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Background <p>Cost of living is one of the key factors in residency selection among U.S. medical graduates, given rising student loan debt. No studies have investigated anesthesiology stipends relative to regional cost of living. This study aimed to compare anesthesiology resident stipends nationwide using the Cost-of-Living Index (COLI) to assess purchasing power.</p> Methods <p>The AAMC directory was queried to obtain accredited anesthesiology residency programs for the 2024–2025 academic year. CA1 (post graduate year 2) stipends were collected via internet search and residency programs were assigned to metro areas using region specific COLI metrics. City, state, geographic region, and reputation ranking were recorded and absolute and relative discrepancies were calculated.</p> Results <p>Of 174 anesthesiology residency programs, 118 (67.8%) were analyzed. The national average CA-1 stipend was $70,757 ± $9,718, with medians of $66,137 in low COLI areas and $74,046 in high COLI areas (median difference $7,909, [95% CI $5,969-$12,728, <i>p</i> &lt; 0.001]. California showed the largest adjusted deficit (-$26,969, -30.98%), whereas Oklahoma had a $13,096 surplus (+ 21.00%). In the 10 major cities, average stipends decreased from $76,052 ± $10,860 to $59,499 ± $11,252 after COLI adjustment (-21.8%, <i>p</i> &lt; 0.001). The absolute discrepancy between small and medium programs was not significant (-$3,498, <i>p</i> = 0.19), while large programs faced a 12.82% shortfall ($9,742) despite higher unadjusted salaries. Among the top 12 programs based on reputation ranking, stipends were higher in high COLI regions with half showing &gt; 30% loss after COLI adjustment.</p> Conclusions <p>Anesthesiology residency stipends showed substantial variation after adjusting for regional cost of living, with many high COLI areas experiencing marked reductions in real purchasing power.&#xa0;Given rising educational debt, applicants should consider COLI adjusted stipends when evaluating programs to better assess regional affordability and financial impact.</p> Trial registration <p>N/A.</p>

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Cost of living and its effect on anesthesiology resident stipends across the United States

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月17日

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  • Benjamin H. P. Corman,
  • Mark C. Kendall,
  • Christopher Malgieri,
  • Merrill Caramagno,
  • Gildasio De Oliveira

摘要

Background

Cost of living is one of the key factors in residency selection among U.S. medical graduates, given rising student loan debt. No studies have investigated anesthesiology stipends relative to regional cost of living. This study aimed to compare anesthesiology resident stipends nationwide using the Cost-of-Living Index (COLI) to assess purchasing power.

Methods

The AAMC directory was queried to obtain accredited anesthesiology residency programs for the 2024–2025 academic year. CA1 (post graduate year 2) stipends were collected via internet search and residency programs were assigned to metro areas using region specific COLI metrics. City, state, geographic region, and reputation ranking were recorded and absolute and relative discrepancies were calculated.

Results

Of 174 anesthesiology residency programs, 118 (67.8%) were analyzed. The national average CA-1 stipend was $70,757 ± $9,718, with medians of $66,137 in low COLI areas and $74,046 in high COLI areas (median difference $7,909, [95% CI $5,969-$12,728, p < 0.001]. California showed the largest adjusted deficit (-$26,969, -30.98%), whereas Oklahoma had a $13,096 surplus (+ 21.00%). In the 10 major cities, average stipends decreased from $76,052 ± $10,860 to $59,499 ± $11,252 after COLI adjustment (-21.8%, p < 0.001). The absolute discrepancy between small and medium programs was not significant (-$3,498, p = 0.19), while large programs faced a 12.82% shortfall ($9,742) despite higher unadjusted salaries. Among the top 12 programs based on reputation ranking, stipends were higher in high COLI regions with half showing > 30% loss after COLI adjustment.

Conclusions

Anesthesiology residency stipends showed substantial variation after adjusting for regional cost of living, with many high COLI areas experiencing marked reductions in real purchasing power. Given rising educational debt, applicants should consider COLI adjusted stipends when evaluating programs to better assess regional affordability and financial impact.

Trial registration

N/A.