Providence Swedish is cutting family medicine residency slots by 26% as it braces for federal Medicaid cuts, a move with ripple effects for Everett's largest private healthcare employer.

Providence Swedish announced in April 2026 it will merge its two Seattle-based family medicine residency programs and shrink the combined cohort from 69 residents to 51 over four years, a 26% reduction.

The system cited looming Medicaid losses as the reason it accelerated budget-trimming decisions, according to a Seattle Times report published Wednesday, July 2.

The residency cuts apply to Providence Swedish's Cherry Hill and First Hill programs in Seattle, not directly to Providence Regional Medical Center Everett. But the financial pressures are system-wide.

Providence cut 600 mostly administrative jobs in June 2025 across its 125,000-person, seven-state workforce. At PRMCE, the system announced in April it would switch hospitalist physician services to a new contractor, Vituity, effective July 29.

PRMCE employs approximately 2,393 people in Snohomish County, making it the county's fifth-largest employer and largest private healthcare employer, according to the Economic Alliance of Snohomish County's 2025 data. The 595-bed hospital serves as the county's only Level II trauma center, with a medical staff of more than 1,350 providers.

Access to health care was ranked the top community health need in Snohomish County in PRMCE's 2022 community health needs assessment. That same assessment found a primary care provider-to-population ratio of 1,930 to 1.

Fewer residency slots statewide matter because graduates of Washington's family medicine programs tend to stay in-state to practice, according to Dr. Russell Maier, associate dean for graduate medical education at Pacific Northwest University of Health Sciences in Yakima.

"It's not a spigot you can just turn back on," Maier told the Seattle Times, noting that residency programs take years to build and cannot be quickly restored once cut.

Starting in 2027, Providence Swedish will accept six fewer new family medicine residents per year through 2029. All current residents will complete their programs.

Even after the reduction, the merged program will remain Washington's largest family medicine residency, according to the Seattle Times.

Washington has about 445 family medicine residency positions across 25 programs. The statewide count grew from 285 in 2014 to a peak of 490 in 2023 but has declined in the past two years.

A separate residency at Community Health Care in Tacoma, which typically graduated eight residents per year, also closed in 2026.

Providence Swedish leaders and community clinic partners had not determined, as of July 2, which of the system's roughly 50 Puget Sound training-site partnerships will continue after the reduction.

Medicaid work requirements under the federal "One Big Beautiful Bill Act," signed in 2025, take effect in most states on Thursday, January 1, 2027.