The influence of medical school and residency training program upon choice of an academic career and academic productivity among otolaryngology faculty in the United States of America: Our experience of 1433 academic otolaryngologists

"Top 20" residency-trained academic orthopaedic surgeons have higher academic productivity and funding in their careers

"Top 20" status on Doximity, an online networking service for medical professionals, is an indicator of the reputation of a residency program. The study assesses how training at a Top 20 (T20) orthopaedic residency program impacts career productivity and funding. Fellowship and Residency Electronic Interactive Database was used in 2022 to identify active orthopaedic residency programs. Demographic and training data was collected for each orthopaedic surgeon using institutional websites and Doximity. The Residency Navigator feature on Doximity was used to rank residency programs by "reputation." Programs were categorized as either T20 or non-T20. The relative citation ratio (RCR) was calculated using the NIH iCite tool and Hirsch index (h-index) was calculated using Scopus. Industry funding was collected from the Centers for Medicare & Medicaid Services Open Payments Program (CMS) for all available years (2014-2020). A total of 2812 academic orthopaedic surgeons were included in the study. Among academic orthopaedic surgeons in the United States, T20 trained orthopedists had more publications and citations (p < 0.001), along with higher h-indices (p < 0.001), RCR (p < 0.001), and industry funding (p = 0.043). Additionally, T20 trained orthopedists were 1.375 times more likely to obtain professor status (95% confidence interval: 1.150-1.645, p < 0.001). Even after propensity-matched analysis, T20 trained orthopedists maintained these differences. Training at a T20 residency program is associated with promotion, productivity, and funding. These findings are especially of concern to medical students who must consider the importance of a residency program's reputation when deciding where to apply for residency.

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.

Individual and Program-Related Predictors of Academic Vascular Surgery Practice

BACKGROUND

Several studies have explored factors affecting academic employment in surgical subspecialties; however, vascular surgery has not yet been investigated. We examined which elements of surgical training predict future academic productivity and studied characteristics of NIH-funded vascular surgery attendings.

METHODS

With approval from the Association of Program Directors in Vascular Surgery (APDVS), the database of recent vascular surgery fellowship (VSF) and integrated vascular surgery residency (IVSR) graduates was obtained, and public resources (Doximity, Scopus, PubMed, NIH, etc.) were queried for research output during and after training, completion of dedicated research years, individual and program NIH funding, current practice setting, and academic rank. Adjusted multivariate regression analyses were conducted for postgraduate academic productivity.

RESULTS

From 2013 to 2017, there were 734 graduates. Six hundred three completed VSF and 131 IVSR; 220 (29%) were female. Academic employment was predicted by MD degree, advanced degree, training at a top NIH-funded program, number publications by end of training, and H-index. Dedicated research time before or during vascular training, advanced degree, or graduating from a top NIH-funded program were predictors of publishing >1 paper/year. Number of publications by end of training and years in practice were predictive of H-index ≥5. VSF versus IVSR pathway did not have an impact on future academic employment, annual publication rate as an attending, or H-index. Characterization of NIH-funded attendings showed that they often completed dedicated research time (72%) and trained at a top NIH-funded program (79%). Mean publications by graduation among this group was 15.82 ± 11.3, and they averaged 4.31 ± 4.2 publications/year as attendings.

CONCLUSIONS

Research output during training, advanced degrees, and training at a top NIH-funded program predict an academic vascular surgery career. VSF and IVSR constitute equally valid paths to productive academic careers.

Influence of Residency Training Program on Pursuit of Academic Career and Academic Productivity Among Oral and Maxillofacial Surgeons

PURPOSE

The purpose of the study was to examine the impact of residency training institutions on the pursuit of a career in academic oral and maxillofacial surgery and assess variables associated with academic productivity.

MATERIALS AND METHODS

This was a cross-sectional study of full-time academic oral and maxillofacial surgeons (OMSs) in the United States. The primary predictor variable was program of residency training. Secondary predictors included gender, fellowship training, advanced degrees, and private practice affiliation. The primary outcome variable was the number of graduates in a ful-time academic position. Academic productivity (h-index, publication number) was a secondary outcome. Descriptive, logistic and linear regression analyses were computed.

RESULTS

The study sample consisted of 294 full-time academic OMSs in 82 training programs. The top 10 high-output residency programs were identified and graduates from these programs were more likely to have a medical degree (OR = 1.99, 9% CI: 1.17 - 3.36, p=0.0108), higher h-indices (11.03 vs 7.96, p = 0.0032) and higher number of publications (40.3 vs 25.6, p = 0.003). Faculty characteristics associated with higher h-indices included a medical degree (10.33 vs 7.66, p = 0.0067), PhD (15.23 vs 8.38, p = 0.0002), MPH (17.47 vs 8.66, p = 0.0040) and fellowship training (11.15 vs 7.76, p = 0.0012). There were no significant differences between genders in having a medical degree, completing a subspecialty fellowship, or academic productivity. Female surgeons represented 16.33% of academic OMSs and were more likely to have entered academia more recently based on duration in years of academic appointment (12.48 versus 21.08; p < 0.001).

CONCLUSIONS

Ten programs have trained 29.6% (n = 87) of all full-time academic OMSs. These programs' graduates were more likely to have a medical degree, higher h-indices, and greater number of publications.

Landscape of Centralized Otolaryngology Research Efforts Grant Recipients Over the Past Decade

OBJECTIVE

To investigate the demographics of CORE grant recipients (Centralized Otolaryngology Research Efforts) over the last decade and evaluate disparity among recipients as compared with otolaryngology overall. To assess whether procurement of a grant predicts pursuit of an academic career.

STUDY DESIGN

Analysis of grant recipients' bibliometrics.

SETTING

Academic medical center.

METHODS

The list of recipients of grants from 2010 to 2019 was obtained from the website of the American Academy of Otolaryngology-Head and Neck Surgery. Demographics of recipients were collected through an internet search, including gender, race, residency program, and h-index. Recipients from 2010 were searched to determine current academic faculty rank. Univariate and multivariate analyses were used to compare these factors with otolaryngology overall.

RESULTS

The distribution of gender among recipients over the last decade remained nearly constant, with no significant difference versus residents in otolaryngology (P > .05). However, there were significantly more female recipients when adjusted for gender differences in the field overall (P < .01). Asians were relatively overrepresented, while Black and Hispanic residents were underrepresented (P < .01). Many recipients (52.6%) trained at institutions recognized as the best training programs with reputations for quality research output. The h-index of recipients decreased over the last decade (P < .01). The h-index of duplicate winners was significantly higher than those of nonduplicate winners (P < .01). After adjusting for gender and rank, recipients were significantly more likely to hold academic positions (P < .01).

CONCLUSION

CORE grants are favorably distributed as related to gender and racial disparities, and recipients frequently go on to achieve high levels of academic success.

Influence of Residency Training on Research Productivity and Plastic Surgery Career

BACKGROUND

The impact of residency training on academic productivity and a career in academic plastic surgery remains uncertain. Previous literature has explored the influence of training institutions on academic careers in surgery. The aims of the study were to assess research productivity during plastic surgery residency training and to illustrate how differences in training programs impact resident research productivity.

METHODS

Academic plastic surgery faculty that graduated in the past 10 years were identified through an Internet search of all Accreditation Council for Graduate Medical Education-accredited residency and fellowship training programs. Research productivity was compared based on h-index, number, and quality of peer-reviewed articles published during residency.

RESULTS

Three hundred seventy-five academic plastic surgeons were identified and produced 2487 publications during residency. The 10 most productive training institutions were Johns Hopkins, Georgetown, University of Michigan, Stanford, University of California Los Angeles, Northwestern, Harvard, New York University, University of Pennsylvania, and Baylor. Academic productivity was higher among integrated residents (integrated = 8.68 publications, independent = 5.49 publications, P < 0.0001). The number of publications positively correlated to faculty size (r = 0.167, P = 0.0013), National Institute of Health (NIH) funding (r = 0.249, P < 0.0001), residency graduation year (r = 0.211, P < 0.0001), and negatively correlated with Doximity ranking (r = -0.294, P < 0.0001). H-index was positively correlated with number of publications (r = 0.622, P < 0.0001), faculty size (r = 0.295, P < 0.0001), and NIH funding (r = 0.256, P < 0.0001) and negatively correlated with Doximity ranking (r = -0.405, P < 0.0001) and residency graduation year (r = -0.163, P < 0.0001).

CONCLUSIONS

Our study has found that there is an elite cohort of programs that are the most productive research institutions. Resident research productivity is higher among integrated residents, recent graduates, and programs that are larger in size, with a higher Doximity ranking and NIH funding. This study can guide medical students and future applicants who are interested in a career in academic plastic surgery in the selection of programs that match their career aspirations.

Characteristics and Academic Productivity Among Pediatric Plastic Surgeons in the United States

BACKGROUND

The characteristics that predispose plastic surgeons to a career in pediatric plastic surgery remain unclear. Therefore, the aim of this study is to analyze the characteristics of current pediatric plastic surgeons and to determine their academic productivity.

METHODS

Pediatric plastic surgeons were identified through an internet search of all academic children's hospitals affiliated with an Accreditation Council for Graduate Medical Education-accredited integrated or independent plastic surgery program. Demographics, training background, institutional and leadership positions, and academic productivity were determined.

RESULTS

A total of 304 pediatric plastic surgeons were identified. The majority of pediatric plastic surgeons were white (n = 217, 71.8%) males (n = 235, 77.6%). Clinical fellowships were completed by 86.8% (n = 263) of the cohort, with craniofacial (n = 181, 59.7%) being the most common followed by hand (n = 54, 17.8%); 41.1% had clinical fellowship training at 10 institutions, with the top 3 most represented programs being University of Pennsylvania (n = 19, 6.2%), University of California-Los Angeles (n = 16, 5.3%), and Harvard University (n = 15, 4.9%); 25.7% (n = 78) held leadership positions within their institutions. A significant higher academic productivity was found among research fellowship-trained surgeons, chiefs of pediatric plastic surgery, fellowship directors, and members of departments of plastic surgery. Those who completed an independent residency had a significant higher H-index and number of citations.

CONCLUSION

Pediatric plastic surgery is represented by surgeons of diverse training background. An elite cohort of programs has trained the most pediatric plastic surgeons. Lastly, high academic productivity was found to be correlated with certain demographic and leadership variables highlighting its impact on career advancement.

Implications of Training Pathways on Future Academic Plastic Surgeon Employment

BACKGROUND

The limited supply of academic plastic surgery positions has led to increased demand and strong competition for these desired positions. Residents and students now seek out academic opportunities earlier in their training to account for this employment shortage. Training pathways and locations play an extremely important role in obtaining an academic position at most institutions. This study aimed to evaluate the training patterns of academic plastic surgeons in an attempt to elucidate its value and role for trainees interested in pursuing future academic careers.

METHODS

All full-time faculty members at currently accredited integrated and independent plastic surgery programs were included in the study; clinical affiliates were excluded. These institutions' websites were then queried to obtain the training history of the surgeons meeting inclusion criteria. Data were entered into a centralized database from which descriptive statistics were obtained.

RESULTS

In the 741 surgeons included in the study, 514 (69.4%) completed the independent plastic surgery track and 227 (30.6%) completed the integrated pathway. Residents completing the independent track had 20.8% and 31.7% employment at the same institution where they finished their general and plastic surgery residency, respectively. Of those completing the integrated pathway, 33.9% are employed at the same institution where they graduated from residency. In addition, 47.9% of the surgeons included in the study completed medical school, residency, or fellowship at the current institution at which they are employed. Lastly, 512 surgeons (69.4%) completed at least 1 postresidency fellowship.

CONCLUSIONS

Academic surgeons commonly complete a postresidency fellowship and are often employed at institutions where they have formerly trained. Trainees considering an academic career should consider these patterns when planning their future careers.

Educational Program Rankings Are Independently Associated With Residents' Academic Career Trajectory in Neurological Surgery

OBJECTIVE

Many studies have sought to determine predictors of academic career placement in surgical subspecialities. However, previous research has yet to establish whether the ranking of a surgeon's undergraduate institution or medical school is significantly associated with pursuit of an academic career. The purpose of this study was to investigate these novel factors' predictive impact on an academic career in the surgical subspeciality of neurosurgery. Factors investigated included undergraduate university rankings, medical school rankings, and residency program rankings.

DESIGN

Data were retrospectively collected for 884 alumni of Accreditation Council for Graduate Medical Education neurological surgery residency programs. Bivariate analyses were conducted to determine covariates for a logistic regression model, and multivariate analysis was performed with 13 covariates to determine which factors were independently associated with academic career trajectory.

RESULTS

In multivariate analysis, factors that were independently associated with an academic career in neurological surgery included having 1 year or more of protected research time during residency (odds ratio [OR] =1.96, p = 0.020), attending a "top" undergraduate university (OR =1.88, p = 0.00033), attending a "top" research medical school (OR = 1.53, p = 0.031) attending a residency program affiliated with a "top" research medical school (OR = 1.78, p = 0.012), possessing a Master of Science (OR = 3.46, p = 0.00097), or Doctor of Philosophy (OR = 2.05, p = 0.0019) degree, and completing a clinical fellowship (OR = 2.56, p = 1.90 × 10^-8).

CONCLUSIONS

Our study establishes 3 novel factors for predicting residents' choice of pursuing an academic career in neurological surgery, namely undergraduate university rank, medical school rank, and completing residency at a program affiliated with a "top" research medical school. Such findings reinforce the notion that educational and training environments are key in shaping the career trajectory of future academic surgical subspecialists.

Influence of training institution on academic affiliation and productivity among plastic surgery faculty in the United States

BACKGROUND

Educational processes that encourage a career in academic plastic surgery remain unclear. The authors' study aim was to examine the impact of training institution on the pursuit of a career in academic plastic surgery.

METHODS

Academic plastic surgery faculty (n = 838) were identified through an Internet-based search of all 94 Accreditation Council for Graduate Medical Education-accredited residency and fellowship training programs. Academic productivity was determined by number of peer-reviewed publications and Scopus h-index. Linear and logistic regression analyses were performed to determine the correlation between attributes after adjusting for the clustering of surgeons within programs.

RESULTS

In the United States, 39 percent of plastic surgeons in academic practice are trained in only 11 programs, 30 percent of faculty remained at training institutions, and 39 percent were affiliated with a private practice model. Faculty from frequently represented training programs were more likely to pursue fellowship training (OR, 1.32; 95 percent CI, 1.00 to 1.75), have higher h-indices (9.0 versus 5.4; p < 0.001), and have a greater number of peer-reviewed articles (46.6 versus 24.3; p < 0.001). Higher h-indices were correlated with male sex (7.1 versus 4.7; p < 0.001), fellowship training (7.3 versus 6.1; p < 0.05), and no private practice affiliation (5.2 versus 7.8; p < 0.001). Female surgeons represented 14.1 percent of academic plastic surgeons, were younger based on the median year of board certification (2005 versus 2000; p < 0.05), and were more likely to be on the tenure track (66.9 percent versus 57.2 percent; p < 0.05) and at the assistant professor level (73.1 percent versus 43.6 percent; p < 0.05).

CONCLUSION

Identification of educational processes that encourage a career in academic practice may improve resident mentorship and resident interest in academic plastic surgery.