背景:手术住院医师根据对未来收入潜力的观念做出可能对职业收入产生重大影响的决定。这项研究考察了债务负担的影响,还款计划,并练习设置普通外科医生的职业价值。
方法:债务水平,还款计划,和实践设置被认为是使用35种情况下的净现值(NPV)来模拟外科医生的职业价值。净现值是用工资计算的,教育债务,年度支出,和5%的贴现率。工资数据来自医疗集团管理协会,来自美国医学院协会的学生债务信息,以及美国政府记录中的税收和家庭支出数据。假设包括培训中没有差距,没有先前的债务,单人家庭,职业生涯35年。
结果:普通外科医生的薪水足以偿还10-25年的100,000-300,000美元的债务负担,无论还款计划或实践设置如何。当债务负担和还款计划保持不变时,实践设置降低了学术外科医生的职业价值:学术外科医生的NPV为382,000美元,而具有相同债务和还款计划的非学术外科医生的NPV为500,000美元。通过无补贴和基于收入的还款计划偿还的债务负担减少了所有外科医生的NPV,而补贴计划增加了净现值。所有方案的预计净现值为235万美元-2.87万美元。
结论:尽管建模的方案没有考虑到先前的债务负担,主要支出,或年度家庭支出增加超过全国平均水平,手术住院医师应该意识到普外科仍然是经济上可行的职业。
Surgical residents make decisions that may have a dramatic impact on career earnings based off conceptions regarding future income potential. This study examines the effect of debt burden, repayment plan, and practice setting on a general surgeon\'s career value.
Debt levels, repayment plans, and practice setting were considered to model a surgeon\'s career value using net present value (NPV) across 35 scenarios. The NPV was calculated using salary, education debt, yearly spending, and a discount rate of 5%. Salary data were obtained from the Medical Group Management Association, student debt information from the Association of American Medical Colleges, and tax and household spending data from U.S. government records. Assumptions included no gaps in training, no prior debt, single-person household, and career duration of 35 y.
A general surgeon\'s salary adequately repays debt burdens from $100,000-$300,000 over 10-25 y, regardless of repayment plan or practice setting. Practice setting decreased career value for academic surgeons when debt burden and repayment plan were held constant: the NPV for an academic surgeon was $382,000 compared to $500,000 for a nonacademic surgeon with the same debt and repayment plan. Debt burden repaid through unsubsidized and income-based repayment plans reduced NPV for all surgeons, while subsidized plans increased NPV. The projected NPV for all scenarios ranged $2.35M-$2.87 M.
Though the modeled scenarios do not account for prior debt burden, major expenditures, or increases in yearly household spending beyond national averages, surgery residents should be aware that general surgery remains a financially feasible career.