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On June 4, the Missoulian included an opinion piece discussing two University of Montana health initiatives, those being the pre-med program and the Family Medicine Residency of Western Montana (FMRWM). This piece will provide additional information on the latter program, as we have been involved in FMRWM since its inception. 

FMRWM was born out of the immense need in our state for primary care physicians in rural and underserved areas. At the time of the matriculation of the first residents in 2013, Montana had only one residency program, which was located in Billings, placing Montana dead last in the U.S. for residency slots per capita.

FMRWM has grown since 2013 to include 30 residents, 17 core faculty, seven administrative staff and well over 200 community faculty, including physicians in 10 rural communities in which residents regularly rotate as part of their experience. Each of the residents and faculty have active clinical practices and those in Missoula have provided over 18,000 patient visits over the past year.

We will graduate our fourth class on June 30 and expect that we will continue to retain more than 75% of our graduates in Montana, as well as greater than 75% in rural and underserved practice settings. As of the fall of 2019, FMRWM graduates will be practicing in Browning, Hamilton, Helena, Kalispell, Lewistown, Libby, Missoula, Polson, Red Lodge, Ronan and in rural communities in California, Idaho, Oregon and Washington. Graduates in these communities are providing outpatient care, in-hospital care, delivering babies and working in emergency departments.

In addition to community health benefits, the infusion of family physicians into Montana communities provides a major economic boost. Established economic analysis indicates that the addition of one new family medicine physician in a rural community produces an annual fiscal benefit of $2.1 million, generated through outpatient practice, hospital admissions and overall community affects. Patients also benefit financially, with savings created from shorter travel distances and more timely access to medical care, especially in an emergency.

As with most successful endeavors, timing and team work are crucial. We are indebted to the University of Washington Family Medicine Residency Network for all of the support they have provided. We gratefully acknowledge the vision of then UM President George Dennison in supporting FMRWM in its earliest phases. We appreciate having an academic home in the UM College of Health Professions and Biomedical Sciences, providing FMRWM with partners in patient care and research.

Our residency program would not exist without the financial acumen of Larry White, the then recently retired president of St. Patrick Hospital, and Barry Kenfield, the former COO/CFO at Missoula Community Medical Center. FMRWM has provided a unique platform for singular cooperation between Providence St. Patrick Hospital, Missoula Community Medical Center and Kalispell Regional Medical Center, without whose support resideny education would not be occurring in western Montana. Finally, Partnership Health Center in Missoula and Flathead Community Health Center in Kalispell have played essential roles as homes for the residency's continuity clinics, where residents and faculty assist in caring for some of the most underserved patients in our communities.

As to the future, we hope that new, innovative models will be created to fund residency programs and train residents, enhancing the ability of rural states like Montana to increase their capacity to train physicians and place them in all of the rural and underserved communities in our state.

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Ned Vasquez, MD, is the Family Medicine Residency of Western Montana program director (retiring June 30). David Forbes, Ph.D., is dean emeritus of the College of Health Professions and Biomedical Sciences at the University of Montana. 

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