How Wyoming Is Bringing Doctors Back Home — And Keeping Them

A 30-year program is keeping Wyoming doctors in the Cowboy State, retaining up to 80% of its graduates. For a state that consistently ranks among the lowest in the nation for physicians per capita, that is a huge step forward. Mason Stillman, a high school student from Gillette who never doubted he wanted to become a physician, is now back in his hometown practicing psychiatry at Campbell County Health. He credits the Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) program with keeping him in Wyoming.

WWAMI is a five-state medical education partnership that has become a key pipeline for the state. About two-thirds of graduates return to Wyoming after residency, and roughly 80% of those stay long-term. In Wyoming, graduates agree to practice for at least three continuous years in exchange for repayment of about 75% of their tuition. Stillman remembers being on the fence about where he would practice. Part of him hoped to stay home, close to family and friends, but another part had a strong urge to explore the wider world. WWAMI ultimately allowed him to do both. He got to explore other places during medical school in Washington and other WWAMI states, then returned home for a practice where he knows he is doing vitally important work.

WWAMI will turn 30 next year, said Clinical Dean Robert Monger. It began because of the special difficulties rural Western states face when recruiting doctors. “Wyoming is such a small, rural state, we’re really not big enough to have our own medical school,” Monger said. The problem was that students sent to other medical schools often ended up staying there. WWAMI structures training to maximize exposure to Wyoming while still providing a top-tier education. Students spend 18 months doing foundational coursework at the University of Wyoming in Laramie, then train in Washington, but return to Wyoming for hospital and clinical rotations. A nonprofit recruiting firm, the Wyoming Health Resources Network, stays in touch with students throughout medical school and residency.

“You have to be a Wyoming resident to get into WWAMI,” Monger said. Admissions committees place heavy emphasis on how likely a candidate is to practice in Wyoming long-term. Interviews are conducted by Wyoming doctors who ask where applicants see themselves in a decade, what communities they prefer, and what kind of medicine they want to practice. “If they say, ‘I grew up in Sheridan, I’m fourth generation, and I can’t wait to go back there and practice,’ that’s a good answer for WWAMI,” Monger said. The track record has been good. There are 123 WWAMI graduates practicing medicine statewide.

The impact is huge for communities like Gillette. Stillman counted about 10 WWAMI-trained physicians in Gillette, including the pediatrician who treats his children. As a WWAMI alumnus, Stillman has joined the alumni network of doctors training new students moving through the same pipeline. Hospitals are eager to recruit WWAMI graduates because they already have roots in Wyoming. By contrast, doctors recruited from distant states may sign up after a sunny summer visit, only to rethink after a couple of High Plains winters. “A winter or two goes by, and they want to move back to Georgia,” Monger said.

Despite WWAMI’s progress, Wyoming still faces serious shortfalls, particularly in specialty care. Several communities, including Rawlins, Evanston, Wheatland, and Kemmerer, have lost obstetric services within the last five years, creating OB deserts. Behavioral health needs are also climbing. Monger said WWAMI is part of the answer, but “we need more than that.” He would like to see new residencies for specific shortage areas, such as psychiatry, internal medicine, or surgery. For Stillman, the program has been vital to his own path back to Wyoming, and he believes he will likely stay well beyond his commitment. “That’s the whole point of the WWAMI program, I think,” he said. “It’s great being able to get this training which I otherwise wouldn’t have had access to, and then being able to come back to the community that I grew up in, that raised me. I can at least be a part of helping.”