To evaluate the contribution  of neurology residents to workforce and professional charges at an academic medical center (AMC).

The Balanced Budget Act of 1997 set a cap in place for Medicare funding to reimburse institutions for costs associated with training residents. In order to meet the rising demand for physicians, institutions now bear the financial burden of training physicians. The state of Utah suffers from an above-average paucity of neurologists.

This is a retrospective cohort pilot study using financial data available from FY 2016-2018 at the University of Utah. The wRVUs and charges generated for each inpatient encounter were identified. Using a qualitative survey, the resident contribution was quantified.

During the FY 2016-2018, neurology residents (n=28) were directly responsible for 104,707 wRVUs and $5,876,157 in net revenue (1 wRVU=$56.12), while rotating on the University inpatient services under direct supervision of attending physicians. Residents averaged 18 weeks/year rotating on the University inpatient services (18 ± 8.2 weeks), with the remaining weeks spent rotating at other hospitals outside the University. Residents averaged 1,950 ± 1,218 wRVU’s and $109,434± $68,354 in net revenue during those 18 weeks. This represents 26% of in-patient wRVUs generated. Retention rates of residents into fellowships and subsequent faculty positions were high as 55% of residents, and 45.1% of fellows remained employed in the Department of Neurology past their training.

Neurology residents trained at an AMC are a significant component of in-patient wRVU generation. Expanding a neurology training program may  be cost effective way for AMCs to provide care, improve access, and expand the future neurology workforce.  The importance of the resident workforce for health-system finances and medical school missions deserve a more detailed economic analysis and need to be carried out in multiple healthcare settings and systems.