Projected Lifetime Salary Compensation Between Academic and Non-Academic Careers in Orthopaedic Trauma Surgery

OBJECTIVES: To compare the projected lifetime salary compensation of orthopaedic trauma surgeons in academic versus non-academic practice settings. METHODS: This was a net present value (NPV) financial analysis and Monte Carlo simulation. Data were obtained for academic and non-academic orthopaedic trauma surgeons in the 2025 American Medical Group Association (AMGA) and Medical Group Management Association (MGMA) salary surveys. Lifetime salary compensation assuming different career lengths, discount rates, and career trajectories were compared between academic and non-academic practices. RESULTS: Compensation per wRVU was consistently lower (range, 20.5%-23.5%) in academia across MGMA percentile benchmarks. With MGMA benchmarks, academic practice had lower lifetime salary compensation than non-academic practice for fixed salaries at the 25th percentile ($10.6 million vs $13.9 million, 23.7% lower), at the 50th percentile ($13.7 million vs $16.6 million, 17.5% lower), and at the 75th percentile ($18.4 million vs $19.7 million, 6.6% lower). Academic orthopaedic trauma surgeons required 4 to 24 additional years based on MGMA benchmarks and 5 to 8 additional years based on AMGA benchmarks to reach parity in lifetime salary compensation with non-academic orthopaedic trauma surgeons. CONCLUSIONS: Academic orthopaedic trauma practice was associated with lower lifetime salary compensation than non-academic practice. The gap was driven by lower compensation per wRVU and not by differences in clinical productivity.