There are lots of reasons doctors do post-residency fellowships. They might be fascinated with a particular organ system, for example. But humans are often motivated by cold hard cash, so it's probably worth figuring out whether all those extra years of training will pay off in ... pay.
Thanks to the , we have data on how much doctors earn on average, by specialty. A new study digs into that data, and AAMC numbers, to calculate not only how much physicians make, but how much they sacrifice by completing fellowships.
The is limited because it looked at only about 15 scenarios, including four in which being an academic was the variable. It also makes a number of assumptions, as economics studies are wont to do. So treating it as hypothesis-generating is probably wise.
Still, this passage caught my eye:
"With respect to fellowship training, the cost of these programs is significant and the return is not necessarily positive. For those pursuing a fellowship in an internal medicine subspecialty, the net value of a fellowship is higher than that of a surgical fellowship. From a purely financial standpoint, fellowships in pediatric urology and colorectal surgery were among the most expensive and had the least value-added to a career financially. While salary data were only available for pediatric urology it is reasonable to extrapolate this principle to other subspecialties in urology."
Those conclusions are based on the study's findings that while a urologist in private practice can expect to make about $3.5 million over a career, a pediatric urologist can expect to make less, about $2.9 million.
A general surgeon in private practice can expect about $3.4 million, a vascular surgeon about $3.6 million, but a colorectal surgeon about $3.1 million.
Figures for internists are quite different from those for cardiologists: $2.2 million vs. $3.8 million. And oncologists can expect to make about $3.5 million.
While a different order of magnitude, those numbers bring to mind that old , "A billion here, a billion there, and pretty soon you're talking real money."