Medical Residency Gaps Threaten Washington’s Primary Care Pipeline
Lilly Hennessey, a final-year medical student at Washington State University’s Elson S. Floyd College of Medicine, argues that the state must aggressively expand residency offerings and training pathways to address a growing shortage of doctors. Hennessey, who grew up on Vashon Island, notes that her own childhood experience with asthma, which required her primary care doctor to open his clinic after hours, shaped her desire to practice medicine in Washington.
The stakes for rural and island communities are significant. Vashon-Maury Island is currently designated by the federal government as a primary care Health Professional Shortage Area (HPSA). According to Hennessey, all 39 counties in Washington state hold at least a partial HPSA designation. This widespread shortage forces many patients to wait months for appointments or rely on emergency departments for care that could have been managed in a primary care setting.
The Economic and Logistic Hurdles for New Physicians
While Hennessey highlights the arrival of a new Sea Mar clinic on Vashon as a positive development, she warns that the facility’s ability to provide services remains tethered to the broader difficulty of recruiting healthcare workers to the island. Current and former health care district commissioners have raised concerns that federal health care cuts, beginning this fall, may further strain the ability of local resources to sustain current levels of care.
For medical students, the path to practicing in Washington is currently obstructed by a lack of specific residency programs. Hennessey explains that while she intends to return to her home state, she is forced to leave for her residency because Washington does not offer a combined internal medicine-pediatrics program.
Hennessey notes that every Washington medical student who must leave for residency is someone the state has to work harder to bring home.
Research shows that physicians are more likely to practice near where they train. By failing to provide these programs, the state inadvertently exports its own medical talent.
Expanding the Training Infrastructure
To reverse this trend, Hennessey proposes a multi-pronged approach to state policy. She suggests that Washington should prioritize supporting medical schools that prioritize Washington students, increase rotations that expose students to strong community-based care, and connect those students with future practice opportunities.
Beyond training logistics, the financial barrier to entry for prospective doctors is rising. New federal loan limits are making the high cost of medical education even more prohibitive. Hennessey points to payment disparities in specialties like pediatrics as a structural issue that financially penalizes doctors who choose to care for children.
As Washington faces a long-term challenge in staffing its clinics, the focus remains on whether the state can build the necessary infrastructure to retain the physicians currently graduating from its own institutions. For patients in underserved communities across the state, the ability to access consistent, timely care depends on whether those training pathways are expanded.
