# Artifical Salary Inflation - Doctors & Engineers **URL:** \ **Category:** Factual Questions\ **Created:** [September 29, 2011, 4:40pm UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029 "2011-09-29T16:40:03Z")\ **Posts on this page:** 8\ **Page:** 3
**Author:** ![Interconnected\_Series\_of\_Tubes](https://avatars.discourse-cdn.com/v4/letter/i/13edae/32.png) [@Interconnected\_Series\_of\_Tubes](https://boards.straightdope.com/u/Interconnected_Series_of_Tubes)\ **Post date:** [October 3, 2011, 2:21am UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/41 "2011-10-03T02:21:28Z")
How many medical school slots there are is mostly irrelevant. The real bottleneck in the supply of doctors comes from the shortage of _residency_ positions relative to national and international graduates. Residency spots are enormously expensive. No residency, no doctor. ---
**Author:** ![Grateful-UnDead](https://avatars.discourse-cdn.com/v4/letter/g/ccd318/32.png) [@Grateful-UnDead](https://boards.straightdope.com/u/Grateful-UnDead)\ **Post date:** [October 3, 2011, 2:28am UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/42 "2011-10-03T02:28:56Z")
> [@Interconnected\_Series\_of\_Tubes](#): > > How many medical school slots there are is mostly irrelevant. > > The real bottleneck in the supply of doctors comes from the shortage of _residency_ positions relative to national and international graduates. Residency spots are enormously expensive. No residency, no doctor. I have read the posts above, and doing some quick back of the envelope direct costings, I still can’t see why a medical education is so much more than any of the other sciences of engineering disciplines. What is the reason residency costs are so expensive? What are the costs involved? Has anybody ever put together a line item costing for a medical education? I’m not trying to be a jerk here, I am just curious and would like to see some numbers. ---
**Author:** ![Implicit](https://avatars.discourse-cdn.com/v4/letter/i/6a8cbe/32.png) [@Implicit](https://boards.straightdope.com/u/Implicit)\ **Post date:** [October 3, 2011, 2:20pm UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/43 "2011-10-03T14:20:29Z")
> [@Grateful-UnDead](#): > > I have read the posts above, and doing some quick back of the envelope direct costings, I still can’t see why a medical education is so much more than any of the other sciences of engineering disciplines. > > What is the reason residency costs are so expensive? What are the costs involved? > > Has anybody ever put together a line item costing for a medical education? > > I’m not trying to be a jerk here, I am just curious and would like to see some numbers. A quick google turns up this [abstract](http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102215440.html) based on data from 1990: > [@](#): > > Residency training programs differ substantially in costs and productivity across services. While residents do generate patient care, they also generate costs and may reduce the productivity of other personnel. Diseconomies of scale are found for residents in medicine and surgery; economies of scale are found in psychiatry. Evaluated at the means of teaching facilities, the marginal cost of a surgical resident is $252,361, of a psychiatric resident is $138,811, and of a medical resident is $90,525. ---
**Author:** ![suranyi](https://avatars.discourse-cdn.com/v4/letter/s/e36b37/32.png) [@suranyi](https://boards.straightdope.com/u/suranyi)\ **Post date:** [October 3, 2011, 5:12pm UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/44 "2011-10-03T17:12:48Z")
> [@Grateful-UnDead](#): > > I have read the posts above, and doing some quick back of the envelope direct costings, I still can’t see why a medical education is so much more than any of the other sciences of engineering disciplines. > > What is the reason residency costs are so expensive? What are the costs involved? > > Has anybody ever put together a line item costing for a medical education? > > I’m not trying to be a jerk here, I am just curious and would like to see some numbers. It’s not the medical education that costs so much, it’s the medical school – if you want to create more of them. A medical school requires a hospital. (The residency positions require hospitals even more directly.) A modern medical school requires a modern hospital. A hospital is far more expensive to build than any engineering lab. ---
**Author:** ![california\_jobcase](https://avatars.discourse-cdn.com/v4/letter/c/9d8465/32.png) [@california\_jobcase](https://boards.straightdope.com/u/california_jobcase)\ **Post date:** [October 3, 2011, 5:18pm UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/45 "2011-10-03T17:18:47Z")
There are many more hospitals in the U.S. than there are med schools. How much of a difference is there between a regular modern hospital and one attached to a medical school? ---
**Author:** ![Implicit](https://avatars.discourse-cdn.com/v4/letter/i/6a8cbe/32.png) [@Implicit](https://boards.straightdope.com/u/Implicit)\ **Post date:** [October 3, 2011, 5:41pm UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/46 "2011-10-03T17:41:10Z")
> [@california\_jobcase](#): > > There are many more hospitals in the U.S. than there are med schools. How much of a difference is there between a regular modern hospital and one attached to a medical school? Many private hospitals aren’t comprehensive enough, even within a speciality, and can’t expose new doctors to everything they need to learn. Not to mention there needs to be funding from somewhere and staff that can and will teach, many doctors choose non-teaching hospitals specifically to avoid that. ---
**Author:** ![KarlGrenze](https://avatars.discourse-cdn.com/v4/letter/k/dbc845/32.png) [@KarlGrenze](https://boards.straightdope.com/u/KarlGrenze)\ **Post date:** [October 3, 2011, 6:47pm UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/47 "2011-10-03T18:47:11Z")
Note that some hospitals may be affiliated with more than one school or may accept students from more than one medical school in their clinical rotations. IIRC, that’s how some of the so-called Caribbean schools and other smaller medical schools work (and also how different students from different schools get externships and experiences outside of their “home” medical school). ---
**Author:** ![BlinkingDuck](https://avatars.discourse-cdn.com/v4/letter/b/eada6e/32.png) [@BlinkingDuck](https://boards.straightdope.com/u/BlinkingDuck)\ **Post date:** [October 3, 2011, 7:13pm UTC](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029/48 "2011-10-03T19:13:25Z")
> [@BubbaDog](#): > > I don’t dispute your claim but it reminded me of a discussion I had once with a friend who gave me an example of proof that the reverse is sometimes true. > > He told me that his brother-in-law was a very sober individual because he was a heart surgeon who lost 75% of his patients soon after operating. The effect of so many people dying under his hands made it difficult for him to socialize on some days so he spent a lot of time alone reading or playing solitaire. > > I commented to my friend that maybe his BIL should not be doing surgery if he was so bad at it. > > His reply was something like, “No, you don’t understand. He’s such a good surgeon that he only performs the most difficult of surgeries that other surgeons won’t or can’t perform. In essence, he saves 1 in 4 people who are clearly medically marked for death.” THAT is a man for whom I’d like to buy a drink. He really, really needs an attitude adjustment though…one that says having 3 out of 4 die on you makes you feel good. I know, easy for me to say…but he really needs to feel good about what he is doing…and he should. [Previous page](https://boards.straightdope.com/t/artifical-salary-inflation-doctors-engineers/598029.md?page=2)