Training decision tool
What does one more training year actually cost?
Every fellowship trades a year (or three) of attending income for a different career. This tool prices that trade for any specialty: the opportunity cost, the breakeven point, and what the difference is worth over a whole career. Using the same labeled income models as the path pages.
Baseline = General Anesthesia / Pain (~$525,000/yr, modeled generalist from General Anesthesia). This tool answers: does subspecializing in Interventional Pain out-earn just practicing general Anesthesia / Pain?
PSLF interaction: if fellowship employment and payments qualify, this adds about 12 more qualifying payments toward the 120-payment PSLF clock. Model the loan side in the Loan Repayment tool.
The headline
Foregoing ~$440,000 of attending income breaks even in about 7.3 years of practice.
General Anesthesia / Pain models ~$525,000/yr vs Interventional Pain at ~$585,000/yr (midpoints of the same modeled ranges shown on the path pages), against a ~$85,000 fellowship stipend. Modeled estimates with confidence labels. Verify against real offers and mentors, and weigh the non-financial reasons that usually decide fellowships.
The full ROI model. Every path, your horizon.
Opportunity cost, invested-difference advantage over your chosen horizon and return rate, and a ranked ROI table across every path in the specialty.
Common questions
Where do the income figures come from?
The midpoints of the same modeled income ranges shown on every DoctorCalculator path page. Hand-authored models with confidence labels, informed by public data. They are modeled estimates, never salary promises; verify against real offers and mentors.
How is breakeven calculated?
Opportunity cost (baseline attending income minus a ~$85k fellowship stipend, times fellowship years) divided by the annual income delta of the fellowship path. The premium view adds an invested-difference model: the money the baseline banks early compounds at your chosen return rate.
My fellowship path models LOWER income. Is that a mistake?
No. Several fellowships (e.g. academic-leaning subspecialties) model below their generalist baseline. The tool says so plainly: the ROI case must then be non-financial: case mix, academics, lifestyle, or identity.
Does this include private-practice ownership upside?
The baseline uses each path's modeled base range midpoint. Ownership and production upside vary enormously by market. Pressure-test them with the path pages, the RVU calculator, and your report.