Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA
Neurosurgery. 2011 Sep;69(3):525-31; discussion 531-2. doi: 10.1227/NEU.0b013e3182181ec2.
The 4-year military Health Professions Scholarship Program (HPSP) provides funds for medical school tuition, books, and a monthly stipend in exchange for a 4-year military commitment (to receive all physician bonuses, an additional 3 months must be served).
To analyze the economics of the HPSP for students with an interest in neurosurgery by comparing medical school debt and salaries of military, academic, and private practice neurosurgeons.
Salary and medical school debt values from the American Association of Medical Colleges, salary data from the Medical Group Management Association, and 2009 military pay tables were obtained. Annual cash flow diagrams were created to encompass 14.25 years that spanned 4 years (medical school), 6 years (neurosurgical residency), and the first 4.25 years of practice for military, academic, and private practice neurosurgeons. A present value economic model was applied.
Mean medical school loan debt was $154,607. Mean military (adjusted for tax-free portions), academic, and private practice salaries were $160,318, $451,068, and $721,458, respectively. After 14.25 years, the cumulative present value cash flow for military, academic, and private practice neurosurgeons was $1 193 323, $2 372 582, and $3 639 276, respectively. After 14.25 years, surgeons with medical student loans still owed $208 761.
The difference in cumulative annual present value cash flow between military and academic and between military and private practice neurosurgeons was $1,179,259 and $2,445,953, respectively. The military neurosurgeon will have little to no medical school debt, whereas the calculated medical school debt of a nonmilitary surgeon was approximately $208,000.
为期 4 年的军事卫生专业奖学金计划（HPSP）为医学院学费、书籍和每月津贴提供资金，以换取 4 年的军事承诺（获得所有医师奖金，还需额外服务 3 个月）。
通过比较对神经外科感兴趣的学生的医学院债务和军队、学术和私人执业神经外科医生的工资，分析 HPSP 的经济学。
从美国医学院协会获得工资和医学院债务数据，从医疗集团管理协会获得工资数据，以及 2009 年的军费表。创建了年度现金流量图，涵盖了 4 年（医学院）、6 年（神经外科住院医师）和军队、学术和私人执业神经外科医生前 4.25 年的实践。应用了现值经济模型。
平均医学院贷款债务为 154607 美元。平均（免税部分调整后）的军队、学术和私人执业工资分别为 160318 美元、451068 美元和 721458 美元。14.25 年后，军队、学术和私人执业神经外科医生的累计现值现金流分别为 1193323 美元、2372582 美元和 3639276 美元。14.25 年后，有医学院学生贷款的外科医生仍欠 208761 美元。
军队与学术和军队与私人执业神经外科医生之间的累计年现值现金流差异分别为 1179259 美元和 2445953 美元。军队神经外科医生几乎没有医学院债务，而非军队外科医生的计算医学院债务约为 208000 美元。
