Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery?

Impact of Integrated Vascular Surgery Residency Training Pathway and Professional Development Time on Career Choice and Research Productivity

OBJECTIVE

The limited availability of academic surgery positions has led to increased competition for these jobs. Integrated vascular surgery residency (IVSR) allows for earlier specialization, with some programs providing professional development time (PDT). We hypothesized that IVSR and PDT lead to academic employment and increased research productivity.

DESIGN

This is a retrospective study of vascular surgery fellowship (VSF) and IVSR graduates.

SETTING

Training, number of publications, H-index, NIH funding, and employment history were collected using institutional websites, Doximity, Scopus, PubMed, and NIH Research Portfolio Reporting.

PARTICIPANTS

After a review of the research protocol, the Association of Program Directors in Vascular Surgery (APDVS) provided a list of vascular surgery fellowship (VSF) and IVSR graduates.

METHODS

After review of the research protocol, the Association of Program Directors in Vascular Surgery (APDVS) provided a list of vascular surgery fellowship (VSF) and IVSR graduates. Training, number of publications, H-index, NIH funding, and employment history were collected using institutional websites, Doximity, Scopus, PubMed, and NIH Research Portfolio Reporting.

RESULTS

From 2013-2017, comparison of IVSR (n=131) to VSF (n=603) graduates showed that IVSR graduates were more likely to be women (38.17% vs 28.19%; p = 0.024), be MD graduates (99.24% vs 93.37%; p = 0.008), attended programs in the northeast (41.98% vs 27.5%; p < 0.001), have advanced degrees (13.74% vs 6.97%; p = 0.01) and graduate from larger programs (median 15 vs 14 faculty; p = 0.013). There was no significant difference in number of publications per trainee by the end of training (median 4 vs 3; P=0.61) or annual trend in average number of publications. After training, there was no significant difference in the type of practice, academic affiliation, practice region, publication number, H-index, NIH funding, level of academic appointment, or leadership positions. From 2013-2019, a comparison of IVSR graduates with (n=32) and without PDT (n=190) demonstrated that those with PDT were more likely to be women (53.13% vs 34.74%; p = 0.038), have advanced degrees (28.12% vs 8.95%; p = 0.002), be at larger programs (median 14 vs 9 faculty; p < 0.001), train at a top 10 NIH funded program (65.62% vs 21.58%; p < 0.001) and publish more by the end of IVSR (median 9 vs 3; p < 0.001). Graduates with PDT were more likely to have academic employment and affiliation, a higher yearly publication rate, and greater H-index.

CONCLUSION

IVSR and VSF graduates have comparable academic employment and research productivity. However, PDT during IVSR correlates with an eventual academic career and greater research productivity. This study supports the importance of PDT in developing academic vascular surgeons. It remains necessary to continue both IVSR and VSF training paradigms as healthcare needs of the population are met through both academic and non-academic surgeons.

Funding a general surgery residency academic development time program

BACKGROUND

To encourage progression of surgeon scientists amongst increasingly limited funding, academic interest, training institutions are supporting mid-training academic development time (ADT). We propose that supporting ADT with a full funding mechanism will improve ADT participation at minimal institutional cost.

MATERIALS AND METHODS

From 2017 to 2022, our surgery department proposed a full funding mechanism for a post-graduate year three (PGY-3) resident to encourage ADT participation. Residents were required to submit at least two external grants. Annual funding sources and total stipend supplementation was calculated by prevalence of ADT residents.

RESULTS

From 2017 to 2022, 30 residents opted to participate in 1-4 years of ADT with increasing prevalence. 5 funding sources were utilized with ∼$530,000 in total annual funding. Departmental contribution was minimal compared to external (9% vs. 91% ($48,102 vs. $485,573, p ​< ​0.001)).

CONCLUSIONS

With commitment of full salary supplementation, residents choosing ADT increased at marginal institutional cost, suggesting a solution to combating the declining number of academic surgeons.

Strengthening the clinical academic pathway: a systematic review of interventions to support clinical academic careers for doctors and dentists

OBJECTIVE

Evaluate existing evidence on interventions intended to increase recruitment, retention and career progression within clinical academic (CA) careers, including a focus on addressing inequalities.

DESIGN

Systematic review.

DATA SOURCES

Medline, Embase, Cochrane Controlled Register of Trials, PsycINFO and Education Resource Information Center searched October 2019.

STUDY SELECTION

Eligible studies included qualified doctors, dentists and/or those with a supervisory role. Outcomes were defined by studies and related to success rates of joining or continuing within a CA career.

DATA EXTRACTION AND SYNTHESIS

Abstract screening was supported by machine learning software. Full-text screening was performed in duplicate, and study quality was assessed. Narrative synthesis of quantitative data was performed. Qualitative data were thematically analysed.

RESULTS

148 studies examined interventions; of which 28 were included in the quantitative synthesis, 17 in the qualitative synthesis and 2 in both. Studies lacked methodological rigour and/or were hindered by incomplete reporting. Most were from North America. No study included in the syntheses evaluated interventions aimed at CA dentists.Most quantitative evidence was from multifaceted training programmes. These may increase recruitment, but findings were less clear for retention and other outcomes. Qualitative studies reported benefits of supportive relationships, including peers and senior mentors. Protected time for research helped manage competing demands on CAs. Committed and experienced staff were seen as key facilitators of programme success. Respondents identified several other factors at a programme, organisational or national level which acted as facilitators or barriers to success. Few studies reported on the effects of interventions specific to women or minority groups.

CONCLUSIONS

Existing research is limited by rigour and reporting. Better evaluation of future interventions, particularly those intended to address inequalities, is required. Within the limits of the evidence, comprehensive multifaceted programmes of training, including protected time, relational and support aspects, appear most successful in promoting CA careers.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework: https://osf.io/mfy7a.

Trends in Matriculation from Neurological Surgery Training Programs into Academic Versus Private Practice

OBJECTIVE

A career in academic neurosurgery is an arduous endeavor. Specific factors influencing physician practice preferences remain unclear. This study analyzes data from the American Association of Neurological Surgeons membership identifying the impact of several demographic and educational characteristics influencing neurosurgical career choices centered on academia, private practice, or a combination in the United States.

METHODS

A list of all current neurosurgeons was obtained from the American Association of Neurological Surgeons membership, and information on physician characteristics was collected via internet searches and institutional databases. The practice type of all neurosurgeons considered in this study were categorized as follows: private practice, academic, or a combination of private practice and academic, termed privademic. These data were subsequently correlated to race, gender, current age, training at a top 40 National Institutes of Health-funded medical school or residency program, and current practice.

RESULTS

The median age of private practice and academic neurosurgeons was 58.18 and 53.61 years, respectively (P < 0.001). Age was significantly associated with practicing in an academic setting (odds ratio 0.96), with younger neurosurgeons pursuing careers in academia. Data indicated a positive and statistically significant contribution of female gender (P < 0.001) and training at a top-40 National Institutes of Health-funded institution to practicing in an academic setting (P < 0.01).

CONCLUSIONS

Neurosurgery as a field has grown significantly over the past century. The authors recommend that future efforts seek to diversify the neurosurgical workforce by considering practice setting, demographic characteristics, and educational background.

Impact of Research Training on Performance in General Surgery Residency

INTRODUCTION

It is common for North American surgical trainees to interrupt clinical training to complete 2 or more years of research training. The impact of this practice on surgical aptitudes is unknown. The University of Toronto has large general surgery and surgeon scientist training programs. We compared the examination scores of general surgery residents in continuous clinical training with those of residents whose training was interrupted by research.

METHODS

We collected anonymized scores obtained at written and oral annual in-training examinations by general surgery residents at the University of Toronto from 2011 to 2016, inclusive. The written exam assessed knowledge, while the oral exam assessed judgment. Residents were dichotomized into continuous versus non-continuous clinical training streams. We compared performance prior to, during, and following divergence for research training both within and between the 2 groups.

RESULTS

At the junior resident level, future enrollment in research training was associated with higher examination performance (P_written = .003). Annual scores plateaued during research training, while scores of residents who continued in continuous clinical training improved year over year (P_written = .009). Non-continuous stream resident exam scores remained stagnant after 1 year then improved in the second year after return to clinical training (P_written = .00007). Scores obtained in the final year of residency training did not significantly differ between residents who underwent continuous versus non-continuous clinical training. Results from written and oral exams trended concordantly.

CONCLUSIONS

We demonstrate that interruption of clinical training for 2 or more years of research is associated with a stagnation of performance on annual in-training examinations assessing both knowledge and judgment. This phenomenon is followed by an eventual catching-up after at least 2 years return to full-time clinical training. This may inform residency program curriculum design.

Facilitating Success of the Early Stage Surgeon Scientist Trainee: Growing the Surgeon Scientist Pipeline

OBJECTIVE

Surgeon scientists bring to bear highly specialized talent and innovative and impactful solutions for complicated clinical problems. Our objective is to inform and provide framework for early stage surgeon scientist training and support.

SUMMARY OF BACKGROUND DATA

Undergraduate, medical student, and residency experiences impact the career trajectory of surgeon scientists. To combat the attrition of the surgeon scientist pipeline, interventions are needed to engage trainees and to increase the likelihood of success of future surgeon scientists.

METHODS

A surgery resident writing group at an academic medical center, with guidance from faculty, prepared this guidance document for early stage surgeon scientist trainees with integration of the published literature to provide context. The publicly available National Institutes of Health RePORTER tool was queried to provide data salient to early stage surgeon scientist training.

RESULTS

The educational path of surgeons and the potential research career entry points are outlined. Challenges and critical supportive elements needed to inspire and sustain progress along the surgeon scientist training path are detailed. Funding mechanisms available to support formal scientific training of early stage surgeon scientists are identified and obstacles specific to surgical careers are discussed.

CONCLUSIONS

This guidance enhances awareness of essential education, communication, infrastructure, resources, and advocacy by surgery leaders and other stakeholders to promote quality research training in residency and to re-invigorate the surgeon scientist pipeline.

Determinants of research productivity during postgraduate medical education: a structured review

BACKGROUND

Although formal participation in research is an integral and often mandatory component of clinical training programs, resulting productivity is highly variable. The objective of this review was to identify determinants of successful research performance among graduate medical education trainees.

METHODS

A structured review of the published literature was performed by searching PubMed, CINAHL, and EMBASE from inception through to 7 April, 2021. Articles examining graduate medical education trainee research productivity evidenced by publications in peer-reviewed journals were included.

RESULTS

Eighty-five articles were included of which most (66; 78%) were reported from the USA or Canada (10; 12%). A wide range of disciplines were represented with the most common being general surgery, internal medicine, orthopedic surgery, and pediatrics. Themes (number of reports) included trainee characteristics (n = 24), project characteristics (n = 8), mentoring/supervision (n = 11), and programmatic aspects (n = 57). Although variable results were observed, research productivity tended to be higher with prior research experience, later years of training, male gender, and pursuit of a postgraduate degree. Few project related aspects of success were identified. Trainee publication was associated with mentors with higher rank, publication productivity, and supportive academic environments. Training programs with organised programs/curricula including protection of time for research were associated with increased productivity as were provision of incentives or rewards but not mandatory requirements.

CONCLUSION

This review identifies several trainee characteristics, project and mentor aspects, and programmatic aspects associated with increased productivity that may serve as a useful resource for trainees and graduate medical education training programs.

Publication Times in Ophthalmology Journals: The Story of Accepted Manuscripts

Introduction: The process of scientific publishing changed greatly in the past decades. The authors aimed to get insight into the time required for articles to be accepted and released online in high-impacted ophthalmology journals.

Methods: Comprehensive review of all original articles published by eight ophthalmology journals during a one-year period was performed for 2020 and 2005. Time taken from submission to acceptance and the first online release of the article was abstracted and analyzed.

Results: A total of 3110 articles were reviewed. In 2020, the overall median time from submission to acceptance (AT) was 119 days (IQR 83-168) and 30 days (10-71) from acceptance to the first online release of the article (OP). AT increased by 7.3% from 2005 to 2020, whereas OP reduced by 73%. Publications, which the corresponding author was affiliated with US-located institution had shorter both AT and OP in 2005 and 2020. The author’s specialty in ophthalmology had an inconclusive impact on AT and OP. Papers with multiple affiliated institutions had shorter AT and OP in both 2005 and 2020; however, these differences were not statistically significant.

Conclusion: This study demonstrated that increasing pressure on authors, editors, and reviewers to publish articles and journals with high impact factor (IF) significantly influenced publication times in ophthalmology journals. Inflation of research papers was associated with rising AT time. A significant decrease in OP time was potentially explained by the editor’s demand to achieve decent journal IF. This article brings to light relative publication times in the ophthalmology scientific journals.

Attainment of an Additional Graduate Degree Is Associated With Sustained Scholarly Activity Beyond Surgical Residency

OBJECTIVE

To determine whether attainment of an additional graduate-level degree during general surgery residency, such as an MSc, MPH, MBA, or PhD, is associated with increased research productivity beyond completion of training.

DESIGN

Observational cohort study comparing publication productivity of general surgery residency graduates who did and did not obtain a degree. PubMed queries and the Web of Science Core Collection were used to capture publication metrics. Graduate characteristics, including degree attainment, were obtained from an institutional database. Practice webpages were reviewed to designate an academic surgical practice, defined as an assistant, associate, or full professorship appointment.

SETTING

Single academic general surgery residency program.

PARTICIPANTS

Categorical general surgery residency graduates who performed at least 1 year of dedicated research.

RESULTS

1768 total publications, representing 1500 unique publications, were authored by 54 residents, of which 18 (33.3%) residents attained an additional graduate-level degree during dedicated research. 1369 (91.3%) publications had identifiable Journal Impact Factors and citation data. Degree attainers were more likely to be female (55.6% vs. 25.0%, p = 0.03) and spend more time in dedicated research (mean 2.2 vs. 1.8 years, p = 0.02). Overall, degree attainers published more frequently during residency (median 4.4 vs. 2.1 publications/year, p < 0.001) and fellowship (median 2.0 vs. 1.0 publications/year, p = 0.046). Analysis of the first 4 post-training years demonstrated degree attainers produced 1.2 more publications per year among all graduates (2.3 vs. 1.1 publications/year, p = 0.02) and 1.6 more publications per year among graduates practicing academic surgery (3.3 vs. 1.7 publications/year, p = 0.02). There were no differences in the Journal Impact Factor or publication citations per year among degree and nondegree attaining graduates.

CONCLUSIONS

Attainment of an additional graduate-level degree was associated with increased research productivity that was sustained beyond surgical residency. Programs with the goal of training academic surgeons should support professional degrees during dedicated research years.

How to Support a Surgeon Scientist: Lessons from National Institutes of Health K-Award Recipients

BACKGROUND

Success in academic surgery is challenging and research cannot survive without funding. NIH K-awards are designed to mentor junior investigators to achieve independence. As a result we aimed to study K awardees in departments of surgery and learn from their experience.

MATERIAL AND METHODS

Utilizing the NIH RePORTer database and filtering by department of surgery, clinically active surgeons receiving a K-award between 2008 and 2018 were asked to complete an online survey. Qualitative data from two open-ended questions were coded independently using standard qualitative methods by three researchers. Using grounded theory, major themes emerged from the codes.

RESULTS

Of the 144 academic surgeons identified, 89 (62%) completed the survey. The average age was 39 ± 3 when the K-award was granted. Most identified as white (69%). Men (70%) were more likely to be married (P = 0.02) and have children (P = 0.05). To identify intention to pursue R01 funding, surgeons having a K-award for 5 y or more were analyzed (n = 45). Most either intended to (11%) or had already applied (80%) of which 36% were successful. Men were more likely to apply (P = 0.05). Major themes to succeed include protected time, mentorship, and support from leadership. Common barriers to overcome include balancing time, pressures to be clinically productive, and funding.

CONCLUSIONS

The demographics and career trajectory of NIH K-awarded surgeons is described. The lack of underrepresented minorities receiving grants is concerning. Most recipients required more than one application attempt and plan to or have applied for R01 funding. The major themes were very similar; a supportive environment and time available for research are the most crucial factors to succeed as an academic surgeon.

Research Productivity of Canadian Radiation Oncology Residents: A Time-Trend Analysis

(1) Background: Research productivity is a mandatory component of Canadian radiation oncology (RO) resident training. To our knowledge, Canadian RO resident research publication productivity has not previously been analysed. (2) Methods: We compiled a 12-year database of RO residents in Canadian training programs who completed residency between June 2005 and June 2016. Resident names and dates of training were abstracted from provincial databases and department websites and were used to abstract data from PubMed, including training program, publication year, journal, type of research, topic and authorship position. Residents were divided into four time periods and the linear trend test evaluated publication rates over time. Univariable and multivariable logistic regression analyses were performed to identify authorship predictors. (3) Results: 227 RO residents representing 363 publications were identified. The majority were first-author publications (56%) and original research (77%). Overall, 82% of first-author, and 80% of any-author articles were published in resident year 4 or higher. Mean number of publications for first-author and any-author positions increased significantly over time (p = 0.016 and p = 0.039, respectively). After adjusting for gender and time period, large institutions (> 3 residents per year) trended toward associations with more first-author publications (odds ratio (OR): 2.44; p = 0.066) and more any-author publications (OR: 2.49; p = 0.052). No significant differences were observed by gender. (4) Conclusions: Canadian RO resident publication productivity nearly doubled over a 12-year period. The majority of publications are released in the last 2 years of residency, and larger residency programs may be associated with more publications. These findings serve as a baseline as programs transition to Competency Based Medical Education (CBME).

Does Intentional Support of Degree Programs in General Surgery Residency Affect Research Productivity or Pursuit of Academic Surgery? A Multi-Institutional Study

OBJECTIVE

To determine whether pursuit of an advanced degree during dedicated research time (DRT) in a general surgery residency training program impacts a resident's research productivity.

DESIGN

A retrospective, multi-institutional cohort study.

SETTING

General surgery residency programs that were approved to graduate more than 5 categorical residents per year and that offered at least 1 year of DRT were contacted for participation in the study. A total of 10 general surgery residency programs agreed to participate in the study.

PARTICIPANTS

Residents who started their residency between 2000 and 2012 and spent at least one full year in DRT (n = 511) were included. Those who completed an advanced degree were compared on the following parameters to those who did not complete one: total number of papers, first-author papers, the Journal Citation Reports impact factors of publication (2018, or most recent), and first position after residency or fellowship training.

RESULTS

During DRT, 87 (17%) residents obtained an advanced degree. The most common degree obtained was a Master of Public Health (MPH, n = 42 (48.8%)). Residents who did not obtain an advanced degree during DRT published fewer papers (median 8, [interquartile range 4-12]) than those who obtained a degree (9, [6-17]) (p = 0.002). They also published fewer first author papers (3, [2-6]) vs (5, [2-9]) (p = 0.002) than those who obtained a degree. Resident impact factor (RIF) was calculated using Journal Citation Reports impact factor and author position. Those who did not earn an advanced degree had a lower RIF (adjusted RIF, 84 ± 4 vs 134 ± 5, p < 0.001) compared to those who did. There was no association between obtaining a degree and pursuit of academic surgery (p = 0.13) CONCLUSIONS: Pursuit of an advanced degree during DRT is associated with increased research productivity but is not associated with pursuit of an academic career.

The Impact of Hospital/University Affiliation on Research Productivity Among US-Based Authors in the Fields of Trauma, Surgical Critical Care, Acute Care, and Emergency General Surgery

BACKGROUND

Research productivity is critical to academic surgery and essential for advancing surgical knowledge and evidence-based practice. We aim to determine if surgeon affiliation with top US universities/hospitals (TOPS) is associated with increased research productivity measured by numbers of peer-reviewed publications in PubMed (PMIDs).

METHODS

A bibliometric analysis was performed for PMIDs. Affiliated authors who published in trauma surgery (TS), surgical critical care (SCC), acute care surgery (ACS), and emergency general surgery (EGS) were evaluated for publications between 2015 and 2019, and lifetime productivity. Our analysis included 3443 authors from 443 different institutions. Our main outcome was PMIDs of first author (FA) and senior author (SA) in each field (2015-2019) and total lifetime publications.

RESULTS

Significant differences exist between PMIDs from TOPS vs non-TOPS in FA-TS (1.34 vs 1.23, P = .001), SA-TS (1.71 vs 1.46, P < .001), total SA-PMIDs (44.10 vs 26.61, P < .001), and SA-lifetime PMIDs (90.55 vs 59.03, P < .001). There were no significant differences in PMIDs for FA or SA-SCC, FA or SA-ACS, FA or SA-EGS, FA-total PMIDs 2015-2019, or FA-lifetime PMIDs (P > .05 for all).

CONCLUSION

There were significantly higher TS PMIDs among FAs and SAs affiliated with top US institutions in 2015-2019, along with higher total PMIDs (2015-2019) and lifetime PMIDs. These findings are of significance to future graduate medical applicants and academic surgeons who need to make decisions about training and future career opportunities.

The changing face of academic general surgery in Canada: a cross-sectional cohort study

Background

Little is known regarding the research and training expectations faced by modern general surgery graduates interested in pursuing academic surgical careers. In this study, we describe the changing face of the Canadian academic general surgeon by outlining the in-residency research productivity and postresidency clinical and academic training trends over time.

Methods

Our cross-sectional cohort included Canadian academic general surgeons, defined as those with a university-affiliated appointment as assistant, associate or full professor. Academic surgeons were identified by the Royal College of Physicians and Surgeons of Canada online directory as well as directories of university and hospital websites. Data points included institution, faculty appointment and rank, graduation year, graduate education, fellowship training and research productivity.

Results

Our cohort included 417 surgeons from 17 Canadian academic institutions. The majority of surgeons were male (72.9%), had completed at least 1 fellowship (72.9%) and had had some form of supplementary research training (51.8%). Surgeons in the cohort had practised a median of 17 (10–27) years. The mean number of total and first-author publications for the participants in this study has increased consistently each decade before the 1980s (p < 0.001). The proportion of academic surgeons completing graduate degrees has increased steadily every decade, reaching a peak of 61.5% for surgeons graduating in the 2010s.

Conclusion

The Canadian academic surgeon is becoming increasingly productive in research during residency and is pursuing higher levels of graduate education and more fellowships than ever before. These changes probably correspond to an evolving employment and research funding landscape that places tremendous academic pressure on surgical trainees.

An Analysis of Medical Students' Attitude and Motivation in Pursuing an Intercalated MSc in Clinical Anatomy

OBJECTIVES

This study aimed to explore what factors influence and motivate medical students to undergo an intercalated degree and why they prefer to choose an intercalated MSc in Clinical Anatomy.

METHODS

The study consisted of 54 medical students enrolled in Queen's University Belfast which offers a range of intercalated degrees, including an iBSc in Medical Science and an iMSc in Clinical Anatomy. Five-point Likert scale survey was used to collect data, designed to discover what the influencing factors were in deciding to take an intercalating degree and if they have a desire to gain research experience. It measured the motivational features of their chosen courses.

RESULTS

In recent years, more students (68.5%, n = 54) opted for the iMSc rather than the iBSc. This difference in number of students was statistically significant (chi-square = 33.4, P < 0.0001). It was theorized that this was due to an interest in future surgical specialization; however, this study has shown that the prime reason 72.2% of students opt to take a year out of their medical degree to carry out an intercalated degree is simply to gain an extra qualification whilst 61.1% thought it would enhance their competitiveness in the job market. Ninety-four percent of the iMSc students recommended the intercalated degree to junior students in comparison to only 34.8% of the iBSc students. This difference in percentage was statistically significant (t = 2.78, P = 0.009).

CONCLUSION

The study shows no significant link to a desire to gain research experience in determining which intercalated programme to undertake. Students favoured iMSc more because they believed it will enhance their employability.

Mentoring Sideways-A Model of Resident-to-Resident Research Mentorship

The traditional apprenticeship model of research mentorship, where residents pursue research projects directed by attending surgeons, may be ill-suited to optimize research innovation, productivity, and leadership experience. This is particularly true in an era of ever mounting demands of academic attending surgeons, easier availability of powerful clinical databases, and more residents beginning training with prior research experience and advanced degrees. To help makeup the gaps of traditional research mentorship, we propose a complementary peer-focused, "sideways mentorship" approach. This model revolves around a consortium of residents who develop their own research ideas, and obtain feedback and technical input from fellow residents. Such a model provides trainees more opportunities to explore their own ideas, become exposed to a wider range of disciplines, share technical knowledge and prior experience, and practice being mentors themselves. We believe sideways mentoring model can be successful in this changing research era, and is a valuable addition to the traditional research model and encourage educational programs to support efforts in establishing resident-run research collaborative.

Supplementing Resident Research Funding Through a Partnership With Local Industry

OBJECTIVE

To develop a model for the supplementation of resident research funding through a resident-hosted clinical immersion with local industry.

DESIGN

Designated research residents hosted multiple groups of engineers and business professionals from local industry in general surgery-focused clinical immersion weeks. The participants in these week-long programs are educated about general surgery and brought to the operating room to observe a variety of surgeries.

SETTING

This study was performed at the University of Minnesota, in Minneapolis, Minnesota, at a tertiary medical center.

PARTICIPANTS

Ten designated research residents hosted general surgery immersion programs. Fifty-seven engineers and business professionals from 5 different local biomedical firms have participated in this program.

RESULTS

General surgery research residents (in collaboration with the University of Minnesota's Institute for Engineering in Medicine) have hosted 9 clinical immersion programs since starting the collaborative in 2015. Immersion participant response to the experiences was very positive. Two full-time resident research positions can be funded annually through participation in this program.

CONCLUSIONS

With decreasing funding available for surgical research, particularly resident research, innovative ways to fund resident research are needed. The general surgery clinical immersion program at the University of Minnesota has proven its value as a supplement for resident research funding and may be a sustainable model for the future.

Factors associated with faculty participation in research activities in dental schools

BACKGROUND

To quantify participation in dental research activities in Malaysia, and investigate its association with socio-demographic and professional characteristics, and perceptions of research and development (R&D) culture.

MATERIALS AND METHODS

Dental academics in Malaysian dental schools were invited to complete a questionnaire by email and post. The survey comprised questions on research activities in the past 12 months, socio-demographic and professional characteristics, and the R&D Culture Index. Principal components factor analysis was carried out to confirm the factor structure of the R&D Culture Index. Chi-square test was used to identify association of research activities with R&D culture, and socio-demographic and professional characteristics. Binary logistic regression was carried to identify predicators of research activities.

RESULTS

Of 256 potential participants contacted, 128 (50%) useable responses were returned. Three R&D Culture factors accounting for 57.4% of variance were extracted. More positive perception of R&D Support was associated with Malaysians (0.025) and those employed in Government schools (0.017). R&D Skills and Aptitude were associated with older respondents (0.050), PhD qualification (0.014) and more years in academia (0.014). R&D Intention was associated with any of the socio-demographic characteristics. Thirty (23.4%) respondents reported a peer-review research publication in the past 12 months, which was associated with having a PhD (OR 12.79, CI 1.28-127.96), after adjustment in regression analyses.

DISCUSSION

Postgraduate research training should be encouraged to promote participation in research activities. R&D culture did not appear to impact on research productivity. Other factors such as individual attitudinal interests should be studied.

Relationship of a Second Professional Degree to Research Productivity of General Surgery Residents

OBJECTIVE

Many general surgery residents interrupt clinical training for research pursuits or advanced degrees during dedicated research time (DRT). We hypothesize that time required to obtain a second degree during DRT decreases resident publication productivity.

DESIGN, SETTING, AND PARTICIPANTS

All consecutive categorical general surgery residents at the University of Virginia in Charlottesville, VA, graduating in 2007 to 2016 were evaluated. PubMed queries identified journal publications for residents during and after DRT, limited to 1 year postgraduation. DRT varied between 1 and 3 years and was standardized by dividing publication number by DRT plus remaining clinical years and 1 postgraduation year. Median publications were compared between residents by receipt of a second degree.

RESULTS

Thirty-six residents were eligible for analysis. Of these, 8 obtained a Master's in Clinical Research, 3 received Master of Public Health, and 1 completed a Doctorate of Philosophy. Publications ranged from 2 to 76 for degree residents and 1 to 36 for nondegree residents. For the 12 degree residents, median publication number per year was 3.8 (interquartile range: 2.3, 5.2) compared to 2.6 (interquartile range: 1.6, 3.5) in residents not pursuing a postdoctoral degree (p = 0.04). There was no significant difference in median number of first and second author publications by degree status.

CONCLUSION

More publications per year were seen among residents earning a second degree, with a statistically significant difference between residents obtaining postdoctoral degrees during DRT compared with their counterparts. Our study demonstrates that residents pursuing a second degree are not hindered in their publication productivity despite the time investment required by the degree program. Additional research is needed to determine whether formal research training through a second degree corresponds to sustained scholarly productivity beyond residency.

Residents as Educators: A Modern Model

Education during surgical residency has changed significantly. As part of the shifting landscape, the importance of an organized and structured curriculum has increased. However, establishing this is often difficult secondary to clinical demands and pressure both on faculty and residents. We present a peer-assisted learning model for academic institutions without professional non-clinical educations. The "resident as educator" (RAE) model empowers residents to be the organizers of the education curriculum. RAE is built on a culture of commitment to education, skill development and team building, allowing the upper level residents to develop and execute the curriculum. Several modules designed to address junior level residents and medical students' educational needs have been implemented, including (1) intern boot camp, (2) summer school, (3) technical skill sessions, (4) trauma orientation, (5) weekly teaching conferences, and (4) a fourth year medical student surgical preparation course. Promoting residents as educators leads to an overall benefit for the program by being cost-effective and time-efficient, while simultaneously promoting professional development of residents and a culture of education.

An analysis of medical students' attitude to surgical careers and pursuing intercalated research degrees

INTRODUCTION

Major changes are occurring in surgical training in the UK and Ireland. Training time is reduced due to the introduction of run-through training and the EWTD. Streamlined training also may affect the number of trainees engaging in full-time higher degrees by research, in spite of the fact that those who do engage are more academically productive. This study assesses the attitudes of medical students towards a career in surgery and their attitudes to research, especially in the context of an intercalated degree programme.

METHODS

615 students comprising both undergraduates and postgraduates from RCSI were surveyed. The influence of a number of factors was ranked using five-point Likert scales. Students were asked to rate the importance of research to their future careers.

RESULTS

595 (97 %) of those surveyed completed the questionnaire satisfactorily. Those interested in surgery were more likely to be male, undergraduate students and younger. Factors encouraging students to pursue a surgical career were prestige, identification of a surgical mentor, financial reward and research opportunities on offer (p < 0.001 in all cases). Almost 27 % of students had already engaged with some form of research project. A significant proportion of those interested and not interested in surgery (26 and 29 % respectively) would consider taking time out to do an intercalated research degree as part of their primary medical studies.

CONCLUSION

Surgical training faces significant challenges. One way to encourage the next generation of academic surgeons may be to offer some candidates intercalated research degrees while pursuing their medical qualification.