Liles Campbell, Tang Alan R, Petrovic Mark, Dambrino Robert J, Thompson Reid C, Chambless Lola B
Department of Neurological Surgery, Vanderbilt Medical Center, Nashville, TN.
Vanderbilt Policy and Cost in Surgery (VPaCS) Research Group, Nashville, TN.
Ann Surg. 2025 Jan 1;281(1):46-53. doi: 10.1097/SLA.0000000000006335. Epub 2024 May 10.
To compare living wages and salaries at US residency programs.
It is unknown how resident salary compares to living wages across the United States.
Cross-sectional analysis of publicly available resident salary affordability from training centers with postgraduate year (PGY)-1 through PGY-7 resident compensation for 2022-2023 was compared with the Massachusetts Institute of Technology Living-Wage Calculator. Resident salary-to-living wage ratios were calculated using PGY-4 salary for each family composition. Univariate and multivariable analysis of PGY-4 salary affordability was performed, accounting for the proportion of expected living wages to taxes, transportation, housing, health care, childcare, and food, as well as unionization and state income tax.
One hundred eighteen residency programs, representing over 60% of US trainees, were included, 20 (17%) of which were unionized. Single-parent families were unable to earn a living wage until PGY-7. Residents with 1 child in 2-adult (single-income) and 2-adult (dual-income) families earn below living wages until PGY-5 and PGY-3, respectively. Residents with more than 1 child never earn a living wage. Multivariable regression analysis using PGY-4 salary: living wage ratios in single-child, 2-parent homes showed food expense and unionization status were consistent predictors of affordability. Unionization was associated with lower affordability prestipend, almost equivalent affordability poststipend, and lower affordability poststipend and union dues.
Resident salaries often preclude residents with children from earning a living wage. Unionization is not associated with increased resident affordability in this cross-sectional analysis. All annual reimbursement data should be centrally compiled, and additional stipends should be considered for residents with children.
比较美国住院医师培训项目的生活工资和薪水。
在美国，住院医师的薪水与生活工资相比情况如何尚不清楚。
对公开可得的培训中心住院医师薪资可负担性进行横断面分析，将2022 - 2023年研究生一年级（PGY）至PGY - 7住院医师的薪酬与麻省理工学院生活工资计算器进行比较。使用PGY - 4薪水针对每种家庭构成计算住院医师薪水与生活工资的比率。对PGY - 4薪水可负担性进行单变量和多变量分析，考虑预期生活工资在税收、交通、住房、医疗保健、儿童保育和食品方面的占比，以及工会化和州所得税情况。
纳入了118个住院医师培训项目，占美国受训人员的60%以上，其中20个（17%）有工会组织。单亲家庭直到PGY - 7才能挣到生活工资。在双亲（单收入）家庭中有1个孩子的住院医师直到PGY - 5才能挣到生活工资，而在双亲（双收入）家庭中有1个孩子的住院医师直到PGY - 3才能挣到生活工资。有多个孩子的住院医师从未挣到生活工资。使用PGY - 4薪水进行多变量回归分析：在有1个孩子的双亲家庭中，食品费用和工会组织状况是可负担性的一致预测因素。工会化与较低的可负担性预支津贴、几乎相当的可负担性支薪后津贴以及较低的支薪后津贴和工会会费可负担性相关。
住院医师的薪水常常使有孩子的住院医师无法挣到生活工资。在本横断面分析中，工会化与住院医师可负担性的增加无关。所有年度报销数据应集中汇总，对于有孩子的住院医师应考虑额外津贴。
