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

PubMed-indexed Research Productivity of Urology Applicants and Residents: Does Medical Student Research Productivity Predict Resident Research or Pursuit of an Academic Career?

OBJECTIVE

To assess the research output of urology residents at top programs and investigate the correlation between medical school research productivity (MRP), research during residency (RRP), and pursuit of academic practice. Further, to characterize trends in MRP before and after the transition to pass/fail scoring of USMLE Step 1.

METHODS

Our team previously reported on the PubMed-indexed research productivity of applicants matching into top 50 urology programs. Here, we used the same list of residents, recorded their publications during residency, and noted their career paths, including fellowships, academic roles, or private practice. We then highlight the relationship between MRP, RRP, and pursuit of an academic career. We also highlight trends in MRP of applicants matching to top residency programs before and after the transition to pass/fail Step 1 exams.

RESULTS

We collected data on 727 residents. On multivariate logistic regression, total medical school publications (OR 1.07, 95% CI 0.97, 1.19), total urology publications (OR 1.05, 95% CI 0.92, 1.21), and total first author publications (OR 1.10, 95% CI 0.91, 1.33) were not associated with academic appointment after residency. On the other hand, RRP was correlated with pursuit of academics (1.08, 95% 1.03,1.14). MRP was significantly higher amongst applicants who applied with a pass/fail exam compared to those who did not.

CONCLUSION

MRP is not predictive of pursuing an academic career, but RRP is. There is a significant increase in average MRP of those matching to top urology programs after the transition to a pass/fail scoring system for Step 1.

Authorship Gender Composition in Urology Literature From 2015 Through 2020

OBJECTIVE

To describe the current landscape of first and last female authorship in urology journals relative to the journals' impact factor. We hypothesized that women would have a smaller proportion of publications in journals with higher impact factors.

METHODS

Eighteen urology journals were divided into groups based on impact factor accordingly: from 33.2 to 6.2 were classified as high (European Urology, Nature Reviews Urology, The Journal of Urology, BJU International, Prostate Cancer and Prostatic Diseases, and The Journal of Sexual Medicine), from 5.8 to 5.0 as medium (Asian Journal of Andrology, European Urology Focus, Sexual Medicine Reviews, Bladder Cancer, Prostate and World Journal of Urology), and from 4.8 to 2.2 as low (Urologic Oncology, Journal of Endourology, Neurourology and Urodynamics, Urology, Journal of Pediatric Urology and Female Pelvic Medicine & Reconstructive Surgery). A computer script was designed using Python to search PubMed and record first and last author of publications between 2015 and 2020. Gender was determined by Gender-Api (https://gender-api.com). Names with an accuracy of <90% were excluded. Type of peer-review and scope of each journal were also analyzed. Statistical analysis was performed using Matlab.

RESULTS

A total of 37,413 first and 28,414 last authors were identified during the study period. Overall, women represented 21% (8,029/37,413) of first and 15% (4,232/28,414) of last authors. Women were significantly less published in high impact journals compared to both medium and low impact journals (P <.001 in all). Among all journals, articles with female first authors were more likely to have a female last author (OR: 2.72, CI: 2.5-2.9, P <.001). Subspecialty journals had more female last authors than general journals (P <.05), and female representation increased if reviews were double-blinded (P <.001). Over the last 6 years, there has been a significant increase in female senior authorship among all journals (P = .045).

CONCLUSION

The proportion of female authorship was significantly lower in higher impact urology journals. While the underlying cause is likely multifactorial, this finding highlights a gender discrepancy that may impact women's ability to achieve career goals in academic medicine when compared to their male counterparts.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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