Integrated Plastic Surgery Match: Trends in Research Productivity of Successful Candidates

Research productivity of first-year Canadian ophthalmology residents: a 12-year trend

OBJECTIVE

Research experience is one criterion of the selection process for applicants to residency training programs. We aim to quantify temporal trends in research productivity of medical students who matched into a canadian ophthalmology residency program.

DESIGN

Retrospective database review.

PARTICIPANTS

A total of 465 residents commencing ophthalmology training from 2010 to 2022 in 15 Canadian ophthalmology residency programs.

METHODS

The names of all residents commencing training in ophthalmology in all Canadian programs from 2010 to 2022 were identified. Bibliometric data including publication count and type, authorship position, and H-index corresponding to the match year were extracted from the Scopus database. Descriptive and univariate statistics were used to characterize and assess trends in research productivity.

RESULTS

A total of 461 ophthalmology residents (99% complete data set) from all 15 residency programs representing 1179 publications, including 679 ophthalmology-related publications, were identified. Most publications were original research (676; 58%), followed by case reports and letters (324; 27%) and reviews (162; 14%). Overall, 62% of residents had at least 1 publication at the time of the match, with a mean of 2.56 ± 3.49 publications and a mean H-index of 1.03 ± 1.48 publications. There was a significant increase (p < 0.001) in all research productivity metrics except senior authorship in the period 2019-2022 compared with 2010-2018. Notably, 91% of residents had ≥1 publication in 2022 compared with 38% in 2010.

CONCLUSION

First-year ophthalmology resident publication productivity doubled from 2010-2016 to 2017-2022 suggesting a greater emphasis on scholarly work from medical trainees, a trend similar to that reported in other specialties.

Update on the Selection Criteria of Plastic Surgery Residents: A Survey of Program Directors and Associate Program Directors

BACKGROUND

Plastic and reconstructive surgery (PRS) is recognized as a highly competitive specialty. Since the first assessment of resident selection criteria in 2007, PRS residency programs have adopted holistic review processes and adapted to changes such as a decline in medical schools participating in the Alpha Omega Alpha Honor Medical Society as well as the recent transition to pass/fail grading for the United States Medical Licensing Examination (USMLE) step 1 examination (Schultz et al. Plast Reconstr Surg Glob Open . 2020;8:e2892; Tadisina et al. Plast Reconstr Surg . 2017;139:330e-331e). This study was devised to evaluate current PRS residency criteria in light of these changes.

METHODS

An anonymous, 12-item, electronic survey was generated and distributed using Alchemer. An email was sent to 171 program directors (PDs) and associate program directors (APDs) of PRS residency programs. Survey questions were developed to collect data regarding respondent demographics and their desired criteria when assessing residency applicants. Complete responses were collected and analyzed with summary statistics and multivariate logistic regression using RStudio (version 1.3.109).

RESULTS

In total, 44 (25.7% response rate) of the 171 PDs and APDs completed the survey. Of the 16 programs (36.4%) with a USMLE cutoff score, 7 (43.8%) reported a range of 230 to 239 and 6 (37.5%) reported a range of 240 to 249. Without a score for step 1, the majority (48.8%) of respondents believe that step 2 scores will replace step 1 scores in terms of assessment criteria, and the content of recommendation letters was selected as the criterion with the greatest increase in weight (66.7%). In addition, 27.3% of programs require a step 2 score at the time of interview. The top 3 academic criteria in order of decreasing importance were the content of recommendation letters, clinical grades, and letter writers, whereas the top 3 nonacademic criteria were subinternship performance, maturity, and interview performance.

CONCLUSIONS

Plastic and reconstructive surgery remains a highly competitive specialty for residency applicants. Our findings suggest that Alpha Omega Alpha membership remains diminished in importance, whereas USMLE cutoff scores have increased. With recent changes in the step 1 grading system, PDs and APDs will rely more heavily on step 2 scores and the content of recommendation letters.

An Evidence-Based Framework for Medical Student Research Training

Background

As research becomes an increasingly important component of medical education, there is greater emphasis on incorporating programmatic enhancements to the research experience. This study builds a logic model to summarize research program inputs, outputs, and outcomes from research-oriented medical schools across the country, providing a framework that institutions can use to design and improve their medical student research training programs.

Methods

Between November 2021 and February 2022, we administered a survey assessing institutional characteristics, research offerings, curriculum, funding, and student scholarly products to the medical schools ranked 1-50 in research in 2021 by US News and World Report. Results were compiled in the form of a logic model.

Results

Thirty-seven institutions (72.5%) responded. Common program inputs included personnel such as at least one funded program director (97.3%), while funding for medical student research activities was highly variable (8-72%). There was much less funding for faculty research mentors (2.7%), advisors (18.9%), and teaching faculty (29.7%). Common outputs included a medical student research office or program (97.3%), formal research curricula (83.8%), and services and programs such as research day (91.9%). The most common outcomes tracked were publications (48.6%), presentations/posters (43.2%), student participation (29.7%), and completion of a research requirement (29.7%).

Conclusions

Common themes in medical student research training programs may be conceptualized with a logic model that schools can use to develop, evaluate, and iteratively improve their programs. Institutions should consider their desired program outcomes prior to designing inputs (e.g., funding, personnel) and outputs (e.g., curriculum, training).

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-024-02001-3.

Clinical Research Fellowship Fosters Mentorship, Teamwork, and Productivity: Our 11-Year Experience With a Craniofacial Research Fellowship

INTRODUCTION

This study describes the development and explores the academic impact of a cleft and craniofacial research fellowship.

MATERIALS AND METHODS

Research and career outcomes from 3 cleft and craniofacial surgeons, 14 clinical fellows, and 25 research fellows between 2010 and 2023 were examined. Academic productivity was measured by the number of peer-reviewed publications indexed in PubMed and podium presentations at national/international meetings. Residency match statistics were recorded for eligible research fellows.

RESULTS

Over this 14-year period (11 with research fellows), the team produced 500 publications in 96 peer-reviewed journals, with 153 (31%) in Plastic and Reconstructive Surgery, 117 (23%) in the Journal of Craniofacial Surgery, and 32 (6%) in The Cleft Palate-Craniofacial Journal. Yearly publications increased from 15.3±7.6 per year (before fellowship) to 23.0±5.3 (with 1 fellow) to 38.3±12.9 (2 fellows) to 81.0±5.7 (3 fellows; P<0.001). There was a strong annual linear growth in publications since the beginning the research fellowship position (r=0.88, P<0.001). All (100%) clinical research fellows developed strong relationships with senior surgeons, and all who applied to plastic surgery residency matched a significantly higher success rate than the national average (P<0.05).

CONCLUSION

Implementing a structured cleft and craniofacial clinical research fellowship was associated with a broad impact across all cleft and craniofacial team members, as reflected by increased academic output and high match rates among fellows. The fellowship also strengthens the talent pipeline into plastic surgery by fostering meaningful mentor/mentee relationships and provides a model that can be adopted in both surgical and nonsurgical fields.

Ethical Principles in Plastic Surgery Research

Research is an integral part of medical progress that leads to better understanding of disease processes and the development of therapies to improve patient care. The medical community has an obligation and societal responsibility to review its practices and advance its knowledge to optimize care for those who entrust it with their health and well-being. While ultimately intended to benefit patients specifically and society as a whole, every laboratory and clinical investigation inherently carries an element of uncertainty and has attendant risks. These can have unintended and, at times, harmful consequences that cannot justify the knowledge gained. In order to mitigate these risks and protect human subjects involved in clinical research studies, a basic framework of ethical principles has been developed to guide responsible experimental design, execution, and data dissemination. This article provides a review of these principles and the historical context from which they were derived and explores the persistent challenges and cognitive biases that can increase susceptibility to unethical research practices.

Socioeconomic Disparities in Research Participation: Bias in Plastic Surgery Residency Match

Background

Integrated plastic surgery residency applicants have increased at a rate disproportionate to available positions. Research productivity has become a surrogate marker for competitiveness, and many applicants pursue it to distinguish themselves. To date, no study has investigated socioeconomic disparities in extended research experience (ERE) participation.

Methods

A 35-question cross-sectional survey was distributed to applicants to United States-based integrated plastic surgery residency programs during the 2019-2022 application cycles. Summary tables, student t test, and chi-square tests were used for statistical analysis.

Results

A total of 161 responses (response rate: 20.9%) were recorded. Fifty-nine (40.7%) respondents participated in an ERE. The most common reason for ERE participation was strengthening one's application. The most common reason against participation was avoiding delays in career progression. A greater percentage of respondents from Northeastern medical schools participated in EREs (P = 0.019). There were no significant differences in debt burden between those who did or did not participate in an ERE. A greater percentage of applicants whose parents had advanced degrees participated in EREs (P = 0.053).

Conclusions

There may be geographic and socioeconomic biases present in access to ERE for students interested in plastic surgery. The growing popularity of EREs may have unintended consequences for applicant diversity. As most plastic surgeons ultimately practice in nonacademic settings, applicants and plastic surgeons may consider the financial hardships and possible socioeconomic disparities in research opportunities before participating in or recommending them.

Article Factors Influencing Gender Disparities in Senior Authorship of Plastic Surgery Publications

INTRODUCTION

Female plastic surgeons publish fewer and lower impact articles. To better understand how to address this gender gap, we explored the temporal trends in female senior authorship and evaluated predictive factors for female senior authorship.

METHODS

A retrospective review of articles published in the 3 highest impact plastic surgery journals published from 2010 to 2020 was conducted. Trends with female senior authorship across time were analyzed with respect to study type, subspeciality, and geographical origin.

RESULTS

Of the 5425 articles included, 13% (n = 720) had a female senior author, and female senior authorship increased across time ( R = 0.84, P = 0.033). Over the decade, an increased proportion of cohort studies ( R = 0.82, P = 0.045), systematic reviews ( R = 0.96, P = 0.003), breast-related articles ( R = 0.88, P = 0.022), and reconstruction-related articles ( R = 0.83, P = 0.039) were published by female senior authors. Subspecialty and geography predicted female senior authorship; articles focused on aesthetic (odds ratio [OR] = 1.3, P = 0.046) and breast (OR = 1.7, P < 0.001) subspecialties or those originating from Canada (OR = 1.7 P = 0.019), Europe (OR = 1.5, P < 0.001), and Latin America (OR = 3.0, P < 0.001) were more likely to have a female senior author. Articles from East Asia were less likely to have female senior authors (OR = 0.7, P = 0.005).

CONCLUSION

Female senior authorship in plastic surgery has increased over the last decade, and the proportion of female plastic surgeons leading cohort studies and systematic reviews is increasing. Sex of the senior author is influenced by plastic surgery subspecialty and geographical origin, but article type did not impact the odds of female senior authorship.

A Systematic Review of the State of Preclinical Mentorship Programs in Plastic and Reconstructive Surgery

Background

Plastic and reconstructive surgery is consistently one of the most competitive medical specialties in the match. The recent United States Medical Licensing Examination score reporting switch to pass-fail led to a change in metrics by which applicants are evaluated by plastic surgery programs. Applicant research productivity and the demand for plastic surgery mentorship will continue to rise. Given the competitive nature of the residency match and shift in metrics emphasis after the change in STEP 1 scoring, early exposure to plastic surgery and mentoring relationships are paramount to applicant success. However, most medical students are not exposed to plastic surgery until they begin clinical rotations.

Methods

A literature review of plastic surgery mentorship programs available during preclinical years was conducted to identify preclinical mentorship opportunities in plastic surgery. Sixty-eight references were identified, but only two studies met the inclusion criteria of addressing mentorship programs in preclinical years.

Results

Examination of the included studies indicated that preclinical medical students achieve self-identified goals and generate longitudinal benefits in plastic surgery by participating in early and focused mentorship programs.

Conclusions

The limited number of studies in this review highlights a lack of available, studied preclinical mentorship programs in plastic surgery and reveals a knowledge gap concerning the creation of successful preclinical mentorship programs. Early exposure to plastic surgery, combined with the development of structured preclinical mentorship programs, can potentially replicate successful outcomes seen in other surgical subspecialties' mentorship programs while addressing the lack of formalized mentorship opportunities for preclinical students in plastic surgery.

Defining Predictors of Future Academic Productivity in Plastic Surgery Residency

Background

Research is a valued component of applications to plastic surgery residency. No prior studies have explored factors associated with increased resident research productivity. This study aims to compare the academic productivity levels of plastic surgery residency graduates based on their pre- and postresidency experiences.

Methods

Residents graduating in 2019 and 2020 were identified from integrated programs. Metrics collected included the number of publications in medical school and residency. Descriptive statistics were completed along with linear regressions to evaluate the impact of these on academic productivity.

Results

A total of 221 residents from the classes of 2019 and 2020 were included. Most residents completed fellowship (75.9%) although less than half went on to academic practice (42.3%). Approximately one in five residents obtained secondary degrees (17.4%). Subjects averaged 3.15 (N = 208, SD = 4.51) publications while in medical school and 8.1 publications during residency (N = 209, SD = 10.0). For h-index calculated at the end of residency, having dedicated medical school research time was the only statistically significant factor (coefficient = 2.96, P = 0.002).

Conclusions

Plastic surgery residents published more often as first authors and overall during residency than medical school, indicating increased research involvement and leadership. The present study builds upon prior studies by confirming the importance of dedicated medical school research time and its lasting impact. Understanding the associations of academic factors with increased research productivity in residency is relevant for both applicants and programs evaluating residency candidates.

The Medical Student Race to Research: Who Presents More at National Plastic Surgery Conferences?

BACKGROUND

presentations increase research output and facilitate networking for medical students applying to plastic surgery. We aim to determine predictors of increased medical student presentation at national plastic surgery conferences, identifying disparities in access to research opportunities.

METHODS

Abstracts presented at the 2 most recent meetings of the American Society of Plastic Surgeons, American Association of Plastic Surgeons, and Plastic Surgery Research Council were extracted from online archives. Presenters without MDs or other professional credentials were classified as medical students. Presenter gender, medical school ranking, plastic surgery division/department, National Institutes of Health funding, number of total and first-author publications, H-index, and research fellowship completion status were recorded. Students with 3 or more (>75th percentile) presentations were compared with those with less by χ2 tests. Univariate and multivariable regressions identified factors associated with 3 or more presentations.

RESULTS

Of 1576 abstracts, 549 (34.8%) were presented by 314 students. The gender distribution was 46.5% male and 53.5% female. Most were from the Northeast (36.9%), 35% came from top 20 medical schools, and 85% attended schools with home plastic surgery programs. While 61.8% presented once, 14.6% presented 3 or more times. Those who previously presented, completed research fellowships or had more publications or higher H-indices were likely to present more ( P ≤ 0.007). On multivariable-adjusted analysis, completing research fellowships (odds ratio [OR], 2.34-2.52; P = 0.028-0.045), affiliation with institutions having higher National Institutes of Health funding (OR, 3.47-3.73; P = 0.004-0.006), or having more total number of publications (OR, 3.81; P = 0.018) or first-author publications (OR, 3.84; P = 0.008) was associated with 3 or more presentations. Presenter gender, geographic region, medical school ranking, home program status, and H-indices were not significant predictors on multivariable analysis.

CONCLUSIONS

There are several potential inequities in access to research opportunities for medical students, disadvantaging those with less well-funded plastic surgery programs and existing research experience. Improving the equitability of these opportunities is crucial for limiting bias in trainee recruitment and diversifying representation in the field.

Objective Residency Applicant Assessment Using a Linear Rank Model

OBJECTIVES

Residency applicant assessment is imperfect, with little objectivity built into the process, which, unfortunately, impacts recruitment diversity. Linear rank modeling (LRM) is an algorithm that standardizes applicant assessment to model expert judgment. Over the last 5 years, we have used LRM to assist with screening and ranking integrated plastic surgery (PRS) residency applicants. This study's primary objective was to determine if LRM scores are predictive of match success and, secondarily, to compare LRM scores between gender and self-identified race categories.

DESIGN

Data was collected on applicant demographics, traditional application metrics, global intuition rank, and match success. LRM scores were calculated for screened and interviewed applicants, and scores were compared by demographic groups. Univariate logistic regression was used to evaluate the association of LRM scores and traditional application metrics with match success.

SETTING

University of Wisconsin, Division of Plastic and Reconstructive Surgery. Academic institution.

PARTICIPANTS

Six hundred seventeen candidates who applied to a single institution over 4 application cycles (2019-2022).

RESULTS

Using area under the curve modeling, LRM score was the most predictive indicator for match success. With every one-point increase in LRM score, there was an 11% and 8.3% increase in the likelihood of screened and interviewed applicant match success (p < 0.001). An algorithm was developed to estimate the probability of match success based on LRM score. No significant differences in LRM scores were appreciated for interviewed applicant gender or self-identified race groups.

CONCLUSIONS

LRM score is the most predictive indicator of match success for PRS applicants and can be used to estimate an applicant's probability of successfully matching into an integrated PRS residency. Furthermore, it provides a holistic evaluation of the applicant that can streamline the application process and improve recruitment diversity. In the future, this model could be applied to assist in the match process for other specialties.

The West Coast Plastic Surgery Mentorship Program: Successes, Failures, and Future Growth

BACKGROUND

Students who are underrepresented in medicine experience limited access to mentorship throughout medical school and when applying to plastic surgery residency. This study describes the creation, growth, and results of the multi-institutional West Coast Plastic Surgery Mentorship Program (WCPSMP), specifically reflecting on barriers to implementation and room for future improvement.

METHODS

Students were eligible to apply to the plastic surgery mentorship program if they were first-, second-, or third-year medical students in a US medical school interested in plastic surgery. Preference was given to students who are (1) underrepresented-in-medicine racial/ethnic minorities; (2) first generation, low income; (3) lesbian, gay, bisexual, transgender, queer; and/or (4) without a home integrated plastic surgery program. Preprogram and postprogram surveys were analyzed.

RESULTS

The 2021-2022 cycle of the WCPSMP included 30 resident mentors and 30 resident mentees, with a 1:1 mentor-to-mentee relationship. The second annual Mentor-Mentee Day was hosted on June 25, 2022, in San Diego, California, with attendance from 18 mentees. There was a 63% response rate in the presurvey and postsurvey. Most students endorsed gaining didactic skills, technical skills, and networking, but only a few gained research opportunities.

CONCLUSION

The WCPSMP is a promising venue to offer underrepresented medical students valuable resident mentorship, as well as acquire surgical knowledge and skills. Further development of the program includes implementing a curriculum for residents on how to be an effective mentor and offering more research opportunities.

Trends in Integrated Plastic Surgery Applicant, Resident, and Junior Attending Research Productivity

INTRODUCTION

Research productivity is critical for matching into integrated plastic surgery residency. This study will identify how pre and intraresidency research productivity correlate with resident/junior attending productivity.

MATERIALS AND METHODS

Retrospective review from 2006 to 2015 issues of the American Board of Plastic Surgery's Annual Newsletter to Diplomates was performed to identify newly board certified plastic surgeons. Only surgeons from US medical schools matching directly into integrated programs were included. Residency type/length, graduation year from medical school, and publication counts were recorded for each surgeon. Publications were categorized as preresidency, intraresidency, and junior attending (6 y post residency/fellowship training).

RESULTS

Six hundred fifty-five integrated plastic surgery graduates were analyzed. The median number of total publications (preresidency, intraresidency, and junior attending) was 4 (interquartile range [IQR], 1 to 10). Linear regression revealed negligible correlation between preresidency and junior attending publications (r = 0.019, P = 0.002). Total publications and increasing graduation y had a significant correlation of 0.89 (P < 0.001). Graduates of fellowships had significantly increased median total publications compared to those without fellowships (7 IQR, 3 to 18 versus 3 IQR, 1 to 7, respectively, P < 0.001). Dedicated research years during residency were associated with significant (P < 0.001) increases in median total and junior attending publications. Total publications ranged from 3 (IQR, 1 to 6) to 8 (IQR, 7 to 18) for those who completed 5- and 8-y residencies, respectively.

CONCLUSIONS

Increased preresidency research productivity is not strongly associated with increased junior attending productivity in integrated plastic surgery. Better markers are completing dedicated research years in residency or fellowship after residency.

How Many Plastic Surgeons Does It Take to Write an Article? A 10-Year Bibliometric Analysis of Authorship Inflation

BACKGROUND

Publications measure academic productivity; they can affect research funding and career trajectory. There is a trend of increased authors per publication in surgery journals. We sought to determine whether authorship inflation exists in the plastic surgery literature and identify independent predictors of the number of co-authors.

METHODS

We performed a bibliometric analysis of articles published in 3 high impact plastic surgery journals at 2-year intervals between 2010 and 2020. For each publication, we collected details on year of publication, article type, plastic surgery topic, gender of senior author, geographical origin of study, and the number of authors.

RESULTS

A total of 5593 articles were collected. The median number of authors per article increased over time (ρ = 0.20, P < 0.001). Cohort studies, basic science investigations, literature reviews, and systematic reviews experienced a significant increase in the number of authors per article from 2010 to 2020 (P < 0.001). The rise in the number of authors was consistent across all plastic surgery topics (P < 0.001). Both male and female senior authors had a significant increase in the number of co-authors (P < 0.001). The regression model demonstrated that article type (cohort studies, basic science investigations, and systematic reviews) predicted more co-authors, whereas geographical region (Africa, Middle East, South and Southeast Asia, and United Kingdom and Ireland) and plastic surgery topics (aesthetic and hand surgery) predicted fewer authors.

CONCLUSIONS

The number of authors per publication is increasing in plastic surgery. Author proliferation was consistent across most article types and unaffected by gender. Possible reasons behind this trend include research complexity, increased collaboration, or gift authorship.

The Impact of Socioeconomic Factors on the 2022 Plastic Surgery Match

BACKGROUND

In 2022, the plastic and reconstructive surgery (PRS) match faced unprecedented system-wide transitions that have redefined conventional measures of applicant success. This challenges the equitable assessment of student competitiveness and diversity in the field.

METHODS

A survey of demography, application content, and 2022 match outcomes was distributed to applicants to a single PRS residency program. Comparative statistics and regression models were performed to assess the predictive value of factors in match success and quality.

RESULTS

A total of 151 respondents (response rate 49.7%) were analyzed. Although step 1 and step 2 CK scores were significantly higher among matched applicants, neither examination predicted match success. Most respondents (52.3%) were women, although gender was also not significantly associated with match success. Underrepresented in medicine applicants made up 19.2% of responses and 16.7% of matches, and the plurality of respondents (22.5%) were raised with a household income ≥$300,000. Both Black race and household income ≤$100,000 were associated with lower odds of scoring above a 240 on either step 1 or step 2 CK (Black: OR, 0.03 and 0.06; P < 0.05 and P < 0.001; income: OR, 0.07-0.47 and 0.1 to 0.8, among income subgroups), receiving interview offers (OR, -9.4; P < 0.05; OR, -11.0 to -5.4), and matching into PRS (OR, 0.2; P < 0.05; OR, 0.2 to 0.5), compared with White and high-income applicants, respectively.

CONCLUSIONS

Systemic inequities in the match process disadvantage underrepresented in medicine candidates and those from lower household incomes. As the residency match continues to evolve, programs must understand and mitigate the impacts of bias in various application components.

Analysis of Research Productivity and Assessment of Geographical Region in the General Surgery Match: How Much is Enough?

OBJECTIVES

The number of publications of prospective surgical residents has steadily increased over the past decade as the emphasis on research output has become paramount. However, the reported data from the National Resident Matching Program (NRMP) does not discriminate amongst impact, author position, and region of matched residents. This study aimed to evaluate categorical general surgery postgraduate year 1 (PGY-1) residents' research productivity by programs' research impact and region of the United States and support the need for additional public data on research metrics of accepted applicants. We hypothesize that residents accepted to top quartile schools will have more total and first author publications and higher h-index compared to residents in the other quartiles, and research metrics would not differ amongst the regions.

DESIGN

The Doximity Residency Navigator was used to sort general surgery programs based on research output, which was determined by the average h-index of residents. All 2021 matriculating PGY-1 categorical residents from the top two programs from each region and quartile that met study criteria were included in the analysis. Web of Science (WoS) citation database was used to collect prior to residency and current total publications, and the first, last, and corresponding author positions of these publications. Residents' h-index and various research metrics reported by WoS were recorded. Descriptive statistics were used to examine the association between quartile and region.

SETTING

Categorical general surgery residency programs throughout the United States.

PARTICIPANTS

Categorical PGY-1 general surgery residents.

RESULTS

The median total number of publications prior to residency was 1 (IQR = 0-5). The median total number of first-author publications prior to residency was 0 (IQR = 0-1), and the current h-index was 0 (IQR = 0-2). The top quartile had more total and first author publications prior to residency, while the other quartiles had similar metrics. Each region had similar total publications and h-index.

CONCLUSIONS

Research output is significant for applicants applying to top-quartile research programs compared to the other 3 quartiles and is relatively similar throughout all regions of the United States. Public data is limited to future applicants.

Disparities in Research during Plastic Surgery Training: How Can We Level the Playing Field?

Background:

Methods:

Results:

Conclusions:

The Association Between H-Index and Publication of Plastic Surgery Meeting Presenters From 2014 to 2017

BACKGROUND

Plastic surgery is a competitive specialty that values research productivity among members of the field. The Hirsch index has been shown to measure a researcher's scientific impact. This study sought to determine whether an association exists between H-indices and the probability of and speed to publication.

METHODS

Using Scopus, Google Scholar, PubMed, and the Plastic Surgery the Meeting (PSTM) website, first author (FAHi) and senior author (SAHi) H-indices (n = 1048) from Plastic Surgery the Meeting (PSTM) abstracts from 2014 to 2017 were collected. Whether or not an abstract was ultimately published in a peer-reviewed journal was noted. If published, number of days between PSTM presentation and publication date were recorded. Logistic regression model was used for statistical analysis.

RESULTS

In total, 592 out of 1048 total abstracts were published as manuscripts. FAHi and SAHi had significant positive correlations with odds of publication. Both FAHi and SAHi showed positive correlation with the odds of abstract publication (P < 0.001 and P = 0.033). Impact of FAHi on likelihood of publication was greater than that of SAHi. The correlation between FAHi and SAHi with the number of days until abstract publication was not significant (P = 0.333 and P = 0.856). For abstracts published before the PSTM presentation date (15.9% of published), only FAHi (P = 0.008) showed positive correlation of publication before presentation.

CONCLUSIONS

The Hirsch index provides an objective method for evaluating the probability that an abstract will lead to manuscript publication, in addition to its traditional application in gauging the impact of research. The findings of this study support that both FAHi and SAHi have a positive, direct correlation with the probability of publication.

What Attributes Make United States Plastic Surgery Programs Desirable? Perspectives from Medical Students and Residents

BACKGROUND

Plastic surgery is a competitive specialty that attracts many qualified applicants. This study provides results of a survey conducted to identify the attributes that make integrated and independent plastic surgery residency programs in the United States most desirable. Medical students' preferences for virtual events during the 2020 to 2021 Match cycle were also investigated.

METHODS

An anonymous 7-question survey was deployed to plastic surgery residency program directors to forward to medical students and current residents during the 2021 to 2022 National Resident Matching Program cycle. Demographics and ranking of program attributes were collected in the survey, and data analysis consisted of both qualitative and quantitative results.

RESULTS

A total of 50 survey respondents from 28% of plastic surgery residency programs was received. The happiness and well-being of residents and training at their preferred geographical location were identified as the most desirable qualities of a program (P < 0.05). However, 82% of respondents opposed mandatory research (P = 0.002). There was a statistically significant larger proportion of students that highly valued faculty responsiveness to feedback over perceived program ranking (P < 0.05). In the context of COVID-19, virtual meet and greets, as well as resident happy hours, were rated most desirable (n = 35, 70%), followed by social media outreach (n = 23, 46%).

CONCLUSIONS

Resident happiness and well-being, followed by preferred geographical location, were the most favorable program attributes. Plastic surgery residency programs may seek to better integrate these preferences within their curricula, as well as showcase them on social media, to attract high-quality applicants and optimize the training experience for matched residents.

"A Sign of Things to Come: Training Research Output Long-Term Scholarship in Academic Plastic Surgery."

BACKGROUNDS

Academic plastic surgery has utilized different methods to promote early involvement of trainees in research. Further analysis is needed to characterize the effects of this early emphasis and their impact on long-term academic contributions to the field.

METHODS

In October 2020, a cross-sectional study of 949 faculty from US academic plastic surgery programs was conducted using publicly available websites. Training research output for each surgeon was compared to post-training research output and other metrics measuring sustained career scholarship.

RESULTS

Increased training publications (P< 0.0001) and citations (P< 0.0001) were associated with fewer years in practice. 727 surgeons (80.0%) had ≥ 1 research article, and this group proceeded to attain significantly higher mean post-training publications per year (3.04 ± 0.14 vs. 1.45 ± 0.13, P< 0.0001) and citations per year (72.12 ± 5.04 vs. 28.39 ± 3.49, P< 0.0001) compared to the 182 (20.0%) surgeons with no training publications. For individuals, total training publications were positively correlated with post-training publications per year (P< 0.0001), a relationship also observed for citations (P< 0.0001). When controlling for years in practice, increased training publications and/or citations were significantly associated with attaining academic professor track (versus clinical professor track) position, endowed professor status, journal board position, and NIH funding (P< 0.05 for all).

CONCLUSIONS

There is a trend of increasing research productivity during plastic surgery training, and increased training output is predictive of attaining multiple measures of career academic achievement. Academic plastic surgery should continue to underscore research participation as a valuable part of the training process.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Research Productivity among Plastic Surgeons in the State of Israel: h-index and M-quotient Assessment

The h-index has been proven in the US and Canada to be a solid tool to assess the quality and impact of individual scientific work in the field of plastic surgery. M-quotient is an additional metric that mitigates the h-index's inherent bias toward more seasoned researchers. The objective of this study was evaluating the relationship between h-index and M-quotient and research productivity among plastic surgeons in the state of Israel.

Methods

A list of all Israeli board-certified plastic surgeons registered in the Israeli Society of Plastic and Aesthetic Surgery was obtained from the organization's website. Relevant demographic and academic factors of each surgeon were retrieved. The Scopus database was queried to determine each surgeon's h-index and M-quotient, among other bibliometric parameters.

Results

Our study included 173 plastic surgeons, 90% of whom were men. In total, 49.7% were working in academically affiliated hospitals; 14.4% of the surgeons had an academic rank. The mean h-index was 6.13; mean M-quotient was 0.27. Statistical analysis demonstrated a positive correlation between total number of publications (P < 0.0001), total number of citations (P < 0.0001), the surgeon's seniority (P < 0.0001), academic rank (P = 0.007), appointed as past/present plastic surgery department director (P < 0.0001), and working in an academic affiliated hospital (P < 0.025). The same parameters were found to have a positive correlation with M-quotient.

Conclusions

The h-index is an effective measure to compare plastic surgeons' research productivity in Israel. M-quotient is an ancillary tool for the assessment of research productivity among plastic surgeons, with the advent of neutralizing the surgeon's seniority.

The Orthopaedic Match: Defining the Academic Profile of Successful Candidates

BACKGROUND

Research productivity forms a vital part of the resident selection process and can markedly affect the chance of a successful match. Current reports regarding the publication record among prospective orthopaedic surgery residents are likely inaccurate. Potential applicants have a poor understanding of the strength of their research credentials in comparison to other candidates.

METHODS

We identified matched applicants from the 2013 to 2017 orthopaedic surgery residency application cycles. We performed a bibliometric analysis of these residents using Scopus, PubMed, and Google Scholar to identify published articles and calculate the h-index of each applicant at the time of application. Details were collected on medical school, advanced degrees, publication type, first authorship, and article relatedness to orthopaedic surgery.

RESULTS

We included 3,199 matched orthopaedic surgery applicants. At the time of application, the median h-index was 0, the median number of publications was 1, and 40% of successful candidates did not hold any publications. The h-index (R 0.08, P < 0.0001) and median number of publications of matched orthopaedic surgery residency candidates significantly increased (R 0.09, P < 0.0001) across application cycles. Furthermore, the proportion of matched applicants without publications at the time of application significantly decreased (R -0.90, P = 0.0350). Conversely, the percentage of articles first-authored by applicants decreased (R -0.96, P = 0.0093), but article relatedness to orthopaedic surgery remained constant (R 0.82, P = 0.0905). Strikingly, notable changes were observed in the type of articles published by successful applicants: the proportion of preclinical studies decreased (R -0.07, P = 0.0041), whereas clinical research articles increased (R 0.07, P = 0.0024).

CONCLUSION

The publication count held by successful orthopaedic surgery applicants is substantially lower than the nationally reported average. Matched orthopaedic surgery candidates demonstrate increasingly impressive research achievements each application cycle. However, increased academic productivity comes at the cost of reduced project responsibility and a shift toward faster-to-publish articles.

Do Dedicated Research Years during Medical School Predict Academic Productivity during Residency?

BACKGROUND

Evidence regarding whether medical school research portends resident research is limited. This information will provide program directors with data that may be useful for selecting applicants with a commitment to continued academic productivity.

METHODS

A questionnaire distributed via the American Society of Plastic Surgeons Resident Council to residents in 44 plastic surgery training programs in May 2020 assessed participation in dedicated research years during medical school, the number of publications completed before residency, and the total number of publications by each resident at the time of the survey. One-way ANOVA and post hoc analysis determined significant associations between publication count and number of research years.

RESULTS

Of the 256 included respondents, 203 did not complete a research year during medical school, 44 completed 1 research year, and nine completed 2 research years. Mean publications before residency were higher for participants who took 1 or 2 research years (9.88 and 27.60, respectively) compared with those who did not (4.83, P < 0.001). A comparison of total publications during residency similarly revealed increased productivity by individuals who took 1 or more research years; however, there was no difference between the number of publications completed during residency for individuals who took 1 versus 2 years (P = 0.23).

CONCLUSIONS

Residents with research experience during medical school continue to produce an increased number of publications during residency compared with those without, suggesting dedicated research years taken during medical school serve as a predictor of academic productivity in plastic surgery residents.

Academic Productivity Among Plastic Surgery Subspecialty Fellowship Applicants

INTRODUCTION

Plastic surgery subspecialty fellowships are highly competitive. Academic productivity is an objective metric that can be used to compare candidates. This study aims to evaluate intersubspecialty differences in academic profiles of plastic surgery fellows.

METHODS

We performed a cross-sectional analysis of the plastic surgery fellows in the United States from 2015 to 2019. We used the San Francisco Match website and individual program websites to obtain details of fellowship programs (microsurgery, aesthetic, hand, and craniofacial) and plastic surgery fellows. Bibliometric data at the time of fellowship application were obtained for each fellow.

RESULTS

A total of 235 fellows were included. There was a significant difference in the median number of publications (P = 0.0067) and h-index (P = 0.0229) across subspecialties. Multivariate analysis demonstrated that dedicated research time was predictive for a high publication count (odds ratio [OR], 3.59; P = 0.0007) and h-index (OR, 4.88; P < 0.0001) at the time of fellowship application. Although international residency and aesthetic fellowship application were predictive of a reduced number of publications (OR, 0.17; P < 0.0001, and OR, 0.43; P = 0.0190, respectively), H-index was increased by possession of an advanced degree (OR, 2.00; P = 0.0291) and decreased with international residency (OR, 0.26, P = 0.0021).

CONCLUSIONS

All plastic surgery fellows have highly qualified academic profiles at the time of fellowship application. Academic productivity differs between subspecialty fellowships. Those wishing to match into competitive subspecialties should consider taking dedicated time for research or attaining an advanced degree.

The Ideal Applicant to the Saudi Plastic Surgery Residency Program

Securing a plastic surgery position is a demanding task for students. Although many papers have been published internationally discussing the traits and features deemed important from the point of view of plastic surgery program directors, a gap exists in the literature where this aspect is not covered in Saudi Arabia. The aim of this study was to fill this gap.

Methods

In this cross-sectional study, a survey was developed targeting all current and former Saudi plastic surgery training program directors. SPSS was used to calculate frequencies and present percentages; independent t-test was done to look for mean differences. Ethical approval was obtained from a local institution.

Results

All current and former Saudi plastic surgery program directors participated (n = 17), including the 8 (47.1%) current directors. When asked to rank 7 items on a scale of importance, they scored a mean of 6.2, 5.8, 5.4, 4.88, 4.82, 4.6, and 3.7 for good impression on interviews, prior experience, research experience, the grade point average (GPA), oral or poster presentations on events, the Saudi Medical Licensing Examination (SMLE), and attaining a post-graduate degree, respectively. The majority [n = 7 (41%)] considers the mode of communication, such as phone calls, as the most important aspect in recommendations. They prefer candidates who took electives/rotations at their department [n = 12 (71%)] and give more value to high-quality publications [n = 9 (47%)]. Applicant's gender was not important.

Conclusion

With early planning, this article could serve as a guide for medical students interested in plastic surgery to build their assets toward a successful interview.

Trends in the research profile of matched independent plastic surgery fellows

The independent plastic surgery pathway recruits candidates with 5 years of surgical training who are typically more advanced in research than their integrated counterparts. Research productivity helps to discriminate between applicants. However, no studies exist detailing the academic attributes of matched independent plastic surgery candidates.We performed a cohort study of 161 independent plastic surgery fellows from accredited residency programs from the 2015 to 2017 application cycles. We performed a bibliometric analysis utilizing Scopus, PubMed, and Google Scholar to identify research output measures at the time of application.The cohort was predominantly men (66%) with a median of 3 articles and a H-index of 1 at the time of application. Interestingly, 16% of successful candidates had no published articles at the time of application, and this did not change significantly over time (P = .0740). Although the H-index remained stable (R 0.13, P = .1095), the number of published journal articles per candidate significantly decreased over 3 consecutive application cycles (R -0.16, P = .0484). Analysis of article types demonstrated a significant increase in basic science articles (R 0.18, P = .0366) and a concurrent decrease in editorial-type publications (R = -0.18, P = .0374).Despite the decline in publication volume of matched independent plastic surgery fellows, the quality of their research portfolio has remained constant. Matched applicants appear to be shifting focus from faster-to-publish articles to longer but higher impact projects. In selecting a training route, applicants must weigh the highly competitive integrated path against the dwindling number of independent positions.

An In-Depth Analysis of Research Output in Successful Integrated Plastic Surgery Match Applicants and Factors Associated With Matching at Top-Ranked Programs

OBJECTIVE

With USMLE Step I score reports becoming pass/fail, research output may become a more important factor for applicants in the integrated plastic surgery match. The authors aim to assess the research output of successful applicants and bibliometric variables associated with matching at higher tier programs.

DESIGN

A search of peer-reviewed publications up to or during September before the matriculant's match year was performed using PubMed, Google Scholar, and Scopus for each resident. Bibliometric variables were analyzed including those associated with matching at higher tier Doximity reputation/research programs.

SETTING

University of Pennsylvania (Philadelphia, Pennsylvania).

PARTICIPANTS

Integrated plastic surgery interns for the 2019 to 2020 and 2020 to 2021 academic years (n = 301).

RESULTS

Three hundred one matriculants at 73 programs produced a total of 731 manuscripts. The mean number of publications and H-index per applicant was 2.43 ± 3.84 and 1.01 ± 1.30, respectively. The average and maximum journal impact factor was 2.8 ± 1.81 and 4.66 ± 5.59, respectively. H-index, total publications, plastic surgery-related and unrelated publications, and first-author studies were all associated with matching into both a higher ranked reputation and research tier program, respectively (p < 0.05). Highest impact factor publications were associated with matching at top tier research programs only (p < 0.05). Among students from US News Top 40 and non-Top 40 medical schools, total publications and first-author publications remained associated with matching at a higher tier reputation and research program (p < 0.05). However, plastic surgery-related publications were significantly linked to matching into a higher tier program for matriculants from non-Top 40 medical schools only (p < 0.05).

CONCLUSIONS

Research productivity, particularly total publications and first-author publications, is associated with an increased likelihood of matching at a higher tier integrated plastic surgery residency. Regardless of their medical school's US News rank, students may gain a competitive edge in the match with increased research output.

Trends in the Academic Credentials of Matched Dermatology Residency Applicants

Introduction Research can be used to enhance the competitiveness of an application and is associated with a successful match. However, current reports regarding the publication record among prospective dermatology residents may be inaccurate. We sought to accurately assess the research credentials of matched dermatology residency candidates at the time of application. Methods We performed a bibliometric analysis to identify published articles of 1152 matched dermatology candidates and calculated the h-index of each applicant at the time of application. Details on article type, first authorship, and dermatology-relatedness of articles were collected. Results The median number of publications was two and the median h-index was 0. At the time of residency application, one-quarter of matched dermatology candidates (24%, n=278) possessed no publications. Over time, the median number of publications (R 0.10, p<0.001) and h-index (R 0.07, p=0.014) of matched applicants increased. The proportion of first-authored articles, dermatology-related papers, and each article type remained constant across application cycles (p>0.0500). An additional graduate degree, completion of a research fellowship, and graduation from a non-US medical school were independently associated with greater research credentials (p<0.0500). Conclusions Each year, applicants are publishing more articles and have a greater scholarly impact than in previous application cycles. However, the verified publication volume of matched dermatology applicants is strikingly lower than the values reported in national statistics.