title: Economic analysis of the military health professions scholarship program for neurosurgeons.
abstract: BACKGROUND
  The 4-year military Health Professions Scholarship Program (HPSP) provides funds for medical school tuition, books, and a monthly stipend in exchange for a 4-year military commitment (to receive all physician bonuses, an additional 3 months must be served).
  
  
  OBJECTIVE
  To analyze the economics of the HPSP for students with an interest in neurosurgery by comparing medical school debt and salaries of military, academic, and private practice neurosurgeons.
  
  
  METHODS
  Salary and medical school debt values from the American Association of Medical Colleges, salary data from the Medical Group Management Association, and 2009 military pay tables were obtained. Annual cash flow diagrams were created to encompass 14.25 years that spanned 4 years (medical school), 6 years (neurosurgical residency), and the first 4.25 years of practice for military, academic, and private practice neurosurgeons. A present value economic model was applied.
  
  
  RESULTS
  Mean medical school loan debt was $154,607. Mean military (adjusted for tax-free portions), academic, and private practice salaries were $160,318, $451,068, and $721,458, respectively. After 14.25 years, the cumulative present value cash flow for military, academic, and private practice neurosurgeons was $1 193 323, $2 372 582, and $3 639 276, respectively. After 14.25 years, surgeons with medical student loans still owed $208 761.
  
  
  CONCLUSIONS
  The difference in cumulative annual present value cash flow between military and academic and between military and private practice neurosurgeons was $1,179,259 and $2,445,953, respectively. The military neurosurgeon will have little to no medical school debt, whereas the calculated medical school debt of a nonmilitary surgeon was approximately $208,000.
authors: Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA brian.ragel@gmail.com
authors: Brian T
authors: BT
authors: Ragel
authors: Paul
authors: P
authors: Klimo
authors: Gerald A
authors: GA
authors: Grant
authors: Derek A
authors: DA
authors: Taggard
authors: David
authors: D
authors: Nute
authors: Randall R
authors: RR
authors: McCafferty
authors: Richard G
authors: RG
authors: Ellenbogen
mesh_terms: D000046:Academic Medical Centers / Q000191:economics; D002321:Career Choice; D003365:Costs and Cost Analysis; D004501:Education, Medical / Q000191:economics; D005257:Fellowships and Scholarships / Q000191:economics*; D006801:Humans; D007352:Insurance, Life / Q000191:economics; D008887:Military Medicine / Q000191:economics* / Q000193:education*; D018803:Models, Economic; D009493:Neurosurgery / Q000191:economics* / Q000193:education*; D010415:Pensions; D011331:Private Practice / Q000191:economics; D012456:Salaries and Fringe Benefits / Q000191:economics / Q000706:statistics & numerical data; D014146:Training Support