This commentary is by Melissa Volansky and John G. King. Melissa Volansky is a primary care family physician working for Lamoille Health Partners and serving as Maple Mountain Consortium’s designated institutional official. John G. King is Maple Mountain Family Medicine Residency program director and professor of family medicine at the University of Vermont’s Larner College of Medicine.
There is widespread debate about the future of health care, both in Vermont and at the federal level. However, one thing everyone agrees on is the importance of primary care. Primary care is essential for maintaining good health and serves as a trusted partner in times of serious illness.
The need for effective primary care is growing, but our workforce is shrinking. Between 2012 and 2022 primary care full-time equivalents in Vermont declined by 59.1, or 13%. In five of Vermont’s 14 counties, 45% of primary care physicians are over 60, and the primary care workforce shrank by 5% between 2020 and 2022. This alarming trend will continue unless we act.
To secure this critical workforce, a group of Vermont health care organizations and clinicians has developed a program aimed at growing and training primary care physicians who are more likely to stay in Vermont. The Maple Mountain Family Medicine Residency is an innovative partnership formed by six rural Federally Qualified Health Centers across the state. The program aims to train the next generation of primary care physicians in rural communities such as Randolph, Morrisville, St. Johnsbury, Hardwick, St. Albans, Rutland and Springfield.
The Residency has received financial support from a federal grant, the state of Vermont and its partners, and the University of Vermont Health Network to develop curriculum and recruit training sites and faculty. However, additional funding is needed to support the program’s launch until federal Teaching Health Center funding is available and residents are fully engaged in patient care.
Investing in this program is a wise decision. Nationally, 56% of family medicine residents who complete their training in rural areas stay in nearby communities. Based on records gathered by John King, the University of Vermont Health Network has seen similar results, with 92 of the 148 graduates from the Burlington and Plattsburgh programs over the last 20 years remaining in Vermont and the Adirondack regions.
Residents who train in rural communities form strong local ties — through relationships with colleagues, spouses’ careers, homeownership, community service, and having children enrolled in our schools — making them more likely to stay.
Vermont will also see a return on this investment. Primary care-based health systems deliver better population health, improved equity, higher quality of care and lower costs — all of which Vermont needs. Supporting this program will strengthen our hospitals, keep families healthy and ensure thriving communities for generations.
You may wonder: will this work? Yes, it can. The Teaching Health Center program has already been a success in other states. In the 2023-2024 academic year, 81 community-based programs trained over 1,000 residents annually, and they have graduated more than 2,000 new primary care physicians and dentists. It’s time to bring this program home to Vermont.
Vermont’s FQHCs provide comprehensive care, but they face challenges attracting physicians to rural areas. The Maple Mountain Family Medicine Residency will train physicians in these communities, allowing them to develop deep roots locally while providing essential primary care. Graduates will be experts in team-based care, maximizing resources and connecting patients to the right care at the right time.
With state support, Maple Mountain Family Medicine Residency can recruit its first residents in July 2026. We urge Vermont’s Legislature to make an investment in this program to ensure a strong, sustainable primary care workforce and better health outcomes for all Vermonters.
