What is the relationship between research productivity in training and future research output? Put another way, are there any reliable predictors of an academic career in orthopedic research?
What Predicts a Proclivity for Orthopedic Research?
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SecondaryAcademic ProductivityRothman Orthopaedicspine publicationsUniversity of Cincinnati College of Medicine
Intuitively, the answer would seem to be that a prolific early researcher will remain so over the course of their career. A team from the Rothman Orthopaedic Institute in Philadelphia and the University of Cincinnati College of Medicine in Ohio set out to find if that, indeed, is a predictor of academic productivity or if, perhaps, other factors are more significant.
Their work, “Predictors of Academic Productivity Among Spine Surgeons,” appears in the March 21, 2023, edition of the Journal of the American Academy of Orthopaedic Surgeons.
The team pulled publishing data for 310 orthopedic and neurosurgical attending spine surgeons from 76 U.S. training programs. Specifically, the researchers calculated:
- the attending publication rate,
- each author’s h-index,
- and estimated the importance, significance, and broad impact of a scientist’s cumulative research contribution.1
When OTW asked why this subject hasn’t been investigated before, Alan Hilibrand, M.D., co-author and co-director of Spine Surgery and Director of the Spine Fellowship program at Rothman Orthopaedic Institute, said, “Access to scores like the h-index and online access to surgeon CVs and training has become easier.”
Furthermore, “I think that when people look at a trainee’s CV and try to see whether they will pursue an academic career, you can’t just count publications. We were curious whether we could predict which individuals, among applicants to fellowship or career jobs, would commit to an academic career, and were wondering what aspect of their CV were most predictive.”
The team found that number of publications during residency and fellowship were significant predictors of an increased publication rate as an attending surgeon.
However, they also determined that the pre-residency publication rate was not significantly predictive of the attending publication rate. Using the analysis of the h-index, the investigators found that residency publication rate had a positive correlation (P = 0.031) compared with pre-residency (P = 0.579) or fellowship (P = 0.257) rates.
As for the impact of geographic location on long-term academic productivity, they found that attendings who had done a residency in the Northeast and currently practicing in the Northeast had a higher publication rate.
“We found that pre-residency publication rates did NOT predict a predilection for an academic career, unless this was followed by an equally productive residency/fellowship,” stated Dr. Hilibrand to OTW. “Everyone publishes to get into residency, but continued academic productivity during the busy years of orthopaedic or neurosurgery residency is more suggestive of a continuing commitment to academic spine.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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