Lawmakers question success of Nevada's Graduate Medical Education program


Lawmakers Monday said they need a lot more information to decide whether the state’s Graduate Medical Education program is working.
The program is in the governor’s recommended budget for $8.53 million over the biennium to try to expand in-state residency slots for graduates of Nevada’s two medical schools.
The program was created because the state doesn’t have enough residency slots for its medical students so many of them are forced to go out of state to do their residency. The problem is, a large percentage of medical students don’t come back to Nevada once they are certified as medical doctors.
“Doctors often have to leave the state to find a residency program,” said Brian Mitchel of the Office of Science, Innovation and Technology, which manages the program. “Physicians likely practice where they do their residency rather than where they go to medical school.”
Asked what percentage of the students funded by the state in residency programs in Nevada actually practice here, Mitchell said about half. He added that it takes three to four years to create a residency program and, since Graduate Medical Education began in 2015, some of the programs it funded are just now coming online.
Assembly Minority Leader Robin Titus, herself an M.D., said she wants data on how many graduates Nevada is producing, not just the number of doctors but nurses, physicians’ assistants and other medical professionals and how many of them stay in Nevada to practice.
Ways and Means Chairman Maggie Carlton of Las Vegas said lawmakers need that data to figure out whether the program is working.
“If only 50 percent are staying, let’s figure out why and address the issues,” she said.
Senate Finance Chairman Chris Brooks of Las Vegas agreed, saying lawmakers need the numbers to figure out how to keep Nevada health professionals here and address the state’s chronic shortage of doctors and other health professionals.
On a different budget, Carlton raised an issue seldom broached by lawmakers, indicating she believes the Governor’s Finance Office needs more professional staff.
The office currently has 21 analysts but Carlton said they are understaffed considering all the issues they have faced managing billions of federal stimulus dollars that have come to the state in the past year.
Under questioning, Deputy Finance Office Director Tiffany Greenameyer conceded that the office has struggled with the load, working a lot of overtime hours to get the job done.
Carlton told Brooks they should look at the resources needed to support the finance office.
“I don’t think the workload is going to get any lighter over the next two years,” she said.
Both lawmakers congratulated the finance office staff for managing to get the work done over the past year.
“This really shined a light on how lean our state government is,” said Brooks.

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