title: An evaluation of four proposals to reduce the financial burden of medical education.
abstract: OBJECTIVE
  To determine the financial impact of four potential solutions to reduce the financial burden of medical education: reducing medical school tuition, decreasing medical school duration, increasing residency compensation, and decreasing residency duration.
  
  
  METHODS
  The four proposed remedies were compared to the current medical education system using net present value, a standard financial metric, which calculates financial impact in today's dollars. Medical school tuition and duration, residency stipends and duration, and physician salaries for general internists and internal medicine subspecialists were modeled based on historical data and current requirements.
  
  
  RESULTS
  Decreasing medical school duration by one year had the greatest financial benefit for future physicians and ranged from 160,000 US dollars to 230,000 US dollars in today's dollars. Reducing residency duration for medicine subspecialists by one year generated a financial benefit of 170,000 US dollars. Increasing residency compensation to that of a first-year physician assistant resulted in a financial benefit of between 60,000 US dollars and 100,000 US dollars. Reducing medical school tuition by 25% had the smallest financial impact, 30,000 US dollars in today's dollars.
  
  
  CONCLUSIONS
  Decreasing the duration of medical education offers the greatest potential for reducing the financial burden of medical education. In many cases, the benefit in current dollars to a prospective physician exceeds 100,000 US dollars. This solution warrants further investigation.
authors.affiliation: University of Rochester Medical Center, 1351 Mt. Hope Ave., Suite 223, Rochester, NY 14620, USA. ray.dorsey@ctcc.rochester.edu
authors.forename: E Ray
authors.initials: ER
authors.lastname: Dorsey
authors.forename: David
authors.initials: D
authors.lastname: Nincic
authors.forename: J Sanford
authors.initials: JS
authors.lastname: Schwartz
mesh_terms: D003363:Cost Control; D003365:Costs and Cost Analysis; D004470:Economics, Medical; D004501:Education, Medical; D005382:Financing, Personal; D006801:Humans; D007396:Internship and Residency / Q000191:economics*; D013038:Specialization; D013997:Time Factors; D014481:United States