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Minimum Instructional and Program-Specific Administrative Costs of Educating Residents in Internal Medicine
Thomas J. Nasca, MD;
J. Jon Veloski, MS;
John A. Monnier, MBA, CPA;
Joseph P. Cunningham, CPA;
Stephen Valerio, MBA;
Thomas J. Lewis, MHA;
Joseph S. Gonnella, MD
Arch Intern Med. 2001;161:760-766.
Background The cost associated with education of residents is of interest from
an educational as well as a political perspective. Most studies report a single
institution's actual incurred costs, based on traditional cost accounting
methods. We quantified the minimum instructional and program-specific administrative
costs for residency training in internal medicine.
Methods Using the Accreditation Council for Graduate Medical Education program
requirements for internal medicine as minimum standards for teaching and administrative
effort, we quantified the minimum instructional and administrative costs for
sponsorship of an accredited residency program in internal medicine. We also
analyzed the impact of resident complement and program curricular emphasis
(outpatient, inpatient, or traditional) on the per-resident cost. The main
outcome measure was the minimum annual per-resident cost of instruction and
program-specific administration.
Results Using the assumptions in this model, we estimated the annual cost per
resident of implementing the program requirements to be $50 648, $35 477,
$28 517, and $26 197 for inpatient intensive residency programs
with resident complements of 21, 42, 84, and 126, respectively. For outpatient
intensive residency programs of identical resident complements, we estimated
the annual per-resident cost to be $58 025, $42 853, $35 894,
and $33 574 for similar resident complements. Fixed costs mandated by
the program requirements, which did not vary across program size or configuration,
were estimated to be $640 737.
Conclusions There are fixed and variable costs associated with sponsorship of accredited
internal medicine residency programs. The minimum cost per resident of education
and departmental administration varies inversely with program size within
the sizes examined.
From the Department of Medicine (Drs Nasca and Gonnella) and Center
for Research in Medical Education and Health Care (Drs Nasca and Gonnella
and Messrs Veloski and Monnier), Jefferson Medical College; Thomas Jefferson
University Hospital (Dr Nasca and Messrs Cunningham and Lewis); and Jefferson
University Physicians (Drs Nasca and Gonnella and Mr Valerio), Philadelphia,
Pa.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
A New Model for Accreditation of Residency Programs in Internal Medicine
Goroll et al.
ANN INTERN MED 2004;140:902-909.
ABSTRACT
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