Medvecz Andrew J, Vogus Timothy J, Terhune Kyla P
Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University, Nashville, Tennessee.
J Surg Educ. 2021 Sep-Oct;78(5):1443-1449. doi: 10.1016/j.jsurg.2021.02.001. Epub 2021 Mar 18.
To quantify surgical trainees' direct financial impact on an academic medical center (AMC) by modeling the cost of replacing them.
The authors developed a model that estimates the financial costs to an AMC if surgical residents were replaced with surgical first assistants (SFAs) and physician assistants (PAs).
One AMC providing tertiary level clinical care.
The model accounts for the training, work hours, and salary differential of residents, as well as other factors that are specific to education and support of residents, SFAs, and PAs.
After accounting for the expenses of surgical residents and the replacement providers in our model, the authors determined that the net cost of replacing 30 surgical residents with PAs and SFAs at one institution is $1,728,628 or $57,621 annually per resident.
Without considering other larger and arguably more important issues of educational value or population needs, we provide a reproducible model of financial considerations regarding residents in an AMC. The costs (and foregone benefits) of not training residents may provide additional support for the funding of graduate medical education and finding the optimal balance of graduate medical education and other providers.
通过模拟替换外科住院医师的成本，量化外科住院医师培训生对学术医疗中心（AMC）的直接财务影响。
作者开发了一个模型，用于估计如果用外科第一助手（SFA）和医师助理（PA）取代外科住院医师，AMC所产生的财务成本。
一家提供三级临床护理的AMC。
该模型考虑了住院医师的培训、工作时间和薪资差异，以及与住院医师、SFA和PA的教育及支持相关的其他因素。
在模型中考虑了外科住院医师和替代人员的费用后，作者确定，在一个机构用PA和SFA替换30名外科住院医师的净成本为1,728,628美元，即每位住院医师每年57,621美元。
在不考虑其他更大且可能更重要的教育价值或人群需求问题的情况下，我们提供了一个关于AMC中住院医师财务考量的可重复模型。不培训住院医师的成本（以及放弃的收益）可能为研究生医学教育的资金提供额外支持，并有助于找到研究生医学教育与其他医疗人员之间的最佳平衡。
