People are sitting here acting like the difference in say 35 years vs of attending salary vs 36 years of attending salary has any bearing or significance. It's largely irrelevant to your decision. No one's life and future after they are gone is dictated by a years worth of attending salary. No one knows when they will retire or one of many life's major occurences pops up in an unexpected way. Don't look at this like "I'm losing 100K because the research pays 90K vs an attending salary of 190K". Plus when you are of age for retirement, will having that extra year of attending salary(lets say only career salary of 4.5 million vs 4.7 million as an ex) have any real bearing on your life, your familys life and their future family? For a number of physicians(including the ones in my extended family who are doctors) the answer is without question no.In fact, there are quite a number of physicians of all ages I know who would argue the opposite; they wish they had time to take a gap year or two in hindsight(back when it was alot less common) and think it would have been great for them.
People don't take gap years to try and make significant money. They take gap years to build invaluable experiences, take a breather from studies and most importantly do things they'll never have quite the opportunity to again in their life as well as experiencing their young and mid 20's(which is experienced differently when studying 80 hours a week in a dark library). If someone wants to gap years, the financial hit of only having 35 years of attending salary vs 36 is the last thing in the world to think about. Because if money is something that is that much of a concern to you and where that extra 200K when you retire is that important(and in some situations it might be I'm not trying to say it NEVER in any situation is), choosing a career where you aren't going to make significant money for another 10 years or so might not be the right way to go about life to say the least.
The only thing I'll say is there are those in financially hard times right now who need to start the process ASAP to start making money to pay off family loans and other various debts and expenses. Those are people who should consider the financial hit of a gap year. Is this your situation OP? And if it is, do you think the 90k you make in the next year will be of significant benefit to your family vs not making any money while in school but getting an attending's salary and residents salary a year earlier? That's really the time I would ever consider the financial hit of a gap year.
Check your motivations for wanting do this job. It is a once in a life time opportunity. It happens to pay well so when you have down time you can spend rather lavishly. There are many things to gain from it. There are also negatives of it but the whole losing one year of attending physician's salary should not be one of them worth much thought.
