Diminishing Returns: An Analysis of Surgeon Compensation in the Setting of Ever-Increasing Student Debt.

Background: The knowledge required to manage surgical patients has expanded considerably during the past 40 years. Simultaneously, the cost of medical education has increased substantially. Surgical trainees are at a particular disadvantage due to the time demands of training. We aim to determine whether surgeon compensation over time has adequately accounted for increasing student debt burden.

Study Design: We conducted a retrospective review of data on surgeon salaries and medical education debt from the Medical Group Management Association and Association of American Medical Colleges (2014 to 2019). Inflation adjustment was performed using the consumer price index calculator from the US Bureau of Labor and Statistics. Outcomes of interest included trends in debt, salaries, and the debt-to-income ratio.

Results: The median salary for a general surgeon in 1984 was $111,287, and median medical school debt was $22,000, corresponding to a salary of $274,900 and $54,344 in 2019, respectively, representing a 147% increase. The reported median salary for a general surgeon in 2019 was $350,000 (214.5% increase), and medical school debt was $200,000 (809% increase). The debt-to-income ratio increased from 0.2 in 1984 to 0.57 in 2012 and has remained stable since that time. Direct comparison of loan burden and salary reveals that although medical school debt has increased by 268% in the past 40 years, surgeon salaries have increased as well, but not nearly to the same degree (27.3%).

Conclusions: The rate of debt accumulation has outpaced the rate of salary growth for general surgeons to a significant degree.