Goodwin M C, Gleason W M, Kontos H A
School of Medicine, Virginia Commonwealth University Medical College of Virginia, Richmond (VCU) 23298-0565, USA.
Acad Med. 1997 Mar;72(3):211-7. doi: 10.1097/00001888-199703000-00016.
To develop a model isolating the annual per-student cost of, and the fund sources for, educating undergraduate medical students at the Virginia Commonwealth University Medical College of Virginia School of Medicine.
For 1994-95, hours that faculty spent in direct scheduled contact with students and time that students spent in direct scheduled contact with faculty were inventoried. Student, faculty, and resident contact hours for clinical clerkships and electives were estimated. Faculty contact hours and average faculty workload profiles were used to compute the number of full-time-equivalent faculty positions required to deliver the undergraduate medical curriculum. Support staff and operating budget requirements were based on the number of required faculty, and actual salary averages were used to compute faculty and staff costs. Other institutional costs that indirectly support undergraduate medical education were estimated. Using faculty contact hours and actual cost data, fund sources that support undergraduate medical education were identified.
Medical school faculty spent more than 89,000 scheduled hours teaching 674 undergraduate medical students. The faculty-student ratio was 1:3.35. Residents spent nearly 79,000 hours training undergraduate medical students. The total annual cost of undergraduate medical education was $69,992 per student. State funds contributed less than a third of the required financial resources; faculty clinical practice funds provided nearly half.
Although there are inherent complexities, isolating the cost and fund sources of undergraduate medical education is an essential first step toward providing categorical funding. The model developed during the study provides a basis for assigning costs, allocating resources among instructional programs, and predicting incremental costs (or savings) and revenue requirements. The model may be of use to other medical schools contemplating new strategies for financing undergraduate medical education.
建立一个模型，用以分离弗吉尼亚联邦大学弗吉尼亚医学院本科医学生教育的人均年度成本及其资金来源。
统计1994 - 1995年期间教师与学生直接安排接触的时长以及学生与教师直接安排接触的时长。估算临床实习和选修课程中，学生、教师及住院医师的接触时长。利用教师接触时长和平均教师工作量概况来计算提供本科医学课程所需的全职等效教师岗位数量。支持人员和运营预算需求基于所需教师数量，并使用实际平均薪资来计算教师和工作人员成本。估算间接支持本科医学教育的其他机构成本。利用教师接触时长和实际成本数据，确定支持本科医学教育的资金来源。
医学院教师花费超过89,000个计划课时教授674名本科医学生。师生比为1:3.35。住院医师花费近79,000小时培训本科医学生。本科医学教育的人均年度总成本为69,992美元。州政府资金贡献不到所需财政资源的三分之一；教师临床实践资金提供了近一半。
尽管存在内在复杂性，但分离本科医学教育的成本和资金来源是提供分类资助的关键第一步。研究期间开发的模型为成本分配、在教学项目间分配资源以及预测增量成本（或节省）和收入需求提供了基础。该模型可能对其他考虑本科医学教育新融资策略的医学院有用。
