Net present value analysis of total salary compensation in hand surgery: academic versus non-academic careers

This is the authors' abstract. We don't add key points for this paper.

Purpose Studies comparing salary compensation of hand surgeons in different practice settings have been limited. This study compared projected lifetime salary compensation between academic and non-academic hand surgeons. Methods Compensation data were sourced from the 2025 Medical Group Management Association (MGMA) and American Medical Group Association (AMGA) salary benchmarks. Net present values of theoretical career paths in hand surgery were calculated assuming a 32-year career and a 3% discount rate. Sensitivity analyses were performed with variable discount rates and career lengths. Monte Carlo simulations were performed. Results Academic practice demonstrated lower lifetime salary compensation than non-academic practice across career trajectories, sensitivity analyses, and Monte Carlo simulations using MGMA data with minimal differences using AMGA data. With MGMA, academic practice ($12.6 million) resulted in 19.7% lower lifetime salary compensation than non-academic practice ($15.7 million). With AMGA, academic practice ($15.0 million) resulted in 2.7% higher lifetime salary compensation than non-academic practice ($14.6 million). Monte Carlo simulations demonstrated lower lifetime salary compensation for academic practice with MGMA ($12.9 million versus $16.0 million, 19.4% difference, P < 0.001) but comparable compensation with AMGA data ($15.1 million versus $15.0 million, 0.7% difference, P = 0.182). Conclusion Hand surgeons in academic practice demonstrated lower lifetime salary compensation than their non-academic counterparts using MGMA data and similar compensation using AMGA data. While compensation alone does not fully capture the complexity of career decision making, this study may be useful to future hand surgeons and service line leaders.