CHEYENNE - The family practice residency programs in Casper and Cheyenne are losing $1 million a year and do not offer high enough stipends to attract top quality applicants, officials said Wednesday.

University of Wyoming President Philip Dubois told the Joint Appropriations Committee the two centers are now recruiting primarily international students.

Dubois is asking the Legislature for slightly more than $2 million in "bridge funding" for the Casper center; which lost money when Congress changed the rules on federal payments for medical education.

The university also is asking for $413,000 for the Cheyenne residency program, and $95,000 to increase to 12 per year the number of Wyoming slots at the University of Washington medical school. This program, called WWAMI, offers medical school education to students from Washington, Wyoming, Alaska, Montana and Idaho.

Dubois said the Casper and Cheyenne centers have been "flat underfunded."

Forty percent of the patients at the two centers either have no insurance or are underinsured, he said.

Although the purpose of the residency program is to train physicians in hopes they will stay and practice in Wyoming, only 40 to 45 percent of them do so, Dubois said.

"You might decide to spend money on physician recruitment instead of medical education," he said.

He added that he believes the university trustees are growing uneasy over the costs of the two centers and dislike siphoning money from other university programs to keep the centers going.

"We were bleeding money out of Casper and Cheyenne for a long time and we still are," he added.

A committee member and retired public health physician, Rep. Larry Meuli, R-Cheyenne, said it is difficult to match the Wyoming family practice residency program with graduating medical students.

The Cheyenne program last year didn't match any, which meant the centers had to turn to the pool of students who didn't get a match to recruit residents.

"Right now, we're on the road to eliminating the family practice residency centers unless we give them more money," Meuli said.

Another committee member, Rep. Pete Jorgensen, D-Jackson, said if the purpose of the two centers is to treat indigents, then they should be transferred to the Department of Health.

But Dubois said people must keep in mind that the two centers are part of the healthcare systems in Casper and Cheyenne.

Dr. James Broomfield, director of the Cheyenne residency program, said both the Cheyenne and Casper programs have had financial problems for years as a result of decisions made early on that limited available sources of money.

"As a result we're not able to offer as competitive a salary to our residents as other places," Broomfield said Wednesday in a telephone interview.

For 2004-05, the Cheyenne center is paying first-year residents $38,496 and third-year residents $41,496, according to the center's Web site.

For the same period, the Casper center is paying first-year residents $37,344 and third-year residents $41,616, according to the Casper center's Web site.

In addition to the size of the residents' stipend, the applicants are interviewed during some of the coldest, windiest wintery months in Wyoming, Broomfield said.

As a result the centers don't get what is considered to be a top applicant, meaning a U.S. born, U.S. medical school graduate, he said.

The two programs haven't completely filled their roster through the match in several years so they go through the "scramble" for the residents left in the pool of applicants.

Many residents consequently are not from the intermountain West and tend to go back to where their families live when they complete the program.

He said his wife had a baby five weeks ago delivered by one of the Cheyenne program residents who was born in Russia and trained in the Caribbean.

Both programs, he said, have quality residents who will become great physicians when they finish their specialty training.

All the program residents are U.S. citizens and a couple are from Utah who received their medical training overseas, he said.

"The biggest issue is we're not able to meet our mandate to put physicians in the state of Wyoming based on the cards we've been dealt at this point," Broomfield said.

The Cheyenne program recruits six residents a year, while the Casper program recruits eight.

Last year the Cheyenne program's budget was $2.6 million while income was a little over $1 million.

"We ended doing up $500,000 in charity care," he said.

If that charity care had been paid for, however, the program still would be short.

No medical education program in the country, he said, makes money and all the programs are subsidized.

The Cheyenne program sees 10,000 to 12,000 patients per year.

Dr. Karen Wildman, director of the Casper program, was busy seeing patients Wednesday afternoon and could not be reached for comment.

Capital bureau reporter Joan Barron can be reached at (307) 632-1244 or joan.barron@casperstartribune.net.