Purpose. To demonstrate the usefulness of self-reported cost-accounting dat
a from the sponsors of training programs for estimating the direct costs of
graduate medical education (GME). The study also assesses the relative con
tributions of resident, faculty, and administrative costs to primary care,
surgery, and the combined programs of radiology, emergency medicine, anesth
esiology, and pathology (REAP).
Method. The data were the FY97 direct costs of clinical education reported
to Minnesota's Department of Health by eight sponsors of 117 accredited med
ical education programs, representing 394 sites of training (both hospital-
and community-based) and 2,084 full-time equivalent trainees (both residen
ts and fellows). Average costs of clinical training were calculated as resi
dency, faculty, and administrative costs. Preliminary analysis showed avera
ge costs by type of training programs, comparing the cost components for su
rgery, primary care, and REAP.
Results. The average direct cost of clinical training in FY97 was $130,843.
Faculty costs were 52%, resident costs were 26%, and administrative casts
were 20% of the total. Primary care programs' average costs were lower than
were those of either surgery or REAP programs, but proportionally they inc
luded more administrative costs.
Conclusions. As policymakers assess government subsidies for GME, more deta
iled cast information will be required. Self-reported data are more cast ef
fective and efficient than are the more detailed and costly time-and-motion
studies. This data-collection study also revealed that faculty costs, driv
en by faculty hours and base salaries, represent a higher proportion of dir
ect costs of GME than studies have shown in the past.