The cost of teaching residents outpatient obstetrics and gynecology in a university medical center.
OBJECTIVE
To quantify the cost of teaching residents ambulatory obstetrics and gynecology, expressed as the difference in revenue generated between a faculty physician practicing as a private practitioner and a faculty physician serving as a resident supervisor.


METHODS
Outpatient revenue generated by faculty generalists and residents was analyzed. The net gain in revenue was calculated per half-day session for faculty and residents by subtracting contractual allowances and expenses from gross patient charges. Net revenue gain per half-day clinical session per year for a faculty member practicing as a private practitioner was compared with that of a faculty member functioning as a supervisor. The net gain for the faculty supervisor was based on the revenue generated by the residents supervised.


RESULTS
The faculty member serving as a private practitioner generated a net gain per session per year of $23,947. The faculty member acting as supervisor for two residents per session generated a net gain or loss per session per year of -$9678, -$972, and $15,542 for first-, second-, and third-year residents, respectively. The cost of teaching, expressed as the difference in the net gain of a faculty member as private practitioner and the net gain of a faculty member as supervisor, for first-, second-, and third-year residents was $33,625, $24,919, and $8405, respectively, per session per year.


CONCLUSIONS
This analysis shows that first-year residents are an expense to the practice site, second-year residents are close to breaking even, and third-year residents begin to generate a net gain.
Flanagan
T
T
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, USA.
Mitchner
B
B
Weyl-Feyling
D
D
Laros
R K
RK
D000553:Ambulatory Care; D003365:Costs and Cost Analysis; D004503:Education, Medical, Graduate / Q000191:economics*; D006176:Gynecology / Q000193:education*; D006784:Hospitals, Teaching; D007396:Internship and Residency; D009774:Obstetrics / Q000193:education*