Assessing the cost of a cardiology residency program with a cost construction model

Background Although the total costs of graduate medical education are diffi cult to quantify, this information is of great importance in planning over the next decade. Methods and Results A cost construction model was used to quantify the cost s of teaching faculty, cardiology fellows' salaries and benefits, overhead (physical plant, equipment, and support staff), and other costs associated with the cardiology residency program at the University of Texas-Houston du ring the 1996 to 1997 academic year. Surveys of cardiology faculty and fell ows, checked by the program director, were conducted to determine the time spent in teaching activities; access to institutional and departmental fina ncial records was obtained to quantify associated costs. The model was then developed and examined for a range of assumptions concerning cardiology Fe llows' productivity, replacement costs, and the cost allocation of activiti es jointly producing clinical care and education. The instructional cost of training (cost of didactic, direct clinical supervision, preparation for t eaching, and teaching-related administration, plus the support of the teach ing program) was estimated at $73,939 per cardiology fellow per year. This cost was less than the estimated replacement value of the teaching and clin ical services provided by cardiology fellows, $100,937 per cardiology fello w per year. Sensitivity analysis, with different assumptions on cardiology fellows' productivity and replacement costs, varied the cost estimates but generally represented the cardiology residency program as an asset. Conclusions cost construction models can be used as a tool to estimate vari ations in resource requirements resulting from changes in curriculum or edu cators' costs. In this residency, the value of the teaching and clinical se rvices provided by cardiology fellows exceeded the cost of the resources us ed in the educational program.