Family Medicine Residency of Idaho

Overview

Location: Boise, Idaho

Website: http://www.fmridaho.org

Residency Programs: Family Medicine

Additional Programs: Caldwell Rural Training Track, Magic Valley Rural Training Track, Sports Medicine Fellowship, HIV Primary Care Fellowship

Undergraduate and Pipeline Programs: Medical Student Clerkships and Sub-Internships

Description: The Family Medicine Residency of Idaho (FMRI) is both a family medicine residency program and a Federally Qualified Health Center Look-Alike. FMRI has the reputation for leading the way in development of innovative programs to train family medicine physicians committed to practice in rural communities or with underserved populations.  The Teaching Health Center designation additionally brings with it the ability to count as much as 50 percent of time spent teaching by National Health Service Corps members. Previously Corps members could only teach 20 percent time making it difficult to attract National Health Service Corps members to residency programs to help train the family medicine residents.  FMRI offers excellent clinical training to produce outstanding family physician leaders for communities in Idaho, the intermountain west, and across the Northwest.  FMRI is the largest service provider for uninsured and underinsured in Ada County.  FMRI is also the largest Medicaid provider in all of Idaho with 20,624 annual Medicaid visits.  This service level results in part from the strong collaborations with community partners, including the two local hospitals (Saint Alphonsus and St. Luke’s Regional Medical Centers), many physician sub-specialists, the Boise VA Medical Center, and the University of Washington School of Medicine, as well as many others. 

Program History

Started in 1975, Family Medicine Residency of Idaho (FMRI), a 501(c)3 non-profit institution, is a three-year family medicine residency program located in Boise, Ada County, Idaho.  FMRI was established for the specific purposes of training outstanding family physicians for our community, state, and region and to serve the underserved.  FMRI was fully accredited in 1975 by the Accreditation Council for Graduate Medical Education (ACGME).  FMRI is also a Federally Qualified Health Center Look-Alike (FQHC Look-Alike) which operates five family health centers in high need areas throughout Ada County Idaho.  FMRI is the largest service provider for uninsured and underinsured in Ada County and the largest Medicaid provider in all of Idaho.  The mission of FMRI is threefold: 1) to train outstanding family physicians in a federally qualified teaching health center; 2) to encourage these family physicians to work in Idaho's underserved and rural areas; and 3) to serve low income, uninsured, disabled and other vulnerable populations of Ada County in a patient centered medical home.

FMRI provides more than 46,000 patient encounters annually. FMRI believes that health care is a basic right and should be accessible to those who need it, regardless of their ability to pay.  FMRI further believes that individuals should participate in the cost of their care, as their means permit, and offers a sliding fee scale to income eligible patients.  FMRI registers and screens patients in a culturally appropriate manner to ensure that this process does not create a barrier to patients receiving care.  As a FQHC Look-Alike, FMRI consistently serves low income and other underserved and vulnerable populations. FMRI currently provides comprehensive care out of five locations throughout the service area.  The service sites are located in West Boise, East Boise, Meridian, and Garden City.  The agency has located its clinics to best serve the low-income target population who face multiple barriers accessing care.

In addition to the obvious unmet need presented by the federal poverty statistics, FMRI serves as the medical home for a large number of special populations including serving as the Ryan White HIV/Aids Program Part C funded clinic for entire state of Idaho and patients with cystic fibrosis.  In addition, Ada County is a refugee resettlement site. FMRI serves as the main screening clinic, seeing approximately 800 refugees in Ada County and 200 in Twin Falls every year.  FMRI provides the medical assessment for these new Americans coming into our country.  The majority of refuges coming into Boise at this time are from Iraq, Afghanistan, Congo, Burma, Bhutan, Somalia, and Uzbekistan. FMRI draws a patient population that speaks 47 languages.  In order to meet the needs of these special populations (e.g. Bosnians, Somalia’s, Sudanese, Vietnamese, etc.) many FMRI staff members are bi-lingual and bi-cultural.  In addition, FMRI serves a disproportionate number of Hispanic patients to the general population.  About 15 percent of FMRI patients are Hispanic while 6.8 percent of Ada County’s population is Hispanic.  All written materials in the clinics are offered in both English and Spanish.

FMRI offers a full spectrum of care.  This includes prenatal services, obstetrical, deliveries, primary and preventative care for all ages, chronic care management, health education, behavioral health care, enabling services, oral health care, lab, x-ray, surgical procedures, and other specialty needs both on-site and through referrals.  As a family medicine residency, the breadth of primary care expands well beyond the typical family medicine facility.  This is exemplified by the fact that many procedures are performed on-site, including laboratory, x-ray, ultrasound, colonoscopy, endoscopy, casting and colposcopy/LEEP, and minor procedures.  In addition to the breadth of services, FMRI also employs educators who specialize in obstetrical, gynecology, pediatrics, psychiatry, and a registered dietitian.  FMRI has established numerous community linkages including a large patient medication assistance program, social work services, case management, and refugee patient care.  In addition to the basic amenities of a patient centered medical home clinic, the facility houses a laboratory, x-ray, ultrasound, and designated rooms for colonoscopies, vasectomies, endoscopy, casting and colposcopy/LEEP, and minor procedures.

FMRI has an extremely talented faculty that consists of family medicine physicians, surgeons, pediatricians, obstetricians, social workers, physician assistants, a nurse practitioner, a nurse midwife, a psychologist, psychiatrists, a registered dietician, infectious disease physicians, sports medicine physicians, and a PharmD to create the team environment needed to train a family physician.  FMRI is also supported by three excellent training medical centers, a committed state legislature, and the backing of the Idaho Medical Association (IMA), the Idaho Hospital Association (IHA), the Idaho Academy of Family Physicians (IAFP), and the Ada County Medical Society (ACMS) to ensure superb family medicine education.

FMRI has been successful in developing a training model which encourages its graduates to not only remain in Idaho but practice in rural locations.  The Rural Training Track (RTT) model was pioneered in the Northwest in the early 1990's as a means of giving residents a broad, procedurally-based, hands-on experience in rural family medicine during residency.  In 2007, Idaho Governor Butch Otter requested that FMRI expand the RTT model to include other locations in Idaho in addition to the Caldwell RTT.  As a result, FMRI began an RTT program in Magic Valley (Twin Falls/Jerome, Idaho) and will have our first graduate from that program in 2012.