That doesn't take into account many other variables at play. This experience will change him and change the choices he would have made. He may develop greater maturity, humility and discretion as a result of this incident. Personal growth and improved decision-making have value which could lead to higher income potential,but could also lead to better outcomes in all aspects of his life. The additional year also means an additional year for application preparation.He may end up at a better school, one with better alum connections or better rotations thus leading to a better residency and more rewarding career. At a minimum, if the maturation and development time he has gained result in an increase in starting salary of just 15k, then over the course of 30 yrs that's an extra 450k, 200k more than the 250k in a lost year of income.