The Cost of Not Training a Surgical Resident.

Objective To quantify surgical trainees’ direct financial impact on an academic medical center (AMC) by modeling the cost of replacing them. Design 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). Setting One AMC providing tertiary level clinical care. Participants 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. Results 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. Conclusions 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.