Time is money: The return on investment of research in surgical training: The ROI of research in surgical training

Future income potential can impact surgical trainees' career choices, particularly when deciding to subspecialize, which often requires additional training and research time. This study quantifies the effects of added time on career value for eight surgical subspecialties. The Net present value(NPV) was calculated for eight subspecialties and general surgery over a 35-year career, factoring in salary, educational debt, tax, inflation, and practice setting. NPV for each was compared over a number of research years (0, 1, 2) using data from the MGMA, AAMC, and US government records. After a 35-year career, six subspecialties in private practice increased career NPV(>$14,000) with 0 research years. One additional research year yielded negative career values for transplant, trauma, and vascular; with two, only cardiovascular and pediatric retained a positive NPV. In academia, 1-2 research years resulted in negative NPV for all but cardiovascular and thoracic surgery. The financial return of additional training years is highly variable.