What neurosurgeons should do to succeed in tomorrow's scientific and socioeconomic environment

Pre-residency publication rate strongly predicts future academic radiology potential

RATIONALE AND OBJECTIVES

Radiology resident selection committees often favor candidates with strong academic potential. The aim of this study was to determine if preresidency academic productivity of current radiologists was predictive of subsequent of future academic performance.

MATERIALS AND METHODS

The academic productivity of all radiology residents trained between 1975 and 2005 at the authors' institution was assessed through identification of their publication histories, National Institutes of Health funding statuses, and Hirsch indexes (h-indexes). These metrics were correlated with numbers of publications generated prior to beginning radiology residency and grouped accordingly (group 0, none prior to residency; group 1, one publication; and group 2, more than one publication). Academic productivity metrics of the different groups were compared using one-way analysis of variance and χ(2) analysis. Spearman's ρ coefficient was used to evaluate correlations between the number of preresidency publications and subsequent productivity.

RESULTS

A cohort of 269 residents was included in this study. Group 0 comprised 182 of the 269 residents (68%), while groups 1 and 2 comprised 27 (10%) and 60 (22%) residents, respectively. Rates of subsequent publication, mean h-index, and National Institutes of Health funding statuses were significantly higher in group 2 compared to both groups 0 and 1 (P < .0001 for each metric). Preresidency publication volume was significantly correlated with future publication performance (ρ = 0.3977, P < .0001), mean h-index (ρ = 0.3086, P < .0001), and National Institutes of Health funding status (ρ = 0.4916, P < .0001).

CONCLUSIONS

Radiology residency candidates with multiple publications are more likely to achieve future academic success compared to candidates with one or zero publications.

Pre-residency peer-reviewed publications are associated with neurosurgery resident choice of academic compared to private practice careers

Factors predictive of neurosurgery resident or applicant choice of an academic career compared to private practice are highly desired and difficult to discern. Neither medical school choice, student induction to faculty membership, age nor gender predict academic versus private practice choice among neurosurgery residents. This study was performed to examine the role of pre-residency peer-reviewed publications (PRP) in post-residency career choice. Over five years (2001-05) the number of PRP prior to onset of residency of 422 graduates from 79 neurosurgery residency programs certified by the Accreditation Council for Graduate Medical Education was retrospectively examined. The number of publications until the end of the calendar year prior to the start of residency was determined using PubMed (www.pubmed.org). This number was then correlated with the choice of an academic or private practice neurosurgery career. A minority of graduates (46.2%) chose academic neurosurgery careers, 32.2% of graduates had at least one PRP at the time of application to neurosurgery residency, with 16.4% having more than one. A total of 41.6% of graduates with no PRP chose academic careers, compared to 53.7% with one PRP, and 58.0% with more than one. With regard to choice of academic career, the difference between no PRP and at least one were statistically significant (p<0.01), but not between one PRP and more than one. Graduates with at least one PRP were 1.34 times more likely to choose an academic career than graduates with no PRP. Therefore, peer-reviewed PRP are strongly associated with resident choice of an academic over private practice neurosurgery career. This information might be useful in predicting the career choices of neurosurgery residents and residency applicants.

Predictors of neurosurgical career choice among residents and residency applicants

OBJECTIVE

Medical students applying for neurosurgery residency positions almost all aspire to become academic neurosurgeons. However, most graduates of neurosurgery residency programs ultimately follow careers in private practice. We hypothesized that there might be factors in a resident's application, interviews, or performance during residency that might predict this change in career orientation.

METHODS

We retrospectively reviewed the applications, interview evaluations, and residency performance reviews of graduates from the Neurological Surgery program at the University of California, San Francisco and examined factors that might correlate with their career choices.

RESULTS

Between 1968 and 2003, 69 neurosurgical residents graduated from the residency program. Of the 54 respondents (78%), 25 (46%) held academic positions and 29 (54%) were in private practice. None of the application data correlated with career choice, and no significant differences in interview scores were observed between academic and private practitioners. Board scores, publications, presentations, and awards received during residency were not predictive of practice orientation. Favorable evaluations during the junior (P = 0.04) and chief residency (P = 0.03) years and pursuit of a subspecialty fellowship (P = 0.006) were predictive.

CONCLUSION

Honest discussion between residents and faculty about the choice between academic and private practice careers may be as informative as the three identified predictors of residents' career orientation. Academic faculty members can encourage communication by discouraging the perception that a resident's education might be compromised if he or she expresses interest in private practice rather than academic neurosurgery. Open communication on this issue might enable faculty mentors to actively advise residents in their career decisions and improve the residents' educational environment.