Self-subsidization of educational expenses by senior radiology residents

The purpose of this study is to document the degree of self-subsidization of educational expenses by senior radiology residents.

Questionnaires were distributed to all radiology residents (n = 176) attending the New Jersey Medical School board review course held twice in 2006. Respondents (n = 175) documented the number and source of financial support for review courses they had or would attend, including the AFIP course in radiologic pathology. They also listed the amount of additional financial allowances paid to them by their programs and cited the funding source for the radiology board examinations.

Average AFIP expenditure, including tuition, room, board, and travel, equaled 3,969 dollars +/- 45 dollars, of which 46% was paid by the residents themselves. The respondents attended, on average, two review courses costing 4,116 dollars +/- 149 dollars, bearing 77% of the costs. The average additional allowance paid to residents was 1,938 dollars +/- 156 dollars. Total board expenditures of 3,120 dollars, including fees and travel, were borne entirely by the residents. Total out-of-pocket expenses for these activities was 7,928 dollars +/- 165 dollars, which amounted to 16% of senior residents' average annual salary (49,746 dollars).

The desire by both programs and trainees for success on the radiology board examination has stimulated the growth of review courses. The enduring popularity of the AFIP course has made this activity an essential rotation for most radiology residency programs. Each of these off-site opportunities incurs significant financial obligations to residents, and when added to the cost of the board exams, equals 16% of their average annual salary. Thus radiology residents are subsidizing their education to a considerable degree relative to their salaries. This study reveals that senior radiology residents significantly subsidize their education and bear the burden of hidden costs associated with their training.