Document Detail


The cost of pursuing a medical career in the military: a tale of five specialties.
MedLine Citation:
PMID:  20671458     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The physician payment system is a focus of potential reform in the United States. The authors explored the effects of the military's method of physician payment on physicians' returns on educational investment for several specialties. METHOD: This retrospective, observational study used national data from 2003 and standard financial techniques to calculate the net present value-the current value of an expected stream of cash flows at a particular rate of interest-of the educational investments of medical students in ten 30-year career paths: either military or civilian careers in internal medicine, psychiatry, gastroenterology, general surgery, or orthopedics. RESULTS: At a 5% discount rate, in the civilian world, the lowest return on an educational investment accrued to psychiatrists ($1.136 million) and the highest to orthopedists ($2.489 million), a range of $1.354 million. In the military, the lowest returns accrued to internists ($1.377 million) and the highest to orthopedists ($1.604 million); however, the range was only $0.227 million, one-sixth that found in the civilian sector. The authors also found that most military physicians do not remain in the military for their full careers. CONCLUSIONS: Choosing a military career substantially decreases the net present value of an educational investment for interventionalists, but it does so only modestly for primary care physicians. Further, a military career path markedly diminishes specialty-specific variation in the net present values of educational investment. Adopting a military structure for engaging medical students might help reverse the current trend of declining interest in primary care.
Authors:
William A Cronin; Jessica A Morgan; William B Weeks
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  85     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-30     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1316-20     Citation Subset:  AIM; IM    
Affiliation:
Dartmouth Medical School, Hanover, New Hampshire, USA.
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MeSH Terms
Descriptor/Qualifier:
Career Choice*
Costs and Cost Analysis
Education, Medical / economics*
Humans
Military Medicine / education*
Occupations / economics*
Physicians / economics*
Retrospective Studies
United States
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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