Subject and Academic Setting of Pre-residency Publications as Potential Predictors of Post-residency Academic Productivity in a Cohort of Ophthalmology Residents

Impact of Gender and Underrepresented in Medicine Status on Research Productivity Among Ophthalmology Residency Applicants

PURPOSE

Insufficient representation of women and underrepresented in medicine (URiM) students remains a problem among the ophthalmology workforce. In the residency selection process, research productivity is an important factor. We aimed to determine the average research output listed by applicants and assess for differences by gender and race.

DESIGN

Retrospective cohort study.

METHODS

All San Francisco Match applications to the Wilmer Eye Institute for the 2019, 2020, and 2021 ophthalmology residency cycles were retrospectively reviewed. Each applicant's number of published research articles was recorded and subclassified into first-author publications in any field, publications in ophthalmology, and first-author publications in ophthalmology. Multivariable logistic regression was performed to determine factors associated with successful publication.

RESULTS

A total of 1376 applications were reviewed. On average, women had a greater number of publications in ophthalmology (2.08 vs 1.73, P = .05) and presentations (4.52 vs 4.09, P = .01) compared with men. Self-identified URiMs were less likely to list publications in ophthalmology (odds ratio [OR] 0.650, P = .05) and first-author publications in ophthalmology (OR 0.570, P = .02) compared to non-URiMs.

CONCLUSIONS

Our findings highlight disparities in research productivity by self-identified URiM status. On the other hand, women had similar if not higher research outputs than men. Greater research mentorship and opportunities to support URiM students may facilitate the recruitment of diverse trainees to ophthalmology programs.

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.

Characteristics of First-Year Residents in Top-Ranked United States Ophthalmology Residency Programs

Objective The aim of the study is to investigate the characteristics of first-year residents associated with attending a top-ranked United States (U.S.) ophthalmology residency program over the past decade.

Methods First-year ophthalmology residents in 2009, 2013, 2016, and 2019 were identified from institutional websites, Doximity, LinkedIn and the Wayback Machine. Publications were obtained from Scopus and Google Scholar; research productivity was measured using the h-index, and medical school region based on U.S. Census Bureau designations. Medical school and ophthalmology training program rankings were based on U.S. News & World Report (U.S. News) rankings and National Institutes of Health (NIH) funding. One-way ANOVA, Wilcoxon rank sum, χ 2, and t-tests were used to analyze trends, and odds ratios (ORs) were calculated using logistic regression.

Results Data were obtained on 81% (1,496/1,850) of the residents; 43% were female; 5% were international medical graduates (IMGs); and 10% had other graduate degrees. Over the decade, the mean h-index increased (0.87–1.26; p <0.05) and the proportion of residents who attended a top 20 medical school decreased (28–18%; p <0.05). In a multivariate logistic regression model, characteristics associated with being a first-year resident in a top 20 program ranked by U.S. News were female gender [OR: 1.32, 95% CI: 1.02–1.72], having a Master's degree [OR: 2.28, 95% CI: 1.29–4.01] or PhD [OR: 2.23, 95% CI: 1.32–3.79], attending a top 20 [OR: 5.26, 95% CI: 3.66–7.55] or a top 40 medical school by NIH funding [OR: 2.45, 95% CI: 1.70–3.54], attending a medical school with a mean USMLE Step 2 score above 243 [OR: 1.64, 95% CI: 1.01–2.67] or located in the Northeast [OR: 2.00, 95% CI: 1.38–2.89] and having an h-index of one or more [OR: 1.92, 95% CI: 1.47–2.51]. Except for gender, these characteristics were also significantly associated with matching to a top 20 ophthalmology program by NIH funding.

Conclusion Female gender, graduate degrees, research productivity, and attending a medical school with high research productivity, high mean USMLE Step 2 score or in the Northeast were key characteristics of first-year residents in top-ranked U.S. ophthalmology residency programs.

Lessons from the life of Asia's first female neurosurgeon for modern neurosurgical trainees and educators worldwide

Surgical specialties, and particularly neurosurgery, have historically had and continue to have poor representation of female trainees. This is especially true of South Asia, considering the added social and cultural expectations for women in this region. Yet it was in India, with its difficult history of gender relations, that Asia's first fully qualified female neurosurgeon, Dr. T. S. Kanaka (1932-2018), took root, flourished, and thereafter played an integral role in helping develop stereotactic and functional neurosurgery in the country. While a few biographical accounts of her exist, highlighted here are the lessons from her illustrious life for neurosurgical trainees and educators worldwide, along with the instances that exemplify those lessons, drawn from several hitherto unutilized primary sources. These lessons are consistent with the factors identified in previous systematic reviews to be contributing to gender disparities in neurosurgery. Many of the virtues that ensured her success are attributes that continue to be critical for a neurosurgical career. Additionally, the circumstances that helped Kanaka succeed have been recounted as considerations for those working to promote diversity and inclusion. Finally, her life choices and sacrifices are described, which are underexplored but relevant concerns for women in neurosurgery.

Predictors of future research productivity among ophthalmology residents

PURPOSE

To investigate the characteristics of first-year ophthalmology residents associated with high research productivity in twelve years.

METHODS

All first-year ophthalmology residents in the United States (US) in 2009 listed by institutional websites were identified. Publications were obtained from Scopus and Google Scholar, h-indices were calculated, and medical school characteristics such as research productivity, region, rank, and average USMLE Steps 1 and 2 scores were obtained from National Institutes of Health, US Census Bureau, and US News.

RESULTS

Data were obtained on 70% (316/453) of residents; most were male, had Doctor of Medicine (MD) degrees, and graduated from medical schools in the US or Canada. Having an additional graduate degree [OR: 3.05, 95% CI: 1.07-8.67], between 1 and 3 publications [OR: 4.16, 95% CI: 2.22-7.79], or 4 or more publications [OR: 14.27, 95% CI: 3.13-64.94] were associated with higher future research productivity.

CONCLUSION

Graduate degrees and publication count were key predictors of future research productivity among ophthalmology residents in the US.