Urology resident publication output and its relationship to future academic achievement

Unlocking Peer Review: Elevating Scholarly Writing and Research Competence in Urology Residency

PURPOSE OF REVIEW

It is incumbent upon training programs to set the foundation for evidence-based practices and to create opportunities for trainees to develop into academic leaders. As dedicated resident research time and funding have declined in recent years, residency programs and the field at large will need to create new ways to incorporate scholarly activity into residency curricula.

RECENT FINDINGS

Literature across specialties demonstrates barriers to resident involvement including lack of time, cost, and absent scholarly mentorship. Peer review stands as a ready-made solution that can be formalized into a collaborative relationship with journals. A formal relationship between professional societies, academic journals, and residencies can facilitate the use of peer review as a teaching tool for residency programs.

Top-cited articles in andrology journals from 2013-2022: a bibliometric analysis

Bibliometric analyses serve to identify influential articles that have shaped medical practice and fostered new research ideas. Over the past decade, research in andrology has witnessed exponential growth, with an increasing number of academic publications, collaborations, and research innovations. However, there is a lack of literature that has identified the top-cited andrology articles. We conducted a bibliometric analysis to identify the top 1000 citations in andrology journals, with a focus on the top funding agencies, authors, institutions, countries/regions, and journals. To perform this analysis, we identified the top-cited articles in andrology journals as indexed in the Web of Science Core Collection. From 2013 through 2022, we found a total of 9827 articles published in andrology journals. The top publishers included "Andrology," the "Asian Journal of Andrology," and "Andrologia." The top affiliations contributing to research include the Cleveland Clinic Foundation (269 publications), Egyptian Knowledge Bank (EKB) (265), and Shanghai Jiao Tong University (202). Funding was primarily provided by notable agencies such as the National Natural Science Foundation of China (905 grants), United States Department of Health Human Services (321), and National Institutes of Health (NIH USA) (317). The present bibliometric analysis highlights andrology research from 2013 through 2022, offering key insights into leading contributors, influential authors, prominent funding sources, and major trends in the field.

Evaluating the Impact of Residency Research Productivity on Craniofacial Surgeons' Career Trajectory

OBJECTIVE

To elucidate trends in publication productivity over the past 50 years and how they correlate with the stage of training as well as the competitiveness of residency and fellowship programs. The authors hypothesize that research qualifications play an important role in obtaining a competitively ranked craniofacial surgery fellowship and that over the past 50 years, there has been an upward shift in the research qualifications held by applicants at the time of application.

DESIGN

A cross-sectional study was performed involving all 121 academic craniofacial surgeons in the United States for whom sex, years since fellowship, current institution rank, current academic position, and years since graduation were available.

MAIN OUTCOME MEASURES

The relationship between research qualifications, as determined by the overall number of publications, number of first authorship publications, H-index scores, and years since fellowship completion, was examined. The study also analyzed the placement of surgeons at programs ranked in the top 25 versus the lower 25.

RESULTS

As the number of decades since beginning craniofacial fellowship decreased, the average number of first authorship publications and average H-index increased. Those who attended higher-ranking residency and fellowship programs had a higher average number of publications, number of first authorship publications, and H-index.

CONCLUSIONS

Over the past 5 decades, research productivity at all stages of medical training has surged, potentially fueled by the trend toward pass/fail grading in medical school evaluations and standardized exams and the need to differentiate oneself in an increasingly competitive field.

Publication rate and factors associated with publication of research projects by obstetrics residents in an academic department over 10 years

OBJECTIVES

To determine the publication rate of mandatory research projects conducted by obstetrics residents and to evaluate the publication-associated factors and reported obstacles.

STUDY DESIGN

This retrospective cohort study included all consecutive residents in an academic obstetrics-gynecology department in Paris, France, between 2010 and 2020. All residents were required to conduct a research project. Information about publication was collected by searching PubMed. A closed-ended questions questionnaire was sent to former residents about their characteristics, subsequent professional development, and research project characteristics. Factors associated with publication were identified by univariable and multivariable analysis with logistic regression.

RESULTS

During the study period, 156 residents trained in our obstetrics-gynecology department. The overall publication rate was 30.8% (48/156) and the median time to publication 27 months (IQR, 18-37). The resident was first author in 36 (75.0%) publications. Among the 130 (83.3%) residents who completed the questionnaire, 43 (33%) had published their research project. Overall, 74/130 (60.8%) residents used their project for their mandatory medical thesis. Factors associated with publication in univariable analysis were younger age (median), completion of a PhD, planned career in academic medicine, prospective study design, presentation at a conference or congress and use their project for their medical thesis. The only factors associated with publication in the multivariable analysis were planned career in academic medicine (aOR 5.62 95 %CI[1.84-17.19]) and the prospective study design of the research project (aOR 6.1 95 %CI[1.24-29.56]). The main reasons for nonpublication reported by resident were lack of time and failure to complete the project.

CONCLUSION

Among the mandatory clinical research projects conducted by obstetrics residents over a decade in our department, 30.8% were published. The main factors associated with publication were planned career in academic medicine and a prospective design of the research project.

Resident Research Mentoring Teams: A Support Program to Increase Resident Research Productivity

Background

Scholarly activity is a requirement for most graduate medical education training programs. However, barriers exist for residents to accomplish projects.

Objective

To evaluate the correlation between a resident research mentoring team (RRMT) program and meeting presentations and publications of resident research projects. We further plan to report feasibility of the RRMT.

Methods

We performed a before-and-after study of meeting presentations and/or publication of resident research projects before institution of the RRMT (2004-2011) and post-RRMT implementation (2016-2019). The RRMT is a diverse group of faculty, statisticians, and research staff who meet regularly with residents to provide guidance for their research studies. It is part of overall research support from the department, which also includes biostatistics, database and regulatory help, travel funds, and project budget funds. Data on meeting presentations and publications were collected from Google Scholar, PubMed, Scopus, and the IUPUI ScholarWorks institutional repository, using resident and faculty names and titles of projects. Comparisons of pre- and post-RRMT groups were made.

Results

Seventy-four residents were in the pre-RRMT group and 40 were in the post-RRMT group. Post-RRMT residents published, presented, and combined published or presented their projects more frequently than those in pre-RRMT group (57.5% vs 28.4%, P=.002; 50% vs 16.2%, P=.001; 67.5% vs 37.8%, P=.002). Controlling for winning a Research Day award and pursuing a fellowship, being in the post-RRMT group was independently associated with presentation or publication of the resident research project (OR 3.62, 95% CI 1.57-8.83).

Conclusions

Support of resident scholarly activity, such as thorough implementation of a program like the RRMT, is associated with increased presentations and publications of research projects.

Early Career Publication Trajectory of Male Infertility Fellows During and After Fellowship

BACKGROUND

Improving evidence-based medicine through research contribution is an important aspect of fellowship training. Prior studies have investigated the research activity of urology fellows during and after fellowship. The main objective of this study was to specifically explore the publication productivity of male infertility fellows both during fellowship and in the first 5 years afterwards.

METHODS

The 19 fellowship program directors from the Society for the Study of Male Reproduction were asked to share a list of fellows from 2004 to 2019. Publications from 87 fellows at 12 programs were analyzed. PubMed® was utilized to search for peer-reviewed publications for each fellow during their fellowship and in the first 5 years afterwards. Each publication was classified by publication type (original research, review article, editorial comment, or case report), topic (fertility, testosterone, or other), and author type (sole, first, middle, or last author).

RESULTS

Some 87 male infertility fellows were analyzed, and a total of 1608 peer-reviewed publications were identified. Some 662 total publications (41.2%) were written on the topic of fertility during fellowship and in the first 5 years afterwards. Some 554 (34.5%) publications were completed during fellowship, 178 (11.1%) in year 1, 164 (10.2%) in year 2, 220 (13.7%) in year 3, 269 (16.7%) in year 4, and 223 (13.9%) in year 5. The mean number of publications during fellowship was 6.37 (range 0-57). Means for years 1-5 after fellowship were 2.12, 1.95, 2.65, 3.36, and 2.97, respectively. After fellowship, 25.3% of the fellows did not publish again. A significant difference was detected between the group mean number of publications (analysis of variance, ANOVA - p = 0.0001) during fellowship and the 5 years afterwards. There was no significant difference between the group mean number of publications between the 1st and 5th years post-fellowship (ANOVA - p = 0.5919).

CONCLUSIONS

As anticipated, male infertility fellows were most productive during fellowship, with relatively stable research production thereafter. Thus, early career support and mentorship remain important to the future academic success of fellows. Future investigation of the relationship between male infertility fellow characteristics and the pursuit of an academic career is warranted.

An Evaluation of Research Publications for General Surgery Residents And its Influence on the Future Pursuit of Fellowship or Academic Career

INTRODUCTION

Traditionally, the Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to implement research and other scholarly activities into their training curriculum. Encouraging residents to publish during residency is believed to promote research throughout their careers; however, the rate of research outcomes among general surgery residents remains unknown. Our study aims to determine associated factors that influence publication rates before, during, and after general surgery residency.

METHODS

This observational study employed a cross-sectional design. We examined whether research outcomes during general surgery residency was associated with academic advancement or continued research involvement after residency. We identified 321 general surgery residency programs on the Doximity website and randomly selected 50 to include in our sample. Of these programs, graduate rosters for 31 programs were located and subsequently included. Of the 405 residency graduates identified, we recorded the number of peer-reviewed publications, H-indices, fellowships, and whether the graduate pursued a career in private practice or academia.

RESULTS

Among the 405 physicians analyzed, 3815 total publications were identified with a mean of 9.4 (SD 11.8) per person. The most reported study design was observational studies (46.5%; 1775/3815) and the least reported was systematic reviews/meta-analyses (1.4%; 52/3815). The number of publications before residency positively correlated with having a higher h-index (r = 0.4). We also found that physicians who completed a fellowship had more publications during residency (mean = 4.7, SD = 6.5) than those not pursuing a fellowship (mean = 1.5, SD = 2.7; t= -4.3. p ≤ 0.001). We observed a statistically significant increase in the likelihood a physician pursued a career in academic medicine if they pursued a fellowship (OR: 3.77, 95% CI: 2.0-7.2) and if they had published research as a primary author (OR 1.25, 95% CI: 1.0-1.5).

CONCLUSION

Increased research productivity was associated with continued academic pursuits and an increased likelihood of pursuing fellowship training after residency.

Association Between Preresidency Peer-reviewed Publications and Future Academic Productivity or Career Choice Among Ophthalmology Residency Applicants

Importance

Ophthalmology-residency selection committees require robust metrics to review applicants. Participation in research activities is a core component of the application process for its perceived association with future academic productivity.

Objective

To evaluate the correlation between the number of preresidency peer-reviewed publications (PPPs) and subsequent peer-reviewed publications or career choices of ophthalmology residency graduates.

Design, Setting, and Participants

In this cross-sectional study, names of ophthalmology residency graduates were obtained. PubMed-indexed publication records were generated and publications were categorized as preresidency, intraresidency, and postresidency. First author and journal publications with an impact factor (IF) score of 3 or more were recorded. Current academic and community-based career statuses were designated. Names were obtained from cohort and alumni lists on residency program websites or by emailing program directors. Participants included US Accreditation Council for Graduate Medical Education-accredited ophthalmology residency graduates from 2013 to 2016.

Main Outcomes and Measures

The primary outcome measure was association of PPPs with later publications, first authorship, and journal publications with an IF score of 3 or more. The secondary outcome measure was difference in characteristics associated with academic vs community-based ophthalmologist.

Results

A total of 964 ophthalmologists (52% of graduates) were studied and most (85.5%) had PubMed-indexed publications. First authorship (ρ = 0.71; 95% CI, 0.67-0.74; P < .001) had a strong positive correlation with intraresidency publications, while journal publications with an IF score of 3 or more (ρ = 0.56; 95% CI, 0.51-0.60; P < .001) and PPPs (ρ = 0.38; 95% CI, 0.32-0.43; P < .001) had moderate and weak positive correlations, respectively. For postresidency publications, journal publications with an IF score of 3 or more (ρ = 0.86; 95% CI, 0.84-0.87; P < .001) had the strongest positive correlation followed by first authorship (ρ = 0.77; 95% CI, 0.74-0.79; P < .001) and PPPs (ρ = 0.26; 95% CI, 0.20-0.31; P < .001). Preresidency (t = 3.3; P = .001), intraresidency (t = 4.1; P < .001), postresidency (t = 7.5; P < .001), first author (t = 6.6; P < .001), and journal publications with an IF score of 3 or more (t = 5.9; P < .001) were greater for academic ophthalmologists compared with community-based ophthalmologists.

Conclusions and Relevance

Preresidency publication history is at least weakly correlated with future publications or work in an academic setting among ophthalmologists. Multiple factors associated with academic productivity were evaluated; however, adjustment for multiple analyses was not done and further testing is required to prove whether these factors are predictive.

Factors Associated with Early Career Research Productivity after Ophthalmology Residency

Background  Few studies have evaluated associations between ophthalmology trainee characteristics and performance with postgraduate research productivity. Purpose  This article evaluates factors associated with post-residency research productivity among U.S. ophthalmology graduates. Methods  Publicly available information of residents graduating between 2009 and 2014 from 30 randomly selected U.S. ophthalmology programs was collected from June to September 2020. Differences in publications between the 5 years post-residency and pre-residency/residency period were used as metrics of productivity. Residents with incomplete records were excluded. Results  A total of 758 of 768 residents, 306 females (40.4%) and 452 males (59.6%), met inclusion criteria. The mean (standard deviation [SD]) number of pre-residency publications was 1.7 (4.0), residency was 1.3 (2.2), and post-residency was 4.0 (7.3). Mean (SD) H-index was 4.2 (4.9). Top-ranked residency ( p  = 0.001), Alpha Omega Alpha (AOA) medical honor status ( p  = 0.002), U.S. medical school graduates ( p  < 0.001), and academic career ( p  < 0.001) were all associated with higher pre-/post-residency mean publication difference. Pursuing fellowship training also was associated with higher total publications ( p  < 0.001). Of all pre-residency degrees, PhD had the greatest odds of high postgraduate publications (defined as > 4). There was a positive correlation between both pre-residency/residency and post-residency publications (rho = 0.441; p  < 0.001) and between mean difference of pre-residency/post-residency publications for residents at a program and that program's Doximity rank (rho = 0.497; p  < 0.001). Multivariate logistic regression revealed, academic career choice (odds ratio [OR] = 3.38; p  < 0.001), Heed fellowship (OR = 3.12; p  = 0.031), > 2 residency publications (OR = 2.89; p  < 0.001), AOA status (OR = 2.0; p  = 0.004), and top-ranked residency programs (OR = 1.89; p  = 0.007), had greatest odds of > 4 postgraduation publications. Conclusion  Higher post-residency productivity was associated with multiple factors, with choice of an academic career, Heed fellowship, and residency productivity playing key roles.

Current status of urological training and differences between institutions

OBJECTIVES

Appropriate training of urology residents is important to secure not only high-quality patient care, but also the bright future of our specialty. We aimed to investigate residency training from the perspective of qualification and standardization and to evaluate surgical education, publication output, working conditions, future plans, and overall satisfaction, in a comprehensive way.

METHODS

We conducted a survey of urology chief residents/recent graduates in Turkey to identify differences between institutions and deficiencies in urology resident training. A total of 155 chief residents/recently graduated specialists were contacted by phone and a survey was completed.

RESULTS

The survey response rate was 96.1%. Respondents had high proficiency in endourology (97.3%), similar to Canada and European countries. However, they reported a lack of proficiency in laparoscopy (28.9%) and functional urology (26.2%). Also, no one had completed a robotic procedure as first surgeon. A total of 75.2% respondents had no first author publication, and 10.1% had no first author abstract presentation. There was no significant difference between institution types with or without certification. There was a satisfaction rate of 87.2% among participants.

CONCLUSIONS

It was observed that qualified and standardized training could has not been achieved and the positive effects of certification have not been seen yet. There is a lack of modernization in all aspects of education, and there is no standardized curriculum addressing academic research. Therefore, there is a risk that future urologists will have insufficient skills. We hope this study serves as a guide for modernization and standardization in urology training.

An analysis of publication trends of orthopedic surgery residency graduates in relation to academic achievement

CONTEXT

Traditionally, the Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to implement research and other scholarly activities into their training curriculum. Encouraging residents to publish during residency is believed to promote research throughout their careers; however, no study has attempted to quantify research productivity among orthopedic surgery residents before, during, and after residency.

OBJECTIVES

To determine whether publishing in peer-reviewed journals during orthopedic residencies was an indicator of continued academic achievement after graduation.

METHODS

This study was observational in nature and employed a cross-sectional design. We examined whether research outcomes during orthopedic residency was associated with academic advancement or continued research involvement after residency. We identified 201 orthopedic residency programs on the Doximity website and randomly selected 50 to include in our sample. Of these programs, graduate rosters for 31 programs were located and subsequently included. Of the 341 graduates identified, we recorded the number of peer-reviewed publications, H-indices, fellowships, and whether the graduate pursued a career in private practice or academia.

RESULTS

Orthopedic residency graduates from 31 programs published a total of 1923 peer-reviewed manuscripts. On average, residents had a total of 5.6 publications and an h-index of 3.2. Residents entering academia and pursuing fellowships had a significantly higher total number of publications, higher number of first-author publications, and greater H-indices compared to those who did not enter academia or pursue a fellowship.

CONCLUSIONS

Increased research productivity was associated with continued academic pursuits and an increased likelihood of pursuing fellowship training after residency.

Research Activity Among Foot and Ankle Surgery Fellows: A Systematic Review

Surgical residents cite a number of reasons to pursue a fellowship training program including improving surgical skills, furthering medical research, pursuing an academic practice, or to generally become an overall better trained surgeon and clinician. The interest in foot and ankle surgery fellowships has increased among graduating residents as have the number of fellowship programs. Since the introduction of these programs, there has been no formal investigation of the scholarly activity among foot and ankle surgery fellows. Using PubMed, a systematic review was conducted from papers published by fellows participating in American College of Foot and Ankle Surgeons or American Podiatric Medical Association approved fellowships during 2013 to 2019. A total of 76 of the 128 identified fellows published research during or within one year of completing their fellowship. Fellows that published at least once prior to fellowship were more likely to publish during fellowship compared to those who had no publication history. Over this 6-year period, fellows contributed to 279 manuscripts where they maintained primary authorship of 34.41% of the publications, across 35 journals, with the most common being the Journal of Foot and Ankle Surgery. Results of this study provide a survey of the scholastic activity among foot and ankle surgery fellows and could be used by applicants and evaluators to stratify applicant aptitude. These results could also serve as a scholarly activity benchmark for current fellows and a method of gauging scholarly involvement for new and current fellowships.

Evaluation of an early career clinical academic training programme using the CIPP model

OBJECTIVES

This study describes the successful implementation and outputs of a combined clinical academic training programme for doctors in their first postgraduate year in Ireland, the Academic Internship Track (AIT).

DESIGN

The AIT was evaluated using the Context, Input, Process and Product model. Literature reviews, meetings with key stakeholders, reviews of similar established programmes overseas, a survey of undergraduate medical students, exit survey, scientific outputs and career trajectory monitoring were all implemented in the programme evaluation.

SETTING

The AIT represents collaboration amongst all six intern training networks in Ireland.

RESULTS

Key stakeholders indicated support and significant interest in establishing the AIT. The input evaluation informed programme design which incorporates protected time to carry out a research project, a named supervisor, a bursary and access to dedicated study days. Since the programme's launch in 2017, there has been 100% uptake of posts and 0% attrition. Exiting participants indicate high levels of satisfaction with the programme; 92% reported having benefited from participation. Over 90% intend remaining in Ireland in both the immediate and longer terms. Fifty-seven per cent of participants in the first 3 years of the programme had succeeded in publishing a research article or review paper in a peer-reviewed journal.

CONCLUSIONS

Now in its fourth year, AIT remains a highly sought-after programme and is perceived to be beneficial to one's career. Participants in the programme have contributed significantly to their field of interest despite being in the earliest career stages. The programme has the potential to help retain medical talent in Ireland.

Publication Trends and Their Relationship With Academic Success Among Dermatology Residents: Cross-sectional Analysis

BACKGROUND

Involvement in scholarly activities is considered to be one of the foundational pillars of medical education.

OBJECTIVE

This study aims to investigate publication rates before, during, and after residency to determine whether research productivity throughout medical training correlates with future academic success and research involvement.

METHODS

We successfully identified a list of 296 graduates from 25 US dermatology residency programs from the years 2013-2015. The publication history for each graduate was compiled using Scopus, PubMed, and Google Scholar. The Pearson correlation test and linear regression were used to assess the relationship between research productivity and continued academic success after residency graduation.

RESULTS

Before residency, graduates published a mean of 1.9 (SD 3.5) total publications and a mean of 0.88 (SD 1.5) first-author publications. During residency, graduates published a mean of 2.7 (SD 3.6) total publications and a mean of 1.39 (SD 2.0) first-author publications. Graduates who pursued a fellowship had more total publications (t294=-4.0; P<.001), more first-author publications (t294=-3.9; P<.001), and a higher h-index (t294=-3.8; P=.002). Graduates who chose to pursue careers in academic medicine had more mean total publications (t294=-7.5; P<.001), more first-author publications (t294=-5.9; P<.001), and a higher mean h-index (t294=-6.9; P<.001). Graduates with one or more first-author publications before residency were 1.3 times more likely to pursue a career in academic medicine (adjusted odds ratio 1.3, 95% CI 1.1-1.5). Graduates who pursued a fellowship were also 1.9 times more likely to pursue a career in academic medicine (adjusted odds ratio 1.9, 95% CI 1.2-3.2).

CONCLUSIONS

Our results suggest that research productivity before and during residency training are potential markers for continued academic success and research involvement after completing dermatology residency training.

Urology residency training in Greece. Results from the first national resident survey

BACKGROUND AND OBJECTIVES

This is the first national survey assessing Greek Urology residency programs. The main objective of this study is to assess the level of confidence and perception of Greek Urology residents regarding their educational program and detect areas of improvement.

MATERIAL AND METHODS

A 51-question survey was developed via an electronic platform and answered by 91 out of 104 Greek residents from March 2019 until May 2019. Fisher's exact test, chi-squared test and Kruskal-Wallis test were used with statistical significance set at p = .05.

RESULTS

The median overall satisfaction regarding surgical training was 6/10 regardless of working schedule, working in a University Department, PGY or number of residents in clinic. Most residents have not performed any scrotal ultrasound or pressure-flow-studies; however, they are more familiar with KUB ultrasound. Double-J stent insertion and cystoscopy were common procedures for residents. Bureaucracy was reported as a major issue by 70.4% of residents. ESWL has not been performed by 80.2% of residents, 58.2% residents performed less than 10 ureteroscopies, and only the last year trainees performed more than 10 TURBT and TURP. Most residents mentioned to rarely perform basic steps in many open or laparoscopic urological procedures. Surprisingly, 59.3% of residents have not published any study in peer-reviewed journals. Regarding satisfaction, 44% rarely feel satisfied at work and 59.3% sometimes suffer from burnout. Response rate reached 87.5%.

CONCLUSIONS

Considering the results from this survey, regulatory authorities should join forces to establish a structured curriculum of clinical, surgical and research training in Urology across Europe.

Urology residency training in Greece. Results from the first national resident survey

BACKGROUND AND OBJECTIVES

This is the first national survey assessing Greek Urology residency programs. The main objective of this study is to assess the level of confidence and perception of Greek Urology residents regarding their educational program and detect areas of improvement.

MATERIAL AND METHODS

A 51-question survey was developed via an electronic platform and answered by 91 out of 104 Greek residents from March 2019 until May 2019. Fisher's exact test, chi-squared test and Kruskal-Wallis test were used with statistical significance set at p=.05.

RESULTS

The median overall satisfaction regarding surgical training was 6/10 regardless of working schedule, working in a University Department, PGY or number of residents in clinic. Most residents have not performed any scrotal ultrasound or pressure-flow-studies; however, they are more familiar with KUB ultrasound. Double-J stent insertion and cystoscopy were common procedures for residents. Bureaucracy was reported as a major issue by 70.4% of residents. ESWL has not been performed by 80.2% of residents, 58.2% residents performed less than 10 ureteroscopies, and only the last year trainees performed more than 10 TURBT and TURP. Most residents mentioned to rarely perform basic steps in many open or laparoscopic urological procedures. Surprisingly, 59.3% of residents have not published any study in peer-reviewed journals. Regarding satisfaction, 44% rarely feel satisfied at work and 59.3% sometimes suffer from burnout. Response rate reached 87.5%.

CONCLUSIONS

Considering the results from this survey, regulatory authorities should join forces to establish a structured curriculum of clinical, surgical and research training in Urology across Europe.

Scholarly Research Productivity among Otolaryngology Residency Graduates and its Relationship to Future Academic Achievement

OBJECTIVE

Scholastic activity through research involvement is a fundamental aspect of a physician's training and may have a significant influence on future academic success. Here, we explore publication rates before, during, and after otolaryngology residency training and whether publication efforts correlate with future academic achievement.

METHODS

This cross-sectional analysis included a random sample of 50 otolaryngology residency programs. From these programs, we assembled a list of residents graduating from the years in 2013, 2014, and 2015. Using SCOPUS, PubMed, and Google Scholar, we compiled the publications for each graduate, and data were extracted in an independent, double-blinded fashion.

RESULTS

We included 32 otolaryngology residency programs representing 249 residents in this analysis. Graduates published a mean of 1.3 (SD = 2.7) articles before residency, 3.5 (SD = 4.3) during residency, and 5.3 (SD = 9.3) after residency. Residents who pursued a fellowship had more total publications (t₂₄₇ = -6.1, P < .001) and more first author publications (t₂₄₇ = -5.4, P < .001) than residents without fellowship training. Graduates who chose a career in academic medicine had a higher number of mean total publications (t₂₄₇ = -8.2, P < .001) and first author publications (t₂₄₇ = -7.9, P < .001) than those who were not in academic medicine. There was a high positive correlation between residency program size and publications during residency (r = 0.76).

CONCLUSION

Research productivity correlated with a number of characteristics such as future fellowship training, the pursuit of an academic career, and overall h-index in this study.

Rapid exponential increase in neurosurgery departmental scholarly output following an intensive research initiative

There has been extensive research into methods of increasing academic departmental scholarly activity (DSA) through targeted interventions. Residency programmes are responsible for ensuring sufficient scholarly opportunities for residents. We sought to discover the outcomes of an intensive research initiative (IRI) on DSA in our department in a short-time interval. IRI was implemented, consisting of multiple interventions, to rapidly produce an increase in DSA through resident/medical student faculty engagement. We compare pre-IRI (8 years) and post-IRI (2 years) research products (RP), defined as the sum of oral presentations and publications, to evaluate the IRI. The study was performed in 2020. The IRI resulted in an exponential increase in DSA with an annual RP increase of 350% from 2017 (3 RP) to 2018 (14 RP), with another 92% from 2018 (14 RP) to 2019 (27 RP). RP/year exponentially increased from 2.1/year to 10.5/year for residents and 0.5/year to 10/year for medical students, resulting in a 400% and 1900% increase in RP/year, respectively. The common methods in literature to increase DSA included instituting protected research time (23.8%) and research curriculum (21.5%). We share our department's increase in DSA over a short 2-year period after implementing our IRI. Our goal in reporting our experience is to provide an example for departments that need to rapidly increase their DSA. By reporting the shortest time interval to achieve exponential DSA growth, we hope this example can support programmes in petitioning hospitals and medical colleges for academic support resources.

Dedicated Residency Research Time and Its Relationship to Urologic Career Academic Success

OBJECTIVE

To explore the relationship between research time during urologic training and career academic success.

METHODS

We included urologists graduating residency between 2002 and 2008 from 36 programs affiliated with a top 50 hospital for urology as ranked by the United States News and World Report, and collected research time during residency, fellowship training, current appointment (private practice, assistant professor, associate professor, professor, chair), national institutes of health (NIH) grant accrual, NIH R01 grant accrual, and current H-index in Scopus database. Publication output during and after residency was identified through the PubMed database.

RESULTS

In our cohort of 543 urologists, 66.3% of graduating trainees pursued private practice. Increasing residency research time was associated with increased publication count (P <.001), pursuit of professor positions (P <.001), and NIH funding (P <.001). One year of dedicated research increased the odds of being in the top 10th percentile of publication output during residency (odds ratio [OR]: 5.7, 95% confidence interval [CI]: 2.7-12.1), pursuing a fellowship (OR: 2.0, 95% CI: 1.3-3.1), promotion to professor (OR: 4.9, 95% CI: 2.0-12.2), obtaining a NIH grant (OR: 6.2, 95% CI: 2.3-16.5), and decreased the odds of pursuing private practice (OR: 0.4, 95% CI: 0.3-0.6). As amount of time dedicated to research in urologic residency increased from 3-4 to 6-12 months, OR increased for career academic success metrics.

CONCLUSION

Although a minority of trainees enter academics, dedicated time for research in urologic residency is associated with career academic success, with more research time associated with increased publication output, academic appointments, and grant funding.

Medical thesis publication and academic productivity of pediatric residents at the Medical University of Marseille: Associated factors and evolution over 20 years

BACKGROUND

In many countries, as in France, medical training is not complete until the defense of a thesis, based on a research project; however, the publication of research work is not mandatory. This study investigated the evolution of the publication pattern of pediatric residents and identified the possible factors associated with an increased productivity, by investigating both thesis and non-thesis-related publications.

MATERIALS AND METHODS

We conducted a retrospective cohort study of pediatric residents who graduated from the Medical University of Marseille in France over a 20-year period (1996-2015). Their theses were retrieved from the French database of university theses (SUDOC). Their publications were collated by scanning the PubMed and Google Scholar databases. Non-thesis-related publications were included up to 1 year after the medical thesis defense and medical thesis publications were included without date limits. For each thesis or publication, the resident's characteristics, the supervisor's characteristics, the thesis characteristics, and bibliometric features were retrieved.

RESULTS

Out of the 148 graduated residents, 110 (74%) published articles (thesis-related article with no publication deadline and non-thesis-related articles with a publication deadline of up to 1 year postgraduation): 76 residents (51%) published their medical thesis and 88 residents (60%) published at least one non-thesis-related article. In multivariate analysis, publishing the thesis was significantly associated with a shorter dissertation length (43 vs. 84 pages [median]; p=0.009**) and with a thesis supervisor more experienced in supervising theses (P=0.01**). The thesis publication rate increased significantly over the years (P=0.005**), with the number of theses published tripling. Dissertation length significantly decreased over the years (linear slope=-4.13 pages/year; P<0.0001***). In multivariate analysis, the number of publications per resident was significantly higher when the resident had also completed a scientific thesis (β=1.62; P=0.007**), when he or she had published more papers during the post-residency period (β=0.40; P<0.0001***) and when he or she graduated at an older age (β=0.24; P=0.04*).

CONCLUSION

The thesis publication rate of pediatric residents has improved significantly in 20 years; however, these results are from a single-center study. Publishing the thesis was significantly associated with shorter dissertation length and a more experienced thesis supervisor.

Predicting Quality of Clinical Performance From Cardiology Fellowship Applications

Variables in cardiology fellowship applications have not been objectively analyzed against applicants' subsequent clinical performance. We investigated possible correlations in a retrospective cohort study of 65 cardiology fellows at the Mayo Clinic (Rochester, Minn) who began 2 years of clinical training from July 2007 through July 2013. Application variables included the strength of comparative statements in recommendation letters and the authors' academic ranks, membership status in the Alpha Omega Alpha Honor Medical Society, awards earned, volunteer activities, United States Medical Licensing Examination (USMLE) scores, advanced degrees, publications, and completion of a residency program ranked in the top 6 in the United States. The outcome was clinical performance as measured by a mean of faculty evaluation scores during clinical training. The overall mean evaluation score was 4.07 ± 0.18 (scale, 1-5). After multivariable analysis, evaluation scores were associated with Alpha Omega Alpha designation (β=0.13; 95% CI, 0.01-0.25; P=0.03), residency program reputation (β=0.13; 95% CI, 0.05-0.21; P=0.004), and strength of comparative statements in recommendation letters (β=0.08; 95% CI, 0.01-0.15; P=0.02), particularly in letters from residency program directors (β=0.05; 95% CI, 0.01-0.08; P=0.009). Objective factors to consider in the cardiology fellowship application include Alpha Omega Alpha membership, residency program reputation, and comparative statements from residency program directors.

An Analysis of Publication Productivity During Residency for 1506 Neurosurgical Residents and 117 Residency Departments in North America

BACKGROUND

Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery continues to evolve.

OBJECTIVE

To calculate a number of publication productivity measures for almost all neurosurgical residents and departments within North America. These measures were correlated with survey results on the educational environment within residency programs.

METHODS

During May to June 2017, data were collected from departmental websites and Scopus to compose a bibliometric database of neurosurgical residents and residency programs. Data related to authorship value and study content were collected on all articles published by residents. A survey of residency program research and educational environment was administered to program directors and coordinators; results were compared with resident academic productivity.

RESULTS

The median number of publications in residency was 3; median h-index and Resident index were 1 and 0.17 during residency, respectively. There was a statistically significant difference in academic productivity among male neurosurgical residents compared with females. The majority of articles published were tier 1 clinical articles. Residency program research support was significantly associated with increased resident productivity (P < .001). Scholarly activity requirements were not associated with increased resident academic productivity.

CONCLUSION

This study represents the most comprehensive bibliometric assessment of neurosurgical resident academic productivity during training to date. New benchmarks for individual and department academic productivity are provided. A supportive research environment for neurosurgical residents is associated with increased academic productivity, but a scholarly activity requirement was, surprisingly, not shown to have a positive effect.

Clinicians’ Publication Output: Self-Report Survey and Bibliometric Analysis

The uncertainties around disease management and control measures have not only motivated clinicians to keep abreast of new evidence available in the scholarly literature, but also to be rigorously engaged in medical research, dissemination and knowledge transfer. We aimed to explore clinicians’ publication output from the Malaysian perspective. A self-report survey and bibliometric analysis was conducted. A total of 201/234 clinicians participated in the survey. Items consisted of demographics, researching habits, publication output and level of importance of journal selection metrics. Descriptive, bivariate and multivariate analyses were conducted. Bibliometric analysis using retrieved records from PubMed between 2009 and October 2019 was conducted and co-occurrence and co-authorship analyses were executed. Self-reported publication output was 16.9%. In the logistic regression model, publication output was significantly higher amongst consultants or clinical specialists (aOR = 2.5, 95% CI 1.1–10.0, p = 0.023); clinicians previously involved in research (aOR = 4.2, 95% CI 1.5–11.4, p = 0.004); clinicians who ever used reference citation managers (aOR = 3.2, 95% CI 1.3–7.7, p = 0.010); and journal publication speed (aOR = 2.9, 95% CI 1.2–7.1, p = 0.019). Most clinicians published original research papers (76.4%) in international journals (78.2%). Published papers were mostly observational studies, genetic, stroke and health services or systems research. In conclusion, socio-demographics, researching habits and journal selection metrics were significantly associated with self-reported publication output. Real outputs from bibliometrics were predominantly focused across five clusters.

Setting the Standards: Examining Research Productivity Among Academic Urologists in the USA and Canada in 2019

BACKGROUND

Research productivity among academic urologists is strongly encouraged, but little data are available on productivity metrics within the field.

OBJECTIVE

To provide the first comprehensive survey of research productivity among academic urologists in the USA and Canada.

DESIGN, SETTING, AND PARTICIPANTS

Using the Accreditation Council for Graduate Medical Education, the Canadian Resident Matching Service, and individual program websites, all active accredited urology faculties were identified. For each individual, we collected data on American Urological Association section, title, gender, fellowship training, Scopus H-index, and citations. Comprehensive searches were completed during March-May 2019.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Descriptive statistics for demographic comparisons were performed using analysis of variance for continuous variables and chi-square test for categorical variables. Multivariable logistic regressions were used to identify the predictors of H-index greater than the median.

RESULTS AND LIMITATIONS

A total of 2214 academic urology faculties (2015 in USA and 199 in Canada) were identified. The median and mean H-indices for the entire cohort of physicians were 11 and 16.1, respectively. On multivariable analysis, physicians in the North Central and Western Sections (vs mid-Atlantic), who were fellowship trained (vs no fellowship training), and of higher academic rank (professor and associate professor vs clinical instructor) were more likely to have H-index values greater than the median. Additionally, female physicians (vs male) were more likely to have H-index values less than the median.

CONCLUSIONS

This study represents the first comprehensive assessment of research productivity metrics among academic urologists. These represent key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to their peers.

PATIENT SUMMARY

In this study, we provide the first comprehensive assessment of research productivity among academic urologists in the USA and Canada. Our results help provide key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to peers.

Standing on the Shoulders of Giants: Dental Students Seek Academically Productive Mentors

PURPOSE

The purpose of this study was to determine whether a strong statistical correlation exists between the involvement of trainee groups and the academic productivity of the senior author.

MATERIALS AND METHODS

A retrospective cohort study of publications in the Journal of Oral and Maxillofacial Surgery from 2002 to 2016 was designed and implemented. The primary predictor variables were the presence of a trainee (dental student or oral and maxillofacial surgery [OMS] resident), year of publication, and study design and topic. The outcome variable was the Hirsch index (h-index) of the senior author. Author affiliations were queried using ScienceDirect, and the Scopus database was used to identify the h-index of the senior author from each publication spanning the previous 15 years. Descriptive statistics and t tests were performed to determine significance.

RESULTS

Of the 6,398 articles published in the Journal of Oral and Maxillofacial Surgery from January 2002 to December 2016, 1,341 (21.0%) met the inclusion criteria. The mean h-index of senior authors of articles with trainees or OMS residents was not significantly different from the mean h-index of senior authors without trainees (P = .50) or OMS residents (P = .37), whereas the mean h-index of senior authors working with dental students was significantly greater than the h-index of those not working with dental students (P < .01). Dental student mentors had a mean h-index that was below the sample mean from 2002 to 2007 but rose above the sample mean from 2010 to 2016. Trainees were more likely to work with academically productive mentors in orthognathic surgery (P < .01), temporomandibular joint (P < .05), retrospective cohort (P < .05), and innovative technique (P < .05) studies but less likely in randomized controlled trials (P < .05).

CONCLUSIONS

Dental students seek more academically productive mentors to a greater degree. More studies should be conducted to elucidate the attributes of the ideal mentor in academic OMS and to determine whether differences in mentorship exist between domestic and foreign OMS programs.

Attitudes and opinions of US neurosurgical residents toward research and scholarship: a national survey

OBJECTIVE

The analysis of resident research productivity in neurosurgery has gained significant recent interest. Resident scholarly output affects departmental productivity, recruitment of future residents, and likelihood of future research careers. To maintain and improve opportunities for resident research, the authors evaluated factors that affect resident attitudes toward neurosurgical research on a national level.

METHODS

An online survey was distributed to all US neurosurgical residents. Questions assessed interest in research, perceived departmental support of research, and resident-perceived limitations in pursuing research. Residents were stratified based on number of publications above the median (AM; ≥ 14) or below the median (BM; < 14) for evaluation of factors influencing productivity.

RESULTS

A total of 278 resident responses from 82 US residency programs in 30 states were included (a 20% overall response rate). Residents predominantly desired future academic positions (53.2%), followed by private practice with some research (40.3%). Residents reported a mean ± SD of 11 ± 14 publications, which increased with postgraduate year level. The most common type of research involved retrospective cohort studies (24%) followed by laboratory/benchtop (19%) and case reports (18%). Residents as a group spent on average 14.1 ± 18.5 hours (median 7.0 hours) a week on research. Most residents (53.6%) had ≥ 12 months of protected research time. Mentorship (92.4%), research exposure (89.9%), and early interest in science (78.4%) had the greatest impact on interest in research while the most limiting factors were time (91.0%), call scheduling (47.1%), and funding/grants (37.1%). AM residents cited research exposure (p = 0.003), neurosurgery conference exposure (p = 0.02), formal research training prior to residency (p = 0.03), internal funding sources (p = 0.05), and software support (p = 0.02) as most important for their productivity. Moreover, more productive residents applied and received a higher number of < $10,000 and ≥ $10,000 grants (p < 0.05). A majority of residents (82.4%) agreed or strongly agreed with pursuing research throughout their professional careers. Overall, about half of residents (49.6%) were encouraged toward continued neurosurgical research, while the rest were neutral (36.7%) or discouraged (13.7%). Free-text responses helped to identify solutions on a departmental, regional, and national level that could increase interest in neurosurgical research.

CONCLUSIONS

This survey evaluates various factors affecting resident views toward research, which may also be seen in other specialties. Residents remain enthusiastic about neurosurgical research and offer several solutions to the ever-scarce commodities of time and funding within academic medicine.

Evaluation of Urology Residency Training and Perceived Resident Abilities in the United States

OBJECTIVE

To identify differences and potential deficiencies in urology residency training programs in the United States as they are perceived by residents/recent graduates and program directors.

MATERIALS AND METHODS

A 45-question and 38-question survey was sent to chief residents/recent graduates and program directors, respectively, at all 120 US urology programs regarding prior medical education, urologic training curricula, and perceived surgical proficiency, among other topics.

RESULTS

Survey response rate was 58% and 52% for residents and program directors, respectively. Responses regarding program characteristics (e.g., salary, vacation) and research training were similar between program directors and residents. However, their responses regarding skills training and subspecialty training (e.g., robotics and pediatrics) differed substantially. Program directors reported the availability of advanced skills trainers (robot-88%, laparoscopic-86%), whereas fewer residents felt they were available (robot 54% and laparoscopic 72%). The same discrepancies persisted with questions about subspecialty exposure (e.g., program directors reported 48% renal transplant experience vs. 13% reported by residents). Most residents felt comfortable performing essential urology procedures (e.g., cystoscopy/ureteroscopy, open nephrectomy). In contrast, the majority expressed a lack of confidence in performing unsupervised advanced minimally invasive procedures (e.g., laparoscopic and robotic partial nephrectomy, endopyelotomy). Among the responding residents, 72% pursued fellowship training; nearly two-thirds of these residents chose to enter fellowship in order to overcome perceived training deficiencies.

CONCLUSIONS

Program directors and residents have differing perceptions regarding the education and resources associated with US urology residency training programs. US graduates of urology residency programs express a perceived lack of confidence in several procedures that are commonly encountered in a general urologic practice.

Surgical Training in South Africa: An Overview and Attempt to Assess the Training System from the Perspective of Foreign Trainees

BACKGROUND

Currently, there are no objective reports evaluating the quality of the South African surgical training. The aim of this study is to evaluate the current state of surgical training in South Africa from an external impartial point of view and to rate the experience of short-term supernumerary registrars and fellows (STSRF) within the South African training system.

METHODS

A 29-item survey was distributed via e-mail and social media to non-South African trainees who worked in South Africa as STSRF for a period of at least 1 month during the past 5 years. The survey evaluated the surgical, clinical and academic training received during their elective period in a South African department.

RESULTS

Sixty-four STSRF replied to the survey. Sixty-two percent of STSRF attended a trauma unit during their experience. For the majority of respondents, open and emergency surgical exposure, as well as experience as first surgeon, is significantly higher in the South African system, while minimally invasive and endoscopic surgery exposure is significantly less. Research project involvement is significantly less, for the STSRF, as opposed to lectures and teaching that constitute a higher percentage. No significant difference was found regarding exposure to hands-on activities.

CONCLUSIONS

The South African system still provides excellent surgical and clinical exposure as well as teaching. However, minimally invasive surgery training and research are generally lacking for the STSRF. Exchange programs between South African and developed country institutes should be improved and encouraged in order to gain mutual benefits.

Introduction of an academic internship in Ireland: views of undergraduate medical students

INTRODUCTION

A combined academic and clinical training programme for junior doctors in Ireland, the academic track for internship, has recently been launched. The academic track offers newly graduated doctors protected time within the working week to undertake a research project in addition to funding, an academic supervisor, and additional training in research skills. This study seeks to investigate the views of undergraduate medical students.

METHODS

The study population was undergraduate medical students at Trinity College Dublin in their penultimate year of study. An online questionnaire was designed and disseminated via a gatekeeper. Descriptive statistics were used to carry out data analysis on students' responses.

RESULTS

The response rate was 50/203 (24.6%). All respondents indicated that protected time would be 'very important' or 'important'. The most frequently cited reason for participating in the academic track was 'To progress my career in a particular specialty' (28/42). The most frequently cited anticipated achievement was research publication (39/42). The most common response when asked what concerns (if any) students had about participating in the programme was 'I am not sure I could achieve all the clinical competencies of an intern in addition to research' (58%).

DISCUSSION

There was a significant interest in the academic track for internship, and it is perceived by students as being of benefit to their careers. The value of protected time and an academic supervisor were recognised, and a research publication was the most frequently cited anticipated outcome. The data gathered in this questionnaire will help inform curriculum development and the identification of suitable learning outcomes.

Predictors of Scholarly Productivity, Pursuit of Fellowship, and Academic Practice Among Urology Residents Using Medical Student Application Materials

OBJECTIVE

To evaluate predictors of urology resident scholarly productivity, pursuit of fellowship, and an academic career using medical student application materials.

METHODS

We reviewed the Mayo Clinic experience with 49 urology residents who matriculated between 2000 and 2011 and graduated between 2006 and 2016. In 2005, the duration of residency was changed from 6 to 5 years. The number of peer-reviewed original publications before and during residency was obtained via Scopus. Associations of features from the medical student application with number of publications, pursuit of fellowship, and an academic career were evaluated with logistic regression.

RESULTS

Among the 49 graduates, 19 (39%) had a peer-reviewed publication before residency. The mean (standard deviation) and median (range) number of publications during residency was 9.0 (9.4) and 6 (1-41), respectively. In a multivariable analysis, the only feature significantly associated with ≥6 publications during residency was a 6 vs 5 year residency program (odds ratio 5.71; P = .018). Twenty five (51%) residents pursued a fellowship, and the only feature significantly associated with this was female gender (odds ratio 7.33, P = .018). Seventeen (35%) residents pursued an academic career, and the only feature from the medical school record that was significantly associated with an academic career was ≥1 publication before residency (odds ratio 3.65; P = .040).

CONCLUSION

A research year during urology residency is significantly associated with scholarly productivity. While women are more likely to pursue fellowships, the only significant predictor of an academic career using medical student application materials was a publication before residency.

CanMEDS scholars: A national survey on urology residents' attitudes towards research during training

INTRODUCTION

Participation in scholarly activity is an important tenet of residency training and is firmly entrenched in Canada since the introduction of CanMEDS roles by the Royal College of Physicians and Surgeons. As Canadian residency programs transition to competency-based training, it will remain important to understand how to best implement and encourage scholarly pursuits among resident trainees. The objective of this study was to understand the experiences, attitudes, and barriers that surgical residents face when pursuing research during their training.

METHODS

An anonymous, cross-sectional, self-report questionnaire was administered to chief residents of all English-speaking urology programs in Canada in 2015. Questions were open- and close-ended, including an agreement score based on a five-point Likert scale. Questions addressed residents' involvement in and attitudes towards research, as well as their perceptions of the utility of research involvement during training. The residents were also asked about the support they received and potential areas to improve the attainment of this competency. Descriptive and correlative statistics were used to analyze the responses.

RESULTS

There was a 100% overall response rate to the questionnaire. This study revealed that Canadian urology residents have a high rate of participation in scholarly work, with the vast majority (94%) publishing at least one manuscript with a mean of four papers. Despite this, there appeared to be significant variation in the respondent's experiences, including protected time for research. Furthermore, many residents appeared unconvinced of the importance of research involvement, with only 51% agreement that participation was important to their overall training. As well, a significant number of residents reported largely external, rather than internal, motivations for research participation, such as attaining a preferred fellowship (66% agreement). While the majority of respondents felt (66% agreement) that the scholar role was important in residency training, it would appear that significant barriers, including time and mentorship, limited the effectiveness of research participation to gain those competencies.

CONCLUSIONS

The results of this self-report survey outline the significant differences in attitudes and experience towards mandatory research as a component of scholarship in Canadian urology training programs. As postgraduate medical education evolves, particularly with the uptake of competency-based medical education, programs and residents will need to address the motives and barriers to better foster academic pursuits during urology training.

The Urology Residency Program in Israel-Results of a Residents Survey and Insights for the Future

OBJECTIVE

Urology practice has undergone several changes in recent years mainly related to novel technologies introduced. We aimed to get the residents' perspective on the current residency program in Israel and propose changes in it.

METHODS

A web-based survey was distributed among urology residents.

RESULTS

61 residents completed the survey out of 95 to whom it was sent (64% compliance). A total of 30% replied that the 9 months of mandatory general surgery rotation contributed to their training, 48% replied it should be shortened/canceled, and 43% replied that the Step A exam (a mandatory written certifying exam) in general surgery was relevant to their training. A total of 37% thought that surgical exposure during the residency was adequate, and 28% considered their training "hands-on." Most non-junior residents (post-graduate year 3 and beyond) reported being able to perform simple procedures such as circumcision and transurethral resections but not complex procedures such as radical and laparoscopic procedures. A total of 41% of non-junior residents practice at a urology clinic. A total of 62% of residents from centers with no robotics replied its absence harmed their training, and 85% replied they would benefit from a robotics rotation. A total of 61% of residents from centers with robotics replied its presence harmed their training, and 72% replied they would benefit from an open surgery rotation. A total of 82% of the residents participated in post-graduate courses, and 81% replied they would engage in a clinical fellowship.

CONCLUSION

Given the survey results we propose some changes to be considered in the residency program. These include changes in the general surgery rotation and exam, better surgical training, possible exchange rotations to expose residents to robotic and open surgery (depending on the availability of robotics in their center), greater out-patient urology clinic exposure, and possible changes in the basic science period.

Medical-surgical activity and the current state of training of urology residents in Spain: Results of a national survey

OBJECTIVES

To determine the actual state of medical-surgical activity and training for urology residents in Spain.

MATERIAL AND METHOD

We designed 2 anonymous surveys, which were uploaded with the Google Docs^© tool so that the respondents could answer the surveys online. The online collection period was September 2015 to January 2016. The collected data were processing using the statistical programme IBM SPSS for Windows, Version 21.0 and the programme R version 3.2.3.

RESULTS

The total number of responders was 163. In reference to the number of physically present on-call residents, the majority conducted between 4 and 6 shifts a month. Eighty-four of those surveyed indicated that they were in the operating room less than 20hours a week, and 43 of these even less than 10hours. Thirty percent of those surveyed had not performed any transurethral resection. The majority had performed at least one prostatic adenomectomy, but had not performed any major oncologic procedure, either laparoscopically or openly. In the questions concerning training and training courses, we found that most of the residents trained in laparoscopy at the hospital or at home. The overall satisfaction for the residence was assessed at 2.6. Based on this score, the overall satisfaction could be considered moderate.

CONCLUSIONS

Efforts should be directed towards standardising the acquisition of surgical and nonsurgical skills, ensuring access to training courses, establishing a minimum of required operations per year and achieving an objective assessment of the specialty.

Does medical school research productivity predict a resident's research productivity during residency?

BACKGROUND

Research productivity is an important component of the CanMEDS Scholar role and is an accreditation requirement of Canadian Otolaryngology training programs. Our objective was to determine if an association exists between publication rates before and during Otolaryngology residency.

METHODS

We obtained the names for all certified Canadian Otolaryngologists who graduated between 1998 and 2013 inclusive, and conducted a Medline search for all of their publications. Otolaryngologists were subgrouped based on year of residency graduation and the number of articles published pre-residency and during residency (0 or ≥1). Chi-squared analyses were used to evaluate whether publications pre-residency and year of graduation were associated with publications during residency.

RESULTS

We obtained data for 312 Canadian Otolaryngologists. Of those 312 graduates, 46 (14.7%) had no identifiable publications on PubMed and were excluded from the final data analysis. Otolaryngology residents had a mean 0.65 (95% CI 0.50-0.80) publications before residency and 3.35 (95% CI 2.90-3.80) publications during residency. Between 1998 and 2013, mean publication rates before and during residency both increased significantly (R ² = 0.594 and R ² = 0.759, respectively), whereas publication rates after residency graduation has stagnated (R ² = 0.023). The odds of publishing during residency was 5.85 times higher (95% CI 2.69-12.71) if a resident published prior to residency (p < 0.0001). The Spearman correlation coefficient between publications before and during residency is 0.472 (p < 0.0001).

CONCLUSION

Residents who publish at least one paper before residency are nearly six times as likely to publish during residency than those who did not publish before residency. These findings may help guide Otolaryngology program selection committees in ranking the best CaRMS candidates.

Factors Determining Scientific Paper Productivity by Neuroradiology Fellows

RATIONALE AND OBJECTIVES

We sought to determine (1) whether United States Medical Licensing Examination (USMLE) scores predict academic productivity in neuroradiology fellows as measured by publications and citations, and (2) what factors predict such productivity.

MATERIALS AND METHODS

We reviewed the USMLE scores, gender, medical school location attended, publication record before and during fellowship, fellowship evaluation ratings and subsequent practice site (private vs academic) of neuroradiology fellows from 2004 to 2014 to determine relationships with publications and citations after fellowship. Spearman's correlation and Poisson regression analyses were performed to assess the association between these factors and quantity of publications and citations per year after fellowship.

RESULTS

USMLE scores and fellowship evaluation scores correlated inversely with radiology publications and citations. There were strong correlations between publication records before or during fellowship and after fellowship. Fellows from international medical schools, with PhD degrees, and those fellows proceeding to academic practice had more publications before or during and after neuroradiology fellowship.

CONCLUSIONS

The best predictors of whether a graduating neuroradiology fellow will publish and have high citation rates is prior publication record, a PhD degree, and staying in academics. USMLE scores and evaluations during the fellowship were inversely correlated with publication measures of academic productivity.

Increasing Scholarly Activity Productivity During Residency: A Systematic Review

PURPOSE

Although resident participation in scholarly activity is mandated by the Accreditation Council for Graduate Medical Education, programmatic factors associated with success are not defined. This systematic review's objective was to determine which interventions are effective in increasing resident scholarly activity productivity (RSAP), as measured by participation in scholarly activity, presentations, or publications.

METHOD

The PubMed, MEDLINE, Cochrane Library of Systematic Reviews, PsycINFO, CINAHL, and ERIC databases were searched through October 2013. English-language articles evaluating interventions to increase RSAP in U.S. or Canadian residency programs were included, without date limits. Two independent reviewers selected articles for inclusion and extracted data. Discrepancies were resolved by consensus.

RESULTS

Of the 6,248 records screened, 80 studies underwent data abstraction. Twenty-six described outcomes without a comparison group, leaving 54 studies representing 13 medical and surgical specialties. Interventions included required scholarly activity participation, protected research time, research curricula, research directors, dedicated research days, and research tracks. Focusing on the 35 studies reporting statistical analysis, RSAP was associated with all interventions. There were some differences in intervention effectiveness between medical and surgical specialties.

CONCLUSIONS

Interventions, including protected time, research curricula, or specialized research tracks, generally result in increased participation in scholarly activity in residency programs, with mixed effects on resident presentations or publications. In many studies, interventions were bundled, suggesting that programs may need to provide increased structure and rigor through multiple pathways. The findings highlight the need for a clear definition of resident scholarly activity success aligned specifically to individual program and resident aims.

The world's contribution to the field of urology in 2015: A bibliometric study

OBJECTIVE

To explore factors associated with a successful research atmosphere by investigating the distribution of articles published in the field of urology in 2015 amongst different world regions, as research is undoubtedly a valuable tool that can help shape the future of human health.

METHODS

The Scopus® database was searched for publications made by Urology journals enlisted in the SCImago journal and country rank website. Details about each article type, language, and country of origin were collected. Journals' bibliometric measures, as well as their country of origin and the number publications since the year 1996 were also collected. Countries were divided according to the United Nations geoscheme.

RESULTS

In all, 80 of 93 registered Urology journals publishing a total of 10,181 articles were included in the study. Results reveal that the highest contribution came from North America (37.4%) followed by Europe (29.4%), Asia (26.5%), South America (2.2%), Africa (1.9%), and Oceania (1.7%). Bibliometric analysis of the published articles showed significantly higher impact measures amongst North American publications, followed by those from Europe, Oceania, South America, Asia, and Africa (P < 0.001). A slight drop in the number of publications was noted in 2015. Finally, a statistically significant regional correlation was detected between the corresponding authors' affiliation and the journals' publishing region (P < 0.001).

CONCLUSION

North America had the highest contribution to the field of urology in 2015. A significant correlation exists between the origin of the published article and the publishing journal's region.

Preresidency publication record and its association with publishing during paediatric residency

OBJECTIVE

To determine whether an association exists between the publication of journal articles before and during paediatrics residency.

METHODS

A retrospective search of PubMed was conducted for publications by all 567 Canadian paediatricians certified between 2009 and 2012, inclusive. Paediatricians were separated into groups based on the number of articles published preresidency (0 or ≥1) and during residency (0 or ≥1). The methodology was validated using a group of local paediatricians who were contacted to verify whether their publications were identified accurately.

RESULTS

A total of 160 of 567 (28%) certified paediatricians had preresidency publications; of these, 93 (58%) subsequently published during their residency period. Among the remaining 407 (72%) paediatricians without preresidency publications, 129 (32%) published during residency. The association between publication before and during paediatric residency was statistically significant (OR 2.98 [95% CI 2.04 to 4.36]; P<0.001). Results from the validation analysis suggested the methodology correctly identified pre- and during residency publication status with 87% and 90% accuracy, respectively.

CONCLUSION

Individuals with previous publications were more likely to publish as residents; however, 42% of individuals with pre-residency publications did not publish as residents. Residency selection committees may find these data helpful in assessing the publication potential of their applicants. In addition, this information may assist in building more targeted and individualized research curricula within residency programs.

Urology Residency Training in Italy: Results of the First National Survey

BACKGROUND

Numerous surveys have been performed to determine the competence and the confidence of residents. However, there is no data available on the condition of Italian residents in urology.

OBJECTIVE

To investigate the status of training among Italian residents in urology regarding scientific activity and surgical exposure.

DESIGN, SETTING, AND PARTICIPANTS

A web-based survey that included 445 residents from all of the 25 Italian Residency Programmes was conducted between September 2015 and November 2015.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The main outcomes were represented by scientific activity, involvement in surgical procedures, and overall satisfaction.

RESULTS AND LIMITATIONS

In total, 324 out of 445 (72.8%) residents completed the survey. Overall, 104 (32%) residents had not published any scientific manuscripts, 148 (46%) published ≤5, 38 (12%) ≤10, 26 (8%) ≤15, four (1%) ≤20, and four (1%) >20 manuscripts, respectively. We did not observe any differences when residents were stratified by sex (p=0.5). Stent positioning (45.7%), extracorporeal shock wave lithotripsy (30.9%), transurethral resection of bladder tumor (33.0%), hydrocelectomy (24.7%), varicocelectomy (17%), ureterolithotripsy (14.5%), and orchiectomy (12.3%) were the surgical procedures more frequently performed by residents. Overall, 272 residents (84%) expressed a good satisfaction for urology specialty, while 178 (54.9%) expressed a good satisfaction for their own residency programme. We observed a statistically decreased trend for good satisfaction for urology specialty according to the postgraduate year (p=0.02).

CONCLUSIONS

Italian Urology Residency Programmes feature some heavy limitations regarding scientific activity and surgical exposure. Nonetheless, satisfaction rate for urology specialty remains high. Further improvements in Residency Programmes should be made in order to align our schools to others that are actually more challenging.

PATIENT SUMMARY

In this web-based survey, Italian residents in urology showed limited scientific productivity and low involvement in surgical procedures. Satisfaction for urology specialty remains high, demonstrating continuous interest in this field of study from residents.

Associations between resident physicians' publications and clinical performance during residency training

BACKGROUND

Both research and clinical medicine requires similar attributes of efficiency, diligence and effective teamwork. Furthermore, residents must succeed at scholarship and patient care to be competitive for fellowship training. It is unknown whether research productivity among residents is related to broad measures of clinical achievement. Our goal was to examine associations between the quantity of internal medicine residents' publications and validated measures of their knowledge, skills and multi-source evaluations of performance.

METHODS

This was a longitudinal study of 308 residents graduating from Mayo Clinic from 2006 to 2012. We identified peer-reviewed articles in Ovid MEDLINE between July of each resident's match year and the end of their graduation. Outcomes included American Board of Internal Medicine (ABIM) certification examination scores, mini clinical examination (mini-CEX) scores, and validated assessments of clinical performance by resident-peers, faculty and non-physicians. Performance assessments were averaged to form an overall score ranging from 1 to 5. Associations between quantity of resident publications--and ABIM, mini-CEX and performance assessment scores--were determined using multivariate linear regression.

RESULTS

The residents published 642 papers, of which 443 (69.0%) were research papers, 198 (30.8%) were case reports, and 380 (59.2%) were first-authored. On adjusted analysis, multi-source clinical performance evaluations were significantly associated (beta; 99% CI; p-value) with the numbers of research articles (0.012; 0.001-0.024; 0.007), and overall publications (0.012; 0.002-0.022; 0.002).

CONCLUSIONS

To our knowledge, this is the first study to demonstrate that scholarly productivity based on journal publication is associated with clinical performance during residency training. Our findings suggest that residents who invest substantial efforts in research are not compromised in their abilities to learn medicine and care for patients.

Residents' scholarly activity: a cost analysis with regard to its effects on departments

PURPOSE OF REVIEW

Current financial strain on training departments may have a significantly negative impact on continuing support for residents' scholarly activity. A cost analysis with regard to residents' scholarly activity effects on anesthesiology training departments is performed.

RECENT FINDINGS

The Accreditation Council for Graduate Medical Education has issued a new outcome-focused scholarly activity requirement. Low scholarly achievement by anesthesiology faculty in the USA has been documented and needs transformation. It is evident that a structured scholarly activity support system is effective. To support such a system, training departments need to support anesthesiology residents' nonclinical time, which would cost an average of $13,500 per month per resident using nonresident hands-on care providers in operating rooms, resident's meeting attendance in average $1,424 per resident per meeting, and faculty mentorship and other infrastructure. It must also be taken into account that missed clinical opportunities by an anesthesiology resident during nonclinical time are an estimated average of 60 cases per month.

SUMMARY

The importance of resident scholarly activity has never been so or as critical as in the present. Anesthesiology leadership must continue to invest to support resident scholarly activity for the future of the specialty while being mindful of costs incurred.

Factors influencing young urologists' productivity and academic career choice

OBJECTIVE

The objective of this study is to identify the variables that affect young urologists' productivity and academic career choice.

PATIENTS AND METHODS

We have conducted an internet-based national survey for urologists randomly sampled from the database of Turkish Urological Association and 110 physicians completed this survey. Participants were asked to answer three-page questionnaire including 37 questions, which takes around 5 min to complete. Questionnaire was consisting of four main sections: 'demography', 'education', 'working conditions' and 'quality of life'.

RESULTS

Increased dedicated research time, being interested in an academic career, being Fellow of the European Board of Urology (FEBU), having English proficiency, and greater numbers of manuscript publication during residency were associated with increased productivity after residency (p = 0.001, p = 0.028, p = 0.046, p&lt;0.001 and p&lt;0.001, respectively). The remaining variables including age at marriage, age at having a child, monthly salary, length of residency, having a mentor or role model during residency showed no significant relationship with manuscript publications. Twenty-nine physicians (26.4%) stated that they had once been interested in their residency but were no longer interested in academic urology. Reasons for this loss of academic interest included lack of effective mentor or role model (27.2%), bureaucracy (17%), financial issues (13.6%), mandatory rule to work in public hospitals (18.2%) or military hospitals (9%) and language problems (21.6%).

CONCLUSIONS

Our data indicate that increased time spent for research, being interested in an academic career, being an FEBU, having English proficiency, and greater publication during residency were associated with increased numbers of publications and academic career choice.

Selecting Residents in Podiatric Medicine and Surgery

Limited information exists to guide students of podiatric medicine and residency directors through the resident selection process. The present study aimed to evaluate the podiatric medicine and surgery resident selection process using an online survey. Residency directors of podiatric medicine and surgery programs across the United States and fourth-year students across all 9 colleges of podiatric medicine were contacted for participation. Two separate surveys were created, one for the directors and one for the students. The directors and students were asked the relative importance of 21 items considered in resident selection on a 7-point importance scale. Subsequent questions covered an array of related topics. The directors, compared with the students, identified the following items as more important (p < .05): previous disciplinary actions against the student, number of classes failed during school, undergraduate experiences and activities, number of Part I board attempts, class rank, involvement in research, and grade point average during podiatric medical school. The manual dexterity portion of the residency interview was considered significantly more important by the students than the directors. The directors more satisfied with their residents placed greater importance on the following items (p < .05): opinions of current residents, opinions of other attending physicians, and letters of recommendation. Additional trends and differences were also discovered. The results of the present study provide baseline data on the selection of podiatric medicine and surgery residents.