Dear Editor, I truly appreciated Olivia Gieger’s recent article in VTDigger on the question of who pays for training Vermont’s doctors. It is a much-needed glimpse into a critical and sorely undercovered subject. The memo — a Green Mountain Care Board filing on what it costs the Univers ity of Vermont Medical Center to train doctors — answers how much. It never asks how much per doctor, and these figures give it. Vermont spends $161 million per year training 320 residents and fellows at any given time. With a typical three-year program, about a third finish each year, and nearly half of those stay on, roughly 50 physicians retained annually. That works out to at least $3 million for every physician Vermont keeps, and longer programs push the number even higher: Surgery runs five years, not three. Three million dollars would bring almost anyone here. It would then be our job to give them a reason to stay. Vermont already knows how, and a hospital has published it. In its fiscal year 2026 budget narrative to the care board, Southwestern Vermont Medical Center lists 11 investments in nursing and concludes, “The areas of investment listed above enable SVMC to avoid nurse travelers.” In the same filing: “SVMC uses locum primary care physicians … when no other reasonable option exists.” Same building, same town, same labor market. Opposite results, and the mechanism for the good one is already written down. Nobody has asked whether it transfers. SVMC’s residency takes its first cohort in 2029, six a year, three years. The first physician finishes in 2032. At the retention rate reported here, about three stay annually thereafter. It’s a sound long-term instrument, but not an answer to a shortage we are living through now. READ MORE SVMC President CEO Estevan Garcia says the program attracts experienced physicians who have a passion for teaching. He has it right, and backward. Residents arriving in 2029 need those physicians already here.  Recruiting them isn’t a consequence of the residency; it is its precondition, and when successful, it works immediately. Fred Schwacke Bondville, Vt. Read the story on VTDigger here: Why are we spending $3 million on doctors who leave?. ...read more read less