University of Iowa Hospitals and Clinics in Iowa City. (Photo courtesy of University of Iowa)
House lawmakers passed a measure 67-28 Wednesday to require at least 80% of students admitted to the University of Iowa’s medical and dentistry colleges to be Iowa residents or people enrolled at Iowa colleges.
In the 2024 academic year, an estimated 70% of students at the UI College of Medicine and College of Dentistry are Iowa residents, according to analysis from the Legislative Services Agency. Rep. Ann Meyer, R-Fort Dodge, said the measure requiring the Board of Regents adopt a policy requiring a higher percentage of Iowans to make up the student body at these colleges would lead to more people staying in the state to practice after completing their education and residency.
Data from the Association of American Medical Colleges found nationwide, 54.2% of medical practitioners who completed their residency from 2008 to 2017 are practicing in the state where they received residency training. The AAMC data found Iowa had a lower rate than the national average at 45.2% of residents choosing to practice in Iowa after their residency.
Meyer said more recent data found that between 2020 to 2024, 81% of Iowa residents who graduated from the UI medical school left for residency, and in 2024, only 44% of University of Iowa Hospitals and Clinics residents stayed in the state after completing the program.
“Unfortunately, University of Iowa’s retention of the physician workforce in Iowa is not providing the results for the entire state that we’d like to see,” Meyer said. “And this bill aims to make improvements while continuing the exceptional medical training received at University of Iowa Health Center.”
Democrats acknowledged that physician shortages and student retention were issues in Iowa, but said limiting out-of-state students from coming to Iowa for training was not the best way to address these problems. Rep. Adam Zabner, D-Iowa City, introduced an amendment to require that Iowa residents receive 80% athletic scholarships offered at state universities.
Zabner withdrew the amendment, but first argued recruiting talented individuals from places outside Iowa was needed to make Iowa’s college athletic teams competitive. He said the same logic should be applied to Iowa’s medical program. He said the restriction would limit Iowa medical school from being “at the top of its game.”
“I don’t think anybody in this chamber who is an Iowa fan, an Iowa State fan or a UNI fan, would vote to limit their ability to recruit outside talent,” Zabner said. “If you want to receive health care at the University of Iowa, you shouldn’t vote for this bill either.”
The bill was successfully amended to include several provisions from other bills, including language giving priority for some medical residencies and fellowships to Iowa residents and people who received a post-secondary education in Iowa. The final bill also includes language requiring that residents in high-need fields like family practice, internal medicine, OB-GYN and psychiatry are given the opportunity to participate in a rural rotation “in order to expose the resident or fellow to rural areas of the state.”
The bill would also require the UIHC program to offer interviews for medical residencies in high-need fields to people with Iowa connections.
Rep. Heather Matson, D-Ankeny, said while she is “sympathetic” to goals of the legislation in addressing Iowa’s physician workforce shortage, she said she “cannot support losing the tool of out-of-state tuition and welcoming more people and quite frankly, more future physicians, to become Iowans.”
She pointed to the LSA note that found the loss of out-of-state students, if the bill is signed into law, would mean a projected decrease of $5,672,300 in UI colleges’ tuition revenues.
Matson also said Iowa lawmakers should consider other factors that may be leading those who receive their medical education in Iowa to leave.
“Yes, Iowa has a real problem with recruiting and retaining doctors, and that should give us pause,” Matson said. “Why is it worse here than in our neighboring states? Let’s reflect on the decisions of this Legislature that limit the scope of practice for our OB-GYNs, demoralize our public health professionals and generally make Iowa a less welcoming place to live for some.”
Meyer said other states with more restrictive abortion laws than Iowa, like South Dakota, have more residents who plan to practice in the state than Iowa. She also said medical programs favoring in-state individuals is not an uncommon practice, pointing to Texas, Illinois and Florida as examples where some state school medical programs only accept or heavily favor applicants from within their state.
“House Republicans will continue to propose solutions to train, recruit and retain physicians in Iowa,” Meyer said. “This bill helps us grow our own. And I think it’s demeaning to all Iowans that those voting no on this bill don’t believe Iowa creates the bright students and can train them to be great doctors in our state.”
The bill now moves to the Senate for further consideration.
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