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

Impact of Early Research Productivity on Future Academic Output Among Head and Neck Fellows

OBJECTIVE

To examine the impact of pre-fellowship publications on future research productivity and career placement among head and neck (H&N) surgery fellowship graduates.

METHODS

H&N surgery fellowship graduates between 2014 and 2022 were identified from publicly available data. Timing of fellowship graduation, number of publications during each stage of education and training, and number of first authorship publications were analyzed for association with scholarly productivity and academic career placement.

RESULTS

In our analysis of 409 H&N fellowship graduates, there was a strong positive correlation between the year of fellowship graduation and the average number of publications in residency (R2 = 0.82) and fellowship (R2 = 0.79). Graduates producing more than the average of 2.37 publications prior to residency had a significantly higher average number of publications during residency and fellowship compared to those who published below average (p < 0.001). A higher number of publications prior to and during residency were both independently associated with a higher likelihood of academic career placement (p = 0.015 and p = 0.002, respectively). More first-author publications prior to residency were associated with a higher number of publications during residency and fellowship (p = 0.015). In sub-analyses, gender did not impact the average number of publications during residency and fellowship. Similarly, the COVID-19 pandemic did not significantly impact the average number of publications during the fellowship when comparing the classes of 2020-2022 to 2017-2019.

CONCLUSION

Research productivity among H&N fellowship graduates has increased in recent years. Research productivity in medical school and residency is associated with scholarly output in later stages of training and academic career placement.

LEVEL OF EVIDENCE

NA Laryngoscope, 134:3165-3169, 2024.

Association of Medical School Gap Year Research and Degree Programs With Otolaryngology Interview and Match Outcomes

OBJECTIVE

To investigate whether a gap year for either research or a master's degree is associated with interview offers or match outcomes among otolaryngology applicants.

METHODS

Using the Texas Seeking Transparency in Application to Residency (Texas STAR) database, we conducted a cross-sectional analysis of otolaryngology applicants from 2018 to 2022. Applicants were stratified based on the presence and type of gap year during medical school. Applicant characteristics, signaling, research productivity, and application costs were analyzed, with primary outcomes including number of interview offers and match status.

RESULTS

Among 564 otolaryngology applicant respondents to the Texas STAR survey, 160 (28%) reported a gap year, including 64 (40%) applicants participating in a research year, 65 (41%) completing a Master of Public Health or Science (MPH and MSc), and 31 (19%) completing a Master of Business Administration, Education, or other degree (MBA and MEd). Gap-year applicants who completed a research year or MPH/MSc degree received more interview offers (P < .01) than MBA, MEd applicants, or those without a gap year. Applicants with a research year had the most publications, oral presentations, abstracts, posters, and research experiences (all P < .01). When controlling for USMLE scores, clerkship honors, and applications submitted, applicants completing a research year or an MPH/MSc-degree received increased interview offers (P < .01). No significant differences were seen in expenditures or match rates.

CONCLUSIONS

Research and MPH/MSc gap years were associated with increased residency interview offers but not increased match success. Further longitudinal studies are needed to assess how yearlong experiences affect long-term career outcomes.

Association of pre-residency publications with research productivity in residency, fellowship, and academic career choice among Canadian ophthalmologists

OBJECTIVE

This study aimed to assess whether the research output of medical students who matched into a Canadian ophthalmology residency program influences their subsequent research productivity during residency, decision to pursue a fellowship, or engagement in academic practice.

DESIGN

Retrospective database review.

PARTICIPANTS

A total of 369 trainees commencing ophthalmology residency from 2004 to 2015 at 15 residency programs.

METHODS

Each trainee's publication record was queried in Scopus before and after the date they started residency. Multiple public sources were searched to identify fellowship placement and the type of subsequent practice (i.e., academic or community). Predictors of research productivity during residency, fellowship, and practice setting were assessed using multivariable regression analyses.

RESULTS

Trainees with pre-residency publications (n = 187) demonstrated significantly higher research productivity during residency than those without pre-residency publications (n = 182), with a mean of 5.17 ± 5.97 versus 1.60 ± 2.38 publications on any topic (p < 0.001). Pre-residency research output was a predictor of research productivity during residency (relative risk = 1.17; 95% CI, 1.09-1.27; p < 0.001), pursuing fellowship (odds ratio, 2.9; 95% CI, 1.74-4.83), and an academic career (odds ratio = 1.85; 95% CI, 1.07-3.2).

CONCLUSION

Pre-residency research output is a significant predictor of research productivity during residency and subsequent career choices, suggesting that pre-residency publishing reflects a propensity toward an academic trajectory. Residency publication count moderates this association, underscoring the role of the residency program environment in fostering research productivity. Addressing barriers such as mentorship, funding, and curriculum may be key to incentivizing trainees to pursue academic medicine.

Research productivity of ophthalmology residents and its relationship to academic career outcomes

OBJECTIVE

To assess the impact of ophthalmology resident research and its relationship to subsequent practice.

DESIGN

Cross-sectional study.

PARTICIPANTS

Three hundred and twenty residents of Canadian ophthalmology programs graduating between 2009 and 2020.

METHODS

Bibliometric data were obtained for each resident from Scopus. Indices of scholarly productivity included number of publications, h-index, m-quotient, and total citations. Demographic and career data were obtained from faculty listings and professional and regulatory web sites. Career outcomes included location and subspecialty of fellowship training and type of ultimate practice (academic vs community).

RESULTS

In total, 208 of 320 graduates (65%) published at least 1 peer-reviewed article during residency. Bibliometric indices, including numbers of papers, h-index, and total citations, were significantly higher for male residents and residents who pursued academic and subspecialized practices. No significant trends were seen regarding scholarly productivity and fellowship match outcomes (e.g., location and subspecialty of fellowship). The bulk of resident research projects was of lower tiers of evidence, including retrospective studies (n = 111) and case reports (n = 108). Five-year scholarly impact of resident research decreased over time (h-index, m = -0.14; p < 0.01) despite stable publication volumes.

CONCLUSIONS

Greater scholarly activity in residency corresponds to more academic and subspecialized practices but is not associated with type of fellowship. The impact of resident research declined between 2009 and 2020. Sex-based disparities exist.

The Relative Citation Ratio: An Impartial Assessment of Productivity in Academic Otolaryngologists

OBJECTIVES

Quantification of academic productivity relies on bibliometric measurements, such as the Hirsch index (h-index). The National Institutes of Health (NIH) recently developed the relative citation ratio (RCR), an article-level, citation-driven metric that compares researchers with others within their respective fields. Our study is the first to compare the usage of RCR in academic otolaryngology.

STUDY DESIGN

Retrospective Database Review.

METHODS

Academic otolaryngology residency programs were identified using the 2022 Fellowship and Residency Electronic Interactive Database. Demographic and training data were collected for surgeons using institutional websites. RCR was calculated using the NIH iCite tool, and h-index was calculated using Scopus. Mean RCR (m-RCR) is the average score of the author's articles. Weighted RCR (w-RCR) is the sum of all article scores. These derivatives are a measure of impact and output, respectively. The career duration of a physician was categorized into the following cohorts: 0-10, 11-20, 21-30, and 31+ years.

RESULTS

A total of 1949 academic otolaryngologists were identified. Men had higher h-indices and w-RCRs than women (both p less than 0.001). m-RCR was not different between genders (p = 0.083). There was a difference in h-index and w-RCR (both p less than 0.001) among the career duration cohorts, but there was no difference in m-RCR among the cohorts (p = 0.416). The faculty rank professor was the greatest for all metrics (p < 0.001).

CONCLUSION

Critics of the h-index argue that it is reflective of the time a researcher has spent in the field, instead of impact. The RCR may reduce historic bias against women and younger otolaryngologists.

LEVEL OF EVIDENCE

NA Laryngoscope, 134:592-599, 2024.

Evaluating Gaps in Otolaryngology Training: An In-Depth Needs Assessment in Saudi Arabia

BACKGROUND

The landscape of otolaryngology training in Saudi Arabia is undergoing transformation due to the expansion of medical colleges and increased overseas medical scholarships. However, concerns persist regarding the satisfaction and adequacy of surgical education. This study aims to assess gaps in otolaryngology training through an in-depth needs assessment.

METHODS

A cross-sectional study was conducted among 85 otolaryngology-head and neck surgery residency graduates in Saudi Arabia between 2019 and 2021. Participants completed a validated questionnaire assessing deficiencies, importance, and competence in different subspecialty areas. Data were analyzed using descriptive statistics, median comparisons, and Kruskal-Wallis tests.

RESULTS

Participants identified deficiencies in training across domains, with significant variations in specific subspecialties among different regions. Dissatisfaction with clinical discussions, research training, access to simulation labs, and training in emerging subspecialties was evident.

CONCLUSION

The study highlights challenges within otolaryngology training, emphasizing the need for continuous evaluation and adaptation to ensure high-quality and comprehensive training. Addressing these gaps is essential to produce well-rounded otolaryngologists capable of meeting the evolving demands of modern healthcare.

What Are the Trends in Research Publication Misrepresentation Among Orthopaedic Residency and Fellowship Applicants From 1996 to 2019? A Systematic Review

BACKGROUND

Because research experience is increasingly important in ranking orthopaedic residency and fellowship applicants, determining the accuracy of candidates reporting their scholarly activity is essential. However, disparate and inconsistent findings have made it difficult to draw meaningful conclusions from individual studies.

QUESTIONS/PURPOSES

In this systematic review, we asked: (1) What percentage of research publications are misrepresented among orthopaedic residency and fellowship applicants? (2) What percentage of applications contain one or more example of academic misrepresentation? (3) Is research misrepresentation associated with any individual applicant characteristics? (4) What is the publication status of articles listed by applicants as having been submitted to journals?

METHODS

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, EBSCOhost, Medline, and Google Scholar electronic databases were searched on March 10, 2022, to identify all studies that evaluated research misrepresentation in orthopaedic residency and fellowship applications between January 1, 1995, and March 1, 2022. Articles were included if full-text articles in English were available and the study reported on research misrepresentation among orthopaedic residency or fellowship applicants. Studies investigating nonorthopaedic publications, systematic reviews, case studies, duplicate studies among databases, and gray literature were excluded. Two reviewers independently evaluated the quality of included studies using the Methodological Index for Nonrandomized Studies (MINORS) tool. This is a validated assessment tool that grades noncomparative studies from 0 to 16 and studies with control groups from 0 to 24, based on eight criteria related to study design, outcomes assessed, and follow-up. All included articles were noncomparative studies, so the maximum score here was 16, with higher scores indicating better study quality. The mean MINORS score was 13 ± 1 in the studies we included. The final analysis included 10 studies with 5119 applicants. Eight studies evaluated orthopaedic residency applicants and two evaluated fellowship applicants. The applicant classes ranged from 1996 to 2019. Research misrepresentation was defined among studies as nonauthorship of an existing article, claimed authorship of a nonexistent article, or incorrect listing of authorship order for an existing article. Each study's findings and definition of research misrepresentation were considered to allow for a discussion of overall trends. The percentage of misrepresentation was further broken down by the misrepresentation type. Applicant characteristics and destination of submitted articles were also evaluated. Given the potential overlap between applicants among the studies, no pooled analysis was conducted, and results are presented as a narrative summary.

RESULTS

The percentage of overall publication misrepresentation was estimated to range between 1% (13 of 1100) and 21% (27 of 131), with more-recent studies reporting a lower proportion of overall articles misrepresented. Most studies we found claimed that authorship of a nonexistent article was the most common type of misrepresentation. Nonauthorship of an existing article and incorrect authorship order were less common. The percentage of applications with at least one misrepresentation was approximately 20% between 1998 and 2017. Most studies found no applicant characteristics, such as match outcomes, demographic markers, or academic records, that were consistently associated with a higher odds of the candidate misrepresenting his or her research credentials. Finally, approximately half of the articles listed as submitted to journals went on to publication, with one-third going to a different journal with a lower Impact Factor.

CONCLUSIONS

Our systematic review found that the percentage of overall publication misrepresentations among orthopaedic residency and fellowship applicants has generally been low over the past 20 years. However, approximately one-fifth of applications had at least one research misrepresentation, with 2% having multiple misrepresentations on reported publications. There were no consistent applicant characteristics associated with higher odds of research misrepresentation. Additionally, most of the articles listed as submitted to journals for publication were ultimately published.

CLINICAL RELEVANCE

Although the decrease in overall publication misrepresentation is encouraging, our finding that one-fifth of applicants have research misrepresentation is a cause for concern. In light of a continually evolving application process, orthopaedic residency and fellowship programs must ensure there is integrity related to information that is self-reported by applicants. These findings also serve to encourage faculty members involved in the application screening and decision process to limit biases related to applicant demographics perceived to be associated with a high odds of misrepresentation. Furthermore, governing agencies and program leadership should evaluate methods of verifying unpublished work and provide opportunities for applicants to give publication updates throughout the application cycle.

An Otolaryngologist's Guide to Understanding the H-index and How It Could Affect Your Future Career

Objectives

The h-index is a measure of research output and contribution that shows strong correlation with academic promotion in medicine. The purpose of this article is to clearly explain how h-index scores are calculated and how otolaryngologists can effectively and advantageously use these scores for their career development.

Data Sources

PubMed.

Review Methods

We performed an up-to-date PubMed literature review describing the design of the h-index and how to use it effectively along with its role in academic medicine, including otolaryngology.

Conclusions

H-index scores are used as a metric for scientific output that considers the number of publications and the number of times each is cited. Search engines can automatically calculate h-index scores for one's work. Studies also revealed significant positive correlations that the h-index has from fellowship involvement, which could be beneficial for career advancement in academic medicine.

Implications for Practice

Aspiring academic otolaryngologists should create a research profile to link and calculate the h-index for publications, submit to well-read high-impact journals for increased viewership and citations, and expand on foundational and personal research topics. Future studies should evaluate faculty and resident awareness of h-indices in the otolaryngology department to see how we can further address any underlying barriers. Otolaryngologists with the knowledge and tools necessary to maximize h-index scores and produce high-quality research in modern-day medicine not only provide potential advantages in career development but also bring significant contribution to the field of otolaryngology and patient care.