Similarly to emergency physician workforce issues on a national level, Wyoming faces a complicated problem with a multitude of contributing factors. Job markets historically ebb and flow and eventually adjust, but that long-term outlook doesn’t help freshly minted emergency physicians who need to find jobs now to avoid serious monetary penalties.  

Altering the contractual obligations for Wyoming participants in the WWAMI program would require a legislative change, and state legislators are hesitant to fix something that is still working for the other specialties within the state. WWAMI’s return rate of 63 percent is “amazing,” said Sheila Bush, who has served as executive director of the Wyoming Medical Society for 16 years. “There has to be a balance so you don’t undermine WWAMI,” she explained. 

Senator John Barrasso, MD, worked 24 years as an orthopedic surgeon and once served as President of the Wyoming Medical Society. “Wyoming’s collaboration with Washington, Alaska, Montana, and Idaho delivers an innovative and state-based solution for medical education,” Sen. Barrasso said. “We need to keep WWAMI strong and able to educate the next generation of physicians, many of which come from rural communities.”

Sen. Barraso and Dr. Wright Becker

Sen. Barrasso believes the situation in Wyoming is indicative of a broader issue. “The challenges facing emergency medicine residents are part of a much larger problem with Graduate Medical Education (GME). Our federal GME funding structure is broken and does not reflect the health care workforce we need in the 21st century. Specifically, GME concentrates funding in large academic medical centers located on the east coast,” he said. “Senators from rural states, especially in the west, agree changes must be made. I’m personally committed to working with both sides of the aisle on GME reform. Fixing GME is essential to close health care disparities in rural America.”

There are no legislative proposals on the table as of this writing, but potential solutions are being discussed: Should the time for return to Wyoming be extended past one year so that physicians have more time to find work within the state without incurring such harsh financial penalties from their WWAMI contracts? Should the law be tweaked to specify that those WWAMI medical students who plan to return to work in Wyoming must pick a certain specialty with more guaranteed employment? Should Wyoming hospitals and health care facilities be incentivized to hire WWAMI graduates? Can the interest rate be reduced or eliminated?