Residency is funded by Medicare (CMS) and that funding is subject to annual renewals by Congress. The total amount of spending was capped in the early 1990s.
However, in 2022, Congress agreed to fund 1000 additional residency slots, phasing them in over 5 years. ( 200/year starting in 2023.)
If you want more residency spots, write/phone/email your Congressional representative to let them know how you feel.
Medicare Graduate Medical Education Payments: An Overview
Yes, they can, but they must fund 100% of the cost of each residency position they create–that includes salary and benefits to the resident, direct and indirect instructional and program-specific cost, instructional materials (think sim labs for procedures) plus overhead. In 2020, the GAO found the cost of funding a single resident ran between $35,000-226,000/year.
State governments fund about 12% of all residency positions in the US. Some states do a better job of funding residencies than others…
In 2016, CA approved a one-time, $100 million budget allocation to support 78 residencies in family medicine, pediatrics, internal medicine, and obstetrics/gynecology for three years. The program is partially maintained ($2.5 million annually) by fees on hospitals, skilled nursing facilities and long-term care facilities. Another $40 million is supported annually by a permanent cigarette tax approved in a 2016
- Doctors funded by these residency funds are trained at sites in underserved areas, and are 40% more likely to choose to practice as a physician in health professional shortage areas (CA Grants 2022]
In 2017, TX approved a one-time, $53 million expansion in grant programs to sponsor over 160 medical residencies and their mentors.
- Overall, residents in this program are twice as likely to select family practice, and mentors are 40% more likely to teach family practice residents ([Nieman 2004]
In 2021, NM doubled the number of state supported primary care residencies, adding 42 new residency positions in underserved areas of the state.