants for Valley Consortium grew from $625,000 in 2011 to $2.55 million in 2014. The consortium also has an orthopedic residency based at Doctors Medical Center.
The family medicine residency program also receives traditional medical education funding that goes through Doctors, Kearns said. The Teaching Health Centers funding has paid for expanding the number of residents and other costs. The teaching centers in California can apply for state grants that might help offset any loss of federal funding but those grants are competitive, Kearns noted.
A dozen first-year residents began the primary care training in Modesto last week.
Kelly Moruza, a resident starting her third year, said there’s reason to be concerned the funding isn’t authorized beyond Sept. 30.
“The population we serve is at higher risk for chronic health problems, so having more residents can help them,” said Moruza, who was working at the county’s Paradise Medical Office on Friday.
Moruza said the congressional stalemate in 2017 resulted in a smaller first-year class for herself and colleagues. There were fewer residents to share the workload.
Along with seeing patients in county health clinics, the residents are trained to care for adults and children at Doctors Medical Center. The residents can pursue training in special areas including inpatient care, group care, global care, maternity and sports medicine.
Working with faculty members, the doctors-in-training assist with low- and high-risk births, with most of the young physicians delivering more than 60 babies.