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.
Address reprint requests to: Tracy Flanagan, MD, Department of Obstetrics, Gynecology, and Reproductive Sciences, 400 Parnassus, Box 0346, University of California–San Francisco, San Francisco, CA 94143–0346
© 1995 The American College of Obstetricians and Gynecologists