Income differentials required to make fellowship training in female pelvic medicine and reconstructive pelvic surgery financially neutral

We used standard financial techniques and a return-on-educational-investment model to calculate the required annual income necessary to render additional fellowship training in female pelvic medicine and reconstructive pelvic surgery financially neutral. To explore a range of potential outcomes, we conducted a sensitivity analysis that used various discount rates and retirement ages. Compared to obstetrics/gynecology residents who go directly into private practice, residents who pursue fellowship training in female pelvic medicine and reconstructive pelvic surgery experience a financial loss of more than $400,000 to $600,000, assuming there is no income differential after fellowship. To render the additional training financially neutral requires an annual income that is 16-31% higher than that of general obstetrician/gynecologists. Required additional annual income was on the lower end of this spectrum when modeling later retirement age estimates and using lower discount rates. Fourth year obstetrician/gynecology residents considering female pelvic medicine/reconstructive surgery require higher incomes over the working lifetime to render fellowship training financially neutral.