When it comes to graduate medical education resident slots, Montana ranks dead last.

Of Montana’s 56 counties, 54 are designated as areas with shortages in primary-care physicians.

What these facts mean for the Treasure State is that not only are Montanans underserved by general practitioners, but also doctors looking to bridge the physician gap are finding few opportunities to gain valuable residency experience in the state.

That was a problem the Flathead Valley, even with a thriving medical culture, faced along with the rest of the state.

When Dr. Ned Vasquez, a Missoula doctor, proposed shipping some of his residents in the Family Medicine Residency of Western Montana to Flathead County, Dr. Justin Buls wanted to be part of it.

“I was really excited about teaching,” he said. “I jumped in with both feet.”

Buls, now the Kalispell site director of the residency program, has worked with doctors and local hospitals to let three residents — Kevin Kropp of Columbia Falls, TJ Sherry of Frenchtown and Scot Swanson of Great Falls — learn on the job.

The three work primarily with Buls in the Community Health Center in Kalispell but also work shifts at Kalispell Regional Medical Center.

“We have clinic every afternoon where we take care of whatever comes our way,” Kropp said. “We will have around four to five scheduled appointments, but we make time for walk-ins. We can see kids for well-child checks, teens for birth control, adults for blood pressure. We see pregnant mothers and can do procedures in this clinic like circumcisions or vasectomies.” 

The residents, all Montana natives, said they wanted to give back to their home state. Buls, from Kalispell, was practicing medicine in a private practice in Columbia Falls for seven years when Vasquez come looking.

“In a small community like this, having residents keeps us cutting-edge,” Buls said. “We have to teach them the new ways of doing things. It’s been really wonderful. We are working with some really well-educated physicians.”

Residents, doctors fresh out of medical school looking to gain experience, have long been a staple in large urban hospitals. The Family Medicine Residency of Western Montana program allows 10 doctors, over the course of three years, to get residency experience.

All doctors spend a year in Missoula, then three are sent to Kalispell.

Kropp, Sherry and Swanson have been in the Flathead for a month. In July 2015, three more residents will join them. For now, the doctors appreciate the special attention they get.

“It’s kind of nice, not being in competition,” Kropp said. “We get plenty of time to spend with patients.  Like 40 minutes, which is longer than they’d see otherwise.”

Swanson agreed.

“Most patients don’t know the difference between a resident and a board-certified doctor, but they are happy to have two doctors come treat them,” he said. “It’s like a two-fer.”

The patients get treatment from obstetrics to child care to end-of-life care. Each resident has different interests and positions they fill.

Kropp is working at Kalispell Regional Healthcare’s Brendan House and Sherry in internal medicine. Swanson works some shifts in the emergency room.

Because the residency program is through the University of Montana and under the University of Washington’s umbrella of influence, most residents in Kalispell and Missoula are from the Pacific Northwest.

“We all want to work in Western Montana,” Sherry said. “And we are having a great time. I told my wife the other day I was going to be late because Dr. Buls was making me laugh too hard and I hadn’t done my paperwork. We’re so happy to be here.”

With doctors excited to heal like these, Montana is taking steps to close the general physician gap in rural areas that leaves it lagging far behind other states.

Reporter Ryan Murray may be reached at 758-4436 or by email at rmurray@dailyinterlake.com.