Lake Erie College of Osteopathic Medicine Health/Millcreek Community Hospital Orthopedic Surgery Resident, 5515 Peach Street, Erie, PA 16509.
Staff Orthopedic Surgeon, Naval Health Clinic New England, 43 Smith Road, Newport, RI 02840.
Mil Med. 2020 Dec 30;185(11-12):e1913-e1918. doi: 10.1093/milmed/usaa214.
The purpose of this study to analyze the financial impact of choosing a civilian or military orthopedic surgery career. It will examine the most common scenarios to become an orthopedic surgeon in the Navy Health Professions Scholarship Program to include becoming a flight surgeon. To the authors' knowledge, there is no peer-reviewed literature that financially analyzes the most common scenarios for a Navy Health Professions Scholarship Program scholarship recipient to become an orthopedic surgeon.
Salaries for Navy orthopedic surgeons, residents, and flight surgeons were recorded using the 2020 Defense Finance and Accounting Service pay tables and Navy Fiscal Year 2019 Medical Corps Special Pay Guidance. The median income of civilian orthopedic surgeons was recorded using Salary.com. The present value (PV) and future value (FV) were calculated using the Consumer Price Index-U and average Department of Defense pay increases over the past 20 years. Six common scenarios were utilized to calculate the PV and FV of civilian compared to Navy orthopedic surgeons.
The two highest earning net FVs among all Navy scenarios were those surgeons who kept their Navy tour to 5 years or less (flight surgeon tour/separate or civilian deferment/separate). The civilian throughout scenario had the highest net FV of $19,974,673 after retiring at the age of 65. Flight surgeon tour/separate and civilian deferment/separate scenarios only made $843,751 and $1,401,630 less respectively than a pure civilian career due to the tax shelter afforded by the military pay. All Navy retirement scenarios to include Navy throughout, civilian deferment/Navy throughout, flight surgeon tour/Navy throughout resulted in a net FV less than $17,700,000. Civilian residency/deferment and retiring in the Navy had the worst net FV among all scenarios.
It was found that the shorter tours in the Navy had a higher net FV than those who made the Navy a career in orthopedic surgery. Flight surgery is a rewarding operational experience with among the highest net FV among Navy scenarios and is only slightly less than the net FV of a pure civilian career. However, it can be more difficult to apply for civilian orthopedic surgery after serving a flight surgeon tour. Lastly, the net FV was very similar between a civilian orthopedic surgeon career and the shorter tours served in the Navy. Factors such as higher civilian income with associated loan repayment/signing bonuses makes the civilian orthopedic surgery route the best financial option. This study will help those medical students considering a military versus a civilian career in orthopedic surgery and aid in Department of Defense recruitment/retention.
本研究旨在分析选择平民或军事骨科手术职业的财务影响。它将研究通过海军卫生职业奖学金计划成为骨科医生的最常见情况，包括成为飞行外科医生。据作者所知，没有经过同行评审的文献从财务角度分析了海军卫生职业奖学金计划奖学金获得者成为骨科医生的最常见情况。
使用 2020 年国防财务和会计服务薪酬表和海军 2019 财年医疗团特别薪酬指南记录海军骨科医生、住院医师和飞行外科医生的工资。使用 Salary.com 记录平民骨科医生的中位数收入。使用消费者价格指数-U 和过去 20 年国防部平均加薪计算现值 (PV) 和未来值 (FV)。利用六种常见情况计算平民与海军骨科医生的 PV 和 FV。
在所有海军方案中，两个收入最高的净 FV 是那些将海军服役时间保持在 5 年或更短时间的外科医生（飞行外科医生/单独或平民延期/单独）。平民终身方案在 65 岁退休时拥有最高的净 FV，为 19,974,673 美元。由于军队工资提供的税收庇护，飞行外科医生/单独和平民延期/单独方案分别仅比纯粹的平民职业少 843,751 美元和 1,401,630 美元。包括海军终身、平民延期/海军终身、飞行外科医生/海军终身在内的所有海军退休方案的净 FV 均低于 17,700,000 美元。平民住院医师延期/海军和在海军退休的方案在所有方案中拥有最差的净 FV。
研究发现，在海军服役时间较短的人比将海军作为骨科手术职业的人拥有更高的净 FV。飞行手术是一种回报丰厚的作战经验，在海军方案中拥有最高的净 FV，仅略低于纯粹平民职业的净 FV。然而，在飞行外科医生服役后申请平民骨科手术可能会更加困难。最后，平民骨科医生职业和在海军服役时间较短之间的净 FV 非常相似。更高的平民收入以及相关的贷款偿还/签约奖金等因素使平民骨科手术成为最佳的财务选择。本研究将帮助那些正在考虑从事军事或平民骨科手术职业的医学生，并为国防部的招聘/留用提供帮助。
