Going for Broke

Abstract

Objective: The objective of this study was to provide a direct comparison of first-year general surgery resident stipends across states and major cities, using the Cost-of-Living Index (COLI) to determine stipend value. Background: Financial challenges are among residents' top sources of stress, and this may be exacerbated in areas with high costs of living. A 2021 survey found that the mean first-year medical resident stipend increased by 0.6%, or $358, from 2020 to 2021, and only 33% of institutions used cost-of-living to determine annual resident stipend adjustments. Methods: An American Medical Association database was used to identify accredited general surgery residency programs. The 2021-2022 stipend data for first-year general surgery positions were obtained, then data were grouped by state and major city and averaged. Major cities were defined as cities with > 4 programs. A direct comparison of stipends was performed using the COLI. Results: Stipend data were available for 337 of 346 general surgery programs.

Graduate Medical Education Financing in the US Department of Veterans Affairs

“…The VA process accounts for local variation in salary rates, whereas the perresident amount set by CMS varies regionally and does not fully account for differences in the cost of living. 24 Because all patients in VA facilities are veterans, VA calculations for reimbursement do not involve ratios of beds like the CMS calculations to determine a proportional share of reimbursement. The VA GME expansion tends to be more directed to VA health workforce needs than CMS, specifying the types of programs and geographic locations to address these needs.…”

“…12 The per-resident amount is set by statute, varies geographically, and is calculated by dividing the hospital' s allowable costs of GME (percentage of CMS inpatient days) divided by the number of residents. 12,24 By comparison, the VA GME payment…”