During the 2023 legislative session, the ONLY significant permanent tax reform signed by Gov. Lujan Grisham involved the elimination of taxes on certain payments to medical professionals.

The elimination of this tax was a long-time priority of RGF and we are glad to see it eliminated. Previously during the Richardson Administration the GRT on health insurance payments to medical providers was eliminated.

Clearly, policymakers understand that taxing services is economically-harmful. But what about the impact of taxing services on the rest of the economy? During the last legislative session Gov. Lujan Grisham and at least some legislators supported reform. Unfortunately, the bill died due to concerns over lost revenue on the part of local governments.

When grocery taxes were ended during the Richardson Administration “hold harmless” payments were made to local governments to fill the gap.  Unfortunately the process of “unwinding” these payments was very messy resulting in some local governments (like Albuquerque) dramatically increasing revenues an others losing out.

• • The State has plenty of revenue right now to reform the GRT;
  • The GRT (especially service taxation/pyramiding) is New Mexico’s “original sin” of economic policy;
  • Eliminating the grocery tax while a “done deal” was a bad policy move for a number of reasons including the increasing of GRT rates by 0.5% and the “hold harmless” debacle;
  • Reforming the GRT should be a much higher priority, it can be done at a much lower “cost” and potentially with a better approach than was undertaken in the past.

There is a comprehensive new report out from Wallethub and, especially considering the prominent role the State of New Mexico’s medical provider shortage played in the 2023 session, we felt it was an important report to analyze.

For starters, having worked extensively on the issue with our own research here and here we found the report to be well-done and thorough. Several issues were discussed and successfully addressed in the 2023 session. Clearly we are not the only state in need of more medical providers.

Aside from our mediocre 34th ranking overall, New Mexico does pretty well on “Dentists Per Capita” and cancer rate.

But, New Mexico does poorly in terms of the percentage of at-risk adults having no routine doctor visits.

Paul had an opinion piece about his recent trip to Texas and observations. It ran in Sunday’s ABQ Journal. Not surprisingly, the article drew heated responses from those who despise Texas and others who appreciated the perspective.

The left wing “Searchlight” New Mexico did a story which was obviously an attempt to make MLG seem like a “moderate” on the environment.

Paul sat down w/ KOAT to discuss the Mayor’s proposed bike trail. In a separate story he also discussed the latest plans for a United Soccer Stadium.

New Mexico subsidizes film industry fat cats. 

Yet another report slams New Mexico’s education system. MLG applauds more spending. 

We have a luncheon on August 8. 

RGF is hosting an education event on September 22nd.

At the Rio Grande Foundation our position on education unions is nuanced. We generally oppose public sector unions, but blame the government-run monopoly for our educational woes. After reading this memo from the Albuquerque Teachers Federation, we may reconsider that position.

In the document which is written in response to a memo from the District (APS), the union attempts to thwart efforts to engage and inform parents in the educational process as relates to their children.

• It starts off with a “bang” with the following statement by the union: “The memo indicates that parent communication must include “Access to the district’s standardized electronic grade book via ParentVue.”

ParentVue is clearly defined as one option for communicating with parents.

• Another gem from the AFT follows: The memo states that “If students are in danger of failing, or not making adequate academic progress, teachers will proactively notify parents in time for early and appropriate intervention.” For high school teachers, this rule is a violation Article 5.L.4 of the APS-ATF Negotiated Agreement, which reads: “If a high school teacher anticipates that any student is failing at the end of the semester, they will be required to provide a list of all students who are at risk of failing a class one week prior to winter break so that the student(s) may be scheduled appropriately. The list is nonbinding and intended for planning purposes only.” 

While there is much more in the document, the final point we’ll focus on is:,

• “Elementary educators must communicate students’ progress in core academic subjects to families weekly via the district electronic gradebook.” This is also in violation of Article 5.L.1, which reads (emphasis added): Teachers are responsible for evaluating student progress and interpreting grades or reports given. If a student is not assigned to a teacher, a professional staff member shall be responsible for the grade. 

A union pushing back against even basic attempts to codify ways in which parents will be informed of their child’s progress is unfortunate. Whether these are indeed “violations” of the APS contract is not our concern. Rather, the whole situation simply highlights how bureaucracies fail to keep the education of our children front and center. Instead it becomes a power struggle.

I knew that writing in praise of Texas’ economic policies (as I did in a recent opinion column) would be polarizing. There is something about Texas that excites the passions of New Mexicans.

Here’s one email:

I read your little article in the Albuquerque Journal. You don’t think Texas has issues? Try this one – highest uninsured sick people in the country. Another one, their aggressive assault on LGBTQ, especially trans people. I’m glad New Mexico is a BLUE STATE. Texas is a litteral s^&* hole red state that let’s girls die of abortion. Their wages are also s^&* whereas wages are better in New Mexico. Even retirement is better in New Mexico then Texas and it’s why many Texans retire in New Mexico.

AND

Rest Stops and Roads.  Coming back from Dallas recently, taking 287 up to Amarillo (rest stops on 287 are fabulous) you can always tell when you cross over into New Mexico on the I-40 from Texas.  Potholes, dreadful roads, axle shattering repairs – it is a disgrace that a road in New Mexico which is far from Santa Fe is allowed to exist in such disrepair.  I pity the truckers who have to travel through our state.  Why is it that the I-40 from Amarillo to the New Mexico border is so smooth and repaired (and the I-40 east of Amarillo as well) and the I-40 in New Mexico is in such horrible condition?

We have been in NM for 16 years, went to grad school at UNM and both children graduated from UNM Law.  One has already left the state for opportunities in Dallas Fort Worth and I doubt the other will stay once she and her husband have children.  Sad but true – no opportunities in NM, lots in Texas as long as you’re willing to work.  But please settle in the state that doesn’t trigger you by all means.

The folks at Wallethub have another report which places New Mexico’s K-12 education firmly at the bottom in terms of education systems across the nation. The State ranks dead last in Math and English scores as well as dropout rate. None of this is particularly news to anyone following education policy in New Mexico.

The most telling component of the Wallethub report is the chart below which shows that New Mexico is the very worst performing state in the nation in terms of outcomes even as it is considered a “high spending” state when it comes to K-12 education.

If you are as frustrated by New Mexico’s horrendous educational performance as we are, make it a point to attend our upcoming free education conference on September 22nd. 

Perhaps unsurprisingly Gov. Lujan Grisham’s general approach to New Mexico’s education situation is to ignore it and count on a friendly media to do the same. Over the recent weekend she tweeted the following:

Our public education system is the cornerstone of our nation’s success, and my administration will continue to #SupportPublicEducation in NM. Whether it’s free and healthy school meals or the best-paid teachers in the Southwest, we are investing in our public school system. pic.twitter.com/QpNZKS365O

— Governor Michelle Lujan Grisham (@GovMLG) July 30, 2023

The following appeared in the Albuquerque Journal on July 30, 2023.

A recent editorial cartoon highlighted the vastly different approaches towards governance of New Mexico and Texas. The cartoon is of the state border circa 2030 as New Mexicans head to Texas for gas-powered vehicles (due to the recent regulations proposed by Gov. Lujan Grisham) while Texans visit NM for abortions and marijuana.

These are hardly the only differences between the two nowadays as Texas has no income tax or job-killing gross receipts tax, it is a right to work state, and state spending per-person is less than half of what it is in New Mexico. Not coincidentally, Texas is also one of the fastest growing states in the nation while New Mexico’s population is stagnant with young people leaving and being replaced by older people and retirees.

People have been talking about Texas’ economic success for decades, but a recent family vacation gave me the opportunity to see it firsthand. I have flown to several major Texas cities and have driven across the Panhandle more times than I care to recall, but this trip involved flying to Dallas and driving from all the way to Corpus Christi and the Gulf Coast. That’s a trip of over 400 miles including stops in major cities including Austin and San Antonio (in addition to Dallas).

We went deep in the heart of Texas and compared what we saw with our home state of New Mexico. Here’s what we saw.

• It seems like all the roads in Texas are under construction. Yes, this is a hassle for visitors and commuters alike, but it also highlights the fact that more people and businesses require more infrastructure. Aside from the road construction, the interchanges are often complicated with extremely high overpasses. Finally, just the sheer amount of construction equipment involved highlights the size and scale of these projects. Construction projects are definitely bigger in Texas.
• Setting aside roads and bridges, businesses are flocking to Texas as well. The Tesla plant outside Austin is the largest manufacturing space in the United States by floor area. Even in and around small towns construction was under way on significant buildings and cranes often dotted the skyline.
• Texas rest areas are incredible. One might think that with New Mexico having two of the nation’s most important east/west highways (I-40 and I-10) running through it (and a booming budget), would invest the tiny level of resources needed to make rest areas a place people want to stop and feel safe and comfortable doing so. This is especially true given the lack of road-side amenities available on many of our highways. Sadly, New Mexico’s rest areas are meager and often in a state of disrepair. Texas has playgrounds and historical/local interest information available for those who need a potty break or just want to stretch their legs.

Texas is booming. It provides a business-friendly environment and a government that does the basics well and at less than half the cost per resident.

While New Mexicans have a long-standing historical resentment of the Lone Star State, but the entrepreneurial, pro capitalist culture and polices clearly have a lot to be said for them. New Mexico can’t and shouldn’t be Texas, but we can also learn some valuable lessons from it.

Paul Gessing is president of New Mexico’s Rio Grande Foundation. The Rio Grande Foundation is an independent, nonpartisan, tax-exempt research and educational organization dedicated to promoting prosperity for New Mexico based on principles of limited government, economic freedom and individual responsibility

On this week’s conversation Paul sits down with Reilly White, PhD. Reilly is Associate Professor at the Anderson School of Management at University of New Mexico. They discuss Professor White’s perspectives on New Mexico’s economy, some of the core issues facing the state, and his views on what can be done to improve things. White is a breath of fresh air from academia and you don’t want to miss this conversation.

RGF president Paul Gessing sat down with KOAT TV to discuss the Mayor’s plans for a new stadium for the NM United Soccer team. The Rio Grande Foundation helped lead the opposition to a ballot measure that would have spent substantial tax dollars on a new stadium.

While not discussed in detail in the article, our primary concern is that City Council has a chance to fully vet and vote on the plan which would use city-owned land at Balloon Fiesta Park. The plan would (unfortunately) spend $13.5 million in State funding but we need to know what, if any, liabilities could be faced by Albuquerque taxpayers. It is also important to understand what the real impacts of the stadium will be on Balloon Fiesta Park’s parking situation and what alternatives could be undertaken with this land.

You can click on the story below:

Opportunity for All Kids NM Conference

September 22, 2023
Albuquerque, NM
St. Pius X High School

Even before the pandemic lockdowns, the New Mexico education system underperformed. After years of being ranked at 49th and 50th, our system has slid further into disrepair. New Mexico is now ranked 51st in the nation for education.

New Mexico’s children are more vulnerable than ever to learning loss. It’s time to find alternatives to New Mexico’s faltering education system.

As families continue to be affected by policies and procedures enacted during the pandemic, it’s time to find solutions for our students and families.

The Opportunity for All Kids conference is for policymakers, teachers, administrators, legislators, parents, and concerned citizens invested in creating opportunity. Whether interested in charter schools, private schools, parochial schools, home schools, or microschools, only together can we reform New Mexico’s systems and expand education options.

Our children and families deserve an education system that sets them up for success. Join the Rio Grande Foundation for a full-day education reform conference as we discuss and collaborate on ideas and strategies for a more child-focused future.

We discussed the details of the Mayor’s proposed mega-expensive $80 million bike trail here, but had a chance to offer a few thoughts in this story for KOAT TV Channel 7.

In summary, this is yet another “big ticket” taxpayer-financed project foisted upon us when what the City desperately needs is improved public safety and an improved economic climate (not to mention a better education system). A neon tumbleweed structure may be nice, but it is certainly not a core government function regardless of your broader thoughts on bike trails and Albuquerque’s extensive trail network.

Check out the story below:

Michelle Lujan Grisham is among the most radically-“green” governors in the United States (certainly as radical as anyone not on the West Coast).

But ideologically-driven pseudo-news outlets like Searchlight New Mexico want to push the Gov. even further to the left. Thus, we get stories like “How Green is New Mexico’s Governor?” Spoiler alert, she’s not as “green” as her most radical environmental interest group supporters in New Mexico would like her to be.

This is nothing new. These well-funded left-wing groups either explicitly or intuitively understand the “Overton Window.” While they wish to move the “window” to complete socialism and energy poverty, we at the Rio Grande Foundation along with some other like-minded groups both in and outside of industry are working to move the “window” in the opposite direction toward more freedom and reasonable regulations that do not hinder energy production and prosperity.

As is clearly evidenced by the article, Searchlight is first and foremost an ideological organization, not a journalistic one (much of the media are sadly ideology-first). They don’t consider both sides’ views on the Gov. and the pros and cons of her environmental policies. They are pushing the window in one direction only. Traditionally that was the purview of think tanks and grassroots organizations, but not any more.

What is really holding MLG back from being as “green” as her radical base would like? Simple reality. Oil and gas are the economic lifeblood of New Mexico which is already one of the poorest states in the union. Absent the oil and gas industry (or a massive shift toward free market policies) we would be the very poorest state.

Paul was in Carlsbad recently. He discussed a number of issues there and met with the Mayor and other community leaders. The oil and gas continues to boom there. Paul offers specific details of his visit here.

As the first paid tourists get ready to launch out of Spaceport America the facility is already going to need millions of dollars in repairs.

Albuquerque is poised to construct an $80 million 7-mile-long bike trail. 

The US Forest Service admits that it set yet another major fire from summer of 2022. 

New Mexico is a good place to be born if you want to BE a billionaire according to a new report. 

The Biden Administration is now coming after your dishwasher. The DOE’s proposal seeks to cut energy use by 27% and water use by 34% in new household dishwashers made or imported into the United States. RGF filed comments in opposition.

As the Gov. pours $100 million more of our money into pre-K, at least one national media outlet is willing to ask whether this is a sensible policy.  

RGF has an upcoming luncheon with previous podcast guest Brian Domitrovic of the (Arthur) Laffer Center on August 8. He will share a “tax history of the United States.” We hope you can attend!

The release of two of the biggest box office movies since COVID shut down the industry (Barbie and Oppenheimer) coincides with the ongoing (and recently expanded) labor strike going on involving writers and actors.

Because New Mexico has spent so much money in the form of subsidies (an estimated $145 million this year alone before the strike) many New Mexicans and their elected officials may feel strongly about taking sides. As seen below Rep. Stansbury did exactly that and it is no surprise that New Mexico’s left-wing political leaders are on the side of labor.

RGF has not taken sides, but we DO oppose subsidizing Hollywood. While Rep. Stansbury supports the film subsidies, she appears to think that CEO’s of the very companies New Mexico subsidizes make too much money. Apparently, the fact that our tax dollars are directly funding the pay of CEO’s running these big corporations is completely lost on her.

Hollywood execs are saying the demands of the writers and actors on strike aren’t realistic.

Walt Disney CEO made $24M
Netflix CEOs made $51M & $50M
Comcast CEO made $32M
Paramount CEO made $32M

Stop saying you cannot afford to pay your actors and writers fair wages.

— Rep. Melanie Stansbury (@Rep_Stansbury) July 21, 2023

According to KOB TV, the City of Albuquerque is about to embark upon the construction of an insanely expensive 7 mile bike trail that, when all is said and done, will cost $80 million. Of course, public works projects are notoriously expensive and often face massive cost overruns, but this may be the biggest boondoggle in New Mexico since Bill Richardson spent $400 million to build the Rail Runner.

The City currently fails to maintain existing bike routes but claims it has $40 million (half of what it needs) to build an elaborate bike path through Mayor Keller’s cherished Rail Yards and to other locations in a loop throughout parts of town.

There are numerous other uses for $80 million but one we thought of would be replacement of the I-25 bridge over the Rio Grande south of Albuquerque. The bridge is used by 35,000 vehicles every day and is in serious need of repairs estimated to cost $78 million. More than $10 million per mile for a bike path is utterly absurd.

See the KOB story below:

The US Forest Service is admitting after months of delay that it caused yet another big New Mexico forest fire. Already the agency has admitted it caused both the Hermits Peak and Calf Canyon fires, but as a recent Albuquerque Journal article pointed out, they had been reluctant to take the blame for the 2022 Cerro Pelado which happened in the Jemez Mountains in Santa Fe National Forest. The fire burned 45,605 acres.

The Agency has officially admitted it caused the fire via a prescribed burn.

For more than a decade the Rio Grande Foundation has argued that the federal government does a poor job of managing its lands and asked that states be allowed to manage national forests instead. Sadly, until fundamental changes are made to land management techniques New Mexico is likely to continue to face fires and lost opportunities.

It is hard to keep up with the myriad (often ridiculous) ways in which the Biden Administration continues to attack Americans’ personal freedom, but whenever possible the Rio Grande Foundation remains ready and willing to help.

For example, a lot of attention has been focused on their latest effort to tighten the energy and water efficiency standards for residential dishwashers, despite the fact that the standards currently in effect are causing serious problems for consumers.

The best way to push back at this point (aside from education) is to submit public comments in opposition to the proposal and RGF was pleased to sign onto comments drafted by the free market Competitive Enterprise Institute based in Washington, DC.

Caught Mayor Keller’s “One ABQ” sign on the move today. I was driving on the Interstate and the sign was on the frontage road. All of the white trucks plus 3 more at the rear of the column were involved so by my count 7 trucks plus the actual moving vehicle and trailer.

According to a 2019 KRQE story it costs $5,500 to move the “statue.”

RGF president Paul Gessing had the opportunity to  speak to the Republican Women’s Club of Carlsbad. He also had a chance to sit down with Mayor Dan Janway and his staff and did an interview with Johnny Chandler of KCCC 930AM for a discussion of the latest issues facing Southeast New Mexico.

Among numerous topics of discussion and local issues facing Carlsbad and the State, we discussed ways in which the Legislature might address revenue loss by local cities impacted by prospective gross receipts tax reform which RGF strongly supports. This is a challenging issue that needs go be considered in GRT reform debates.

It was also great to catch up with Reps. Cathrynn Brown and Jimmy Mason, both of whom capably represent the Carlsbad region.

If your civic group would like to hear a presentation on New Mexico’s economic situation and how the Legislature can move the State out of 50th place, please contact us at: info@riograndefoundation.org

Virgin Galactic has finally launched its first paid flight from New Mexico’s taxpayer-financed Spaceport America, but the facility which was built starting in 2009 at a cost of more than $200 million (plus numerous additions) is already in need of millions of dollars in repairs.

Roof repairs alone could run from $800,000 to $3 million.

The Spaceport will also install an expensive water treatment system to remove the minerals, adding that to its utilities costs.

Finally, a new 30,000-square foot building including staff offices, conference rooms, an auditorium, cafeteria, dining area and server storage is also being considered as an addition to the facility with estimated the costs ranging between $45 million and $60 million.

The good news? Virgin Galactic is finally launching from the facility.

The bad news is that New Mexico taxpayers have spent well over the $220 million construction price for the facility and are going to likely be spending millions more before Virgin Galactic even shows that they have a viable operation.

Recently, RGF noted in this space that Forbes had named Ron Corio of Array Solar the State of New Mexico’s first billionaire. But if you look at the data by place of birth as a new report does, New Mexico is actually a great place to be from to be a billionaire. As the chart below shows New Mexico ranks 7th as a place to be FROM and become a billionaire.

Many New Mexicans are aware that Jeff Bezos, the Founder of Amazon.com and the richest man in the United States was born in New Mexico, but how about Dan Kurzius who founded MailChimp (Albuquerque), Ernest Garcia II who founded Drive Time and is CEO of Carvana (Gallup), or Paul Foster who founded Western Refining (Lovington)?

And, of course Bill Gates (3rd on the richest list) famously founded Microsoft in Albuquerque before moving his company to the Seattle area.

What does it all mean? Arguably it is just random, but perhaps it is an indicator that New Mexicans are as entrepreneurial as anyone (if not more) but that they have to leave New Mexico to make their business work (unless they are in a subsidized industry like solar).

Despite MLG’s claims, NM still lags in job creation.

Another data point highlights the fact that New Mexico government spends much more than its neighboring states. 

New Mexico has seen a steep drop in the number of young children. 

Santa Fe mayor plans to raise the City’s minimum wage to $20 an hour. 

In another potential bad policy move from Santa Fe the City is considering an excise tax for affordable housing. 

RGF leads national coalition effort to highlight problems with the federal Railway Safety Act being considered in Congress.

“…In this world nothing can be said to be certain, except death and taxes.”

— Benjamin Franklin, in a letter to Jean-Baptiste Le Roy, 1789

We’ve all heard the quote before, but how have tax burdens directed economic growth in the United States over the last century? Our upcoming speaker Brian Domitrovic has co-authored the book Taxes Have Consequences: An Income Tax History of the United States, with Arthur B. Laffer, to answer this and other questions.

Domitrovic will join the Rio Grande Foundation to discuss American history, especially the past 100 years since creation of the federal income tax at a luncheon hosted by the Rio Grande Foundation.

August 8, 2023
Taxes Have Consequences
11:45AM – 1:00PM
Indian Pueblo Cultural Center
2401 12th St NW, Albuquerque, NM 87104

About Brian Domitrovic:
Brian Domitrovic is an intellectual historian interested in the history and development of supply-side economics. He is the author of six books, beginning with the now standard history of supply-side economics Econoclasts (2009) and extending to the history of the income tax Taxes Have Consequences (2022 and co-authored with Arthur B. Laffer and Jeanne Sinquefield). He has been a professor at institutions in Texas and Colorado and is the Richard S. Strong Scholar at the Laffer Center in Nashville. He holds a Ph.D. in history from Harvard University.

Tickets:
Tickets are limited. Price before July 28, 2023: $50
Price on and after July 29, 2023: $55
Price at the door if available: $60

DonorboxEventWidget.embed({container: ‘donorboxEmbed’,embedFormSlug: ‘https://donorbox.org/embed_event/476453’});

Cancellation policy:
The Rio Grande Foundation will honor cancellation requests until July 31, 2023 at 12:00PM MT, 2023, minus a 15% transaction fee.

The following is a guest post by Manu Mathew, M.D. who describes himself as a National Advocate for Unmatched Doctors

According to a recent study conducted by the Association of American Medical Colleges, the national shortage of primary care physicians is projected to range from 17,800 to 48,000 by 2034. Additionally, a survey conducted in December 2021 revealed that a significant number of physicians and advanced practice registered nurses intend to reduce their work hours or retire, further exacerbating the healthcare workforce shortage.

This shortage has led to thousands of medical graduates being unable to submit a rank list or secure a match each year. Fortunately, physician assistants and nurse practitioners have been able to slowly expand their scope of practice, seeking prescriptive authority and even being able to prescribe controlled substances. In fact, nurse practitioners are currently working independently in over 25 states (including New Mexico), with the aim of alleviating the healthcare workforce shortage.

This shortage is especially acute in New Mexico. The 2023 legislative session included numerous bills dealing with everything from Medicaid reimbursement rates to tort reform and taxation and more to bring and keep more doctors in New Mexico. The problem is by no means solved. Access to care in rural areas is limited due to misguided policy decisions resulting in a shortage of practicing physicians. Allowing medical school graduates to practice under provisional licenses could help mitigate this shortage.

The reason why medical graduates are not being matched may be due to various reasons, for example the person did not score high enough on the US Medical License Examination ( or did not apply to enough residency programs. The Association of American Medical Colleges (AAMC) sets guidelines for medical residency programs and (National Residency Matching Program) NRMP conducts the match every year. The entire world applies to the match when there are not enough residency seats which makes it anti-competitive as stated in the American Medical Association’s (AMA) recent resolution.

Expanding the number of residency seats is one possible way to increase the number of doctors in the United States, but much of the problem is created by the Centers for Medicare & Medicaid Services. There are solutions to the issue that can be undertaken right here in New Mexico.

Several states have implemented innovative and alternative solutions to increase the supply of available physicians. In general, these solutions allow medical graduates, upon successful passage of American medical licensing exams, to work under the supervision of licensed physicians.  Some states, such as Alabama and Idaho allow medical graduates to work under such a provisional license until they match into a residency program, others such as Missouri, allow such graduates to do so indefinitely.

The criticism has been; this produces inferior class of medical graduates, however this is not true since “one big difference between the PANCE and the USMLE is the test format. While test-takers take the sections of the PANCE all at once, the USMLE is divided into three steps. Step 1 is an eight-hour exam that encompasses 280 multiple-choice questions that aim to evaluate the test-taker’s knowledge of basic sciences and their ability to apply these concepts to the clinical practice of medicine. Questions on this test might cover topics of the mechanisms that contribute to health, disease and treatments.

Step 2 of the USMLE is another one-day test, this time consisting of 318 multiple-choice questions administered over a period of nine hours. In this step of the USMLE exam process, test-takers answer questions about the clinical science and medical skills used to care for patients, promote health and prevent disease. Finally, Step 3 is a two-day test that consists of 232 multiple-choice questions on the Foundations of Independent Practice (FIP) and 180 multiple-choice questions plus 13 computer-based case simulations pertaining to Advanced Clinical Medicine (ACM).”1

Tennessee has adapted elements of the Australian medical licensure model, streamlining experienced foreign doctors into the American medical system so they can practice independently without doing a residency at all.   Increasing the number of medical residency positions, in combination with these measures, will help retain the physician workforce in New Mexico. New Mexico should consider unmatched doctors as a resource to tackle the healthcare shortage.