A cost analysis of an introduction to clinical medicine course in a non-university teaching hospital

Purpose. To determine the major direct costs associated with teaching the Introduction to Clinical Medicine (ICM) course at a non-university teaching hospital. Method. The major direct costs were calculated for ICM, a ten-week course taught at the Columbia Michael Reese Hospital and Medical Center, a non-university teaching hospital, to second year students from the University of Illinois College of Medicine at Chicago. The major components of ICM are physical diagnosis, clinical pathology, and radiology, as well as some pediatrics; the bulk of the costs for these components is incurred for physician staff time. Physician time was reported by component coordinators, who also estimated preparation and teaching times. Physician cost per hour was chosen as that equivalent to assistant professors' salaries. Resident cost per hour was determined from the average resident salary at the hospital. Miscellaneous direct costs (of basic life-support certification, gift certificates, and standardized patients) were calculated from the receipts and bills submitted for payment. In the spring of 1995 the hospital conducted ICM for 26 students. Results. The attending physicians worked a total of 736.5 hours, for a cost of $37,303. The residents worked a total of 314 hours, for a cost of $4,396. Miscellaneous costs totaled $2,019. The total of these major direct costs was $43,718, or $1,681 per student. Conclusion. These results can help medical educators and policymakers as they investigate innovative teaching methods and funding sources.