When Dr. Melissa Volansky thinks about her colleagues retiring, she gets the sense that no one is coming to take their place.
She works at Lamoille Health Partners in Morrisville, a community health center across the street from Copley Hospital. There’s a view of the mountains outside the front door. Inside, there’s a big rainforest mural in the hallway leading to pediatric exam rooms.
Volansky said it's a great place to work — she's been a family medicine doctor there for 25 years. But recruiting new clinicians is not always easy.
“I’ve been left at the altar a few times by potential candidates,” she said. “Housing has been a problem. I think also opportunity, child care, schools, all of that kind of stuff. It’s also just a question of people getting comfortable where they train.”
Right now, the only place in Vermont where family medicine doctors can do their training after medical school is at the University of Vermont Medical Center. They graduate six residents a year, and they can’t take any more.
Volansky has been working to change that. That’s because wherever doctors do their residency training, they’re more likely to stay and practice for their careers, especially in rural areas. Most family medicine residents stay in the same state after they graduate.
A few years ago, she and other health care workers got about $500,000 from the federal government to develop another family medicine residency program in Vermont, based at health centers in smaller communities. Last month, they officially got academic accreditation for a three-year program to train residents at the clinic and hospital in Morrisville and at Gifford Medical Center in Randolph.
When the program has a full cohort of 12 residents, it will get $1.9 million a year from a federal grant, along with revenue residents generate from seeing patients — an estimated 8,000 clinic visits a year. But for the first few years, they need financial help.
“It's going to take some investment on the part of the state to get it started,” Volansky said.
Right now, the program is short about $4 million over the next four years. And community health centers and hospitals where residents would be based have little to no wiggle room in their budgets to cover the costs.
"We would very much like to run this program, but the money matters," said Michael Costa, the CEO of Gifford Medical Center, who would also head the new residency program. "You can't lose millions of dollars and then take this on."
Volansky and Costa recently testified to lawmakers asking for an appropriation. They'll find out if they received the funding when the state budget is finalized.
If we don't invest in this now, then what's going to happen in five to 10 years for these organizations that then don't have doctors?Nicole Marcheterre, program administrator for Maple Mountain Consortium
“This is really something to invest in," said Nicole Marcheterre, the program administrator. "Because if we don't invest in this now, then what's going to happen in five to 10 years for these organizations that then don't have doctors and can't actually provide services to their patients?”
If the program does get state funding, residents would arrive next summer, in July of 2026.
Then, the long term plan is to expand the program to other parts of the state, at health centers paired with nearby hospitals in St. Johnsbury, Rutland, Springfield, St. Albans and surrounding communities.
"We'll prove the concept," Volansky said. "Then I think everybody will want one."
