ImportanceGiven that resident physician financial strain has been associated with poor outcomes, objective metrics to forecast financial well-being may be useful to (1) applicants when evaluating ophthalmology residency programs and (2) programs when determining resident benefits.ObjectivesTo determine and compare the relative value of ophthalmology resident stipends plus benefits when adjusted for cost-of-living expenses and to analyze program characteristics associated with greater resident net incomes.Design, Setting, and ParticipantsIn this cross-sectional study, the American Medical Association’s Fellowship and Residency Electronic Interactive Database was used to identify US Accreditation Council for Graduate Medical Education–accredited ophthalmology residency programs. Resident physician stipends and stipends plus benefits as well as residency program characteristics from the 2023-2024 academic year were noted for all eligible programs. The Massachusetts Institute of Technology’s Living Wage Calculator’s required annual income (RAI) was selected as a surrogate to approximate cost-of-living expenses.ExposureResidency program characteristics, including affiliation, size, ranking, presence of housing benefit, and training year.Main Outcomes and MeasuresThe primary outcome was the annual stipend plus benefits income surplus (SPBIS) for each residency program, defined as the resident’s stipend plus benefits (SPB) minus the RAI for the county in which the residency program is located. Secondary outcomes included income surplus variation by program characteristics.ResultsOf 116 ophthalmology residency programs analyzed, 37 (31.9%) were located in the Northeast, 36 (31.0%) in the South, 29 (25.0%) in the Midwest, and 14 (12.1%) in the West. The mean (SD) postgraduate year 1 resident annual SPB was $65 397 ($8205), and the median (IQR) was $63 986 ($59 992-$69 698). After adjusting for the cost of living, the mean (SD) SPBIS was $27 459 ($5734) and the median (IQR) was $27 380 ($23 625-$31 796). Annual cost-of-living expenses varied by as much as $8628 (95% CI, $6310-$10 947) and SPBIS varied by as much as $6283 (95% CI, $3367-$9198) between regions. Resident SPB increased by a mean (SD) of 3.97% (0.98%) for each subsequent training year (range, 0.93%-7.26%). Annual SPBIS increased by a mean (SD) of 9.48% (3.60%) for each subsequent training year.Conclusions and RelevanceAfter adjusting for living costs, intraregional and interregional differences in SPBIS among ophthalmology residents can vary by thousands of dollars, impacting residents’ financial security. Further discussion regarding compensation may lead to innovative strategies that aim to improve resident well-being and performance.

中文翻译：

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眼科住院医生薪酬和生活费用的地理趋势


重要性鉴于住院医生的财务压力与不良结果相关，预测财务状况的客观指标可能有助于 (1) 评估眼科住院医师项目时的申请者和 (2) 确定住院医师福利时的项目。 目的 确定和比较相对根据生活费用进行调整后，眼科住院医师津贴加福利的价值，并分析与更高的住院医师净收入相关的计划特征。设计、设置和参与者在这项横断面研究中，美国医学会的研究员和住院医师电子交互式数据库用于识别美国研究生医学教育认证委员会认可的眼科住院医师项目。所有符合条件的项目均注明了 2023-2024 学年的住院医师津贴和津贴加福利以及住院医师项目特征。麻省理工学院的生活工资计算器的所需年收入 (RAI) 被选为近似生活费用的替代指标。ExposureResidency 计划特征，包括从属关系、规模、排名、住房福利的存在和培训年份。主要成果主要成果是每个住院医师项目的年度津贴加福利收入盈余 (SPBIS)，定义为居民的津贴加福利 (SPB) 减去住院医师项目所在县的 RAI。次要结果包括按项目特征划分的收入盈余变化。 结果 在分析的 116 个眼科住院医师项目中，37 个（31.9%）位于东北部，36 个（31.0%）位于南部，29 个（25.0%）位于中西部，14 个（12.1%）位于中西部。 %）在西方。 研究生一年级住院医师年 SPB 的平均值 (SD) 为 65 397 美元 (8205 美元)，中位数 (IQR) 为 63 986 美元 (59 992 美元-69 698 美元)。调整生活成本后，SPBIS 平均值 (SD) 为 27 459 美元（5734 美元），中位数 (IQR) 为 27 380 美元（23 625 美元-31 796 美元）。各地区之间的年度生活费用差异高达 8628 美元（95% CI，6310-10 947 美元），SPBIS 差异高达 6283 美元（95% CI，3367-9198 美元）。随后的每个培训年，住院医师 SPB 平均 (SD) 增加 3.97% (0.98%)（范围为 0.93%-7.26%）。随后的每个培训年，年度 SPBIS 平均 (SD) 增加 9.48% (3.60%)。结论和相关性调整生活成本后，眼科住院医师的 SPBIS 区域内和区域间差异可能相差数千美元，影响居民的财务状况安全。关于补偿的进一步讨论可能会产生旨在改善居民福祉和绩效的创新策略。