Do Plastic Surgery Programs with Integrated Residencies or Subspecialty Fellowships Have Increased Academic Productivity?: A Review of the PRS Global Open Article

by Daniel Y. Cho, MD, PhD

Plastic surgery has a proud history of innovation and research, which has allowed the field to evolve into the diverse and dynamic field it is today.  This tradition continues through applicants in the plastic surgery match with the most recent Charting Outcomes in the Match, published by the National Residency Match Program, revealing that the average number of abstracts, presentations, and publications for matched US plastic surgery applicants was 12.5 compared to 4.4 for general surgery applicants1.  These statistics are consistent with literature on the plastic surgery match, which note that plastic surgery programs “are seeking the next generation of leaders, educators, and innovative thinkers who will continue to advance the field”2.  However, does this academic productivity that is essential to match into plastic surgery residency continue after training?

The authors of this study sought to evaluate the academic productivity of plastic surgery departments and divisions relative to their general and subspecialty counterparts as well as to identify the influence of integrated residency programs and subspecialty fellowships, both of which were hypothesized to increase the academic productivity of their programs in terms of publications, citations, and extramural research funding.  The authors evaluated the productivity of academic plastic surgeons at the 55 top NIH funded academic departments of surgery as identified by the Blue-Ridge Institute for Medical Research compared to their colleagues in general surgery and the other surgical subspecialties. They identified surgeons by their academic rank and leadership roles as well as their academic productivity in terms of total publications, total citations, h-index, and NIH funding for analysis.  Statistical analysis was performed to compare metrics of academic output for each of the three subsets of surgeons.  It is important to note that this study does exclude a few highly regarded plastic surgery programs due to the nature of the ranking system and also fails to take into consideration the quality of the papers included the analysis.

Interestingly, the results of this study revealed those academic plastic surgery faculty are less academically productive than their general surgery and surgical subspecialty colleagues in terms of publications, citations, and NIH funding.  The authors postulate that this may be due to the clinical demand on academic plastic surgeons, intraoperative resident education, and economic pressures of practicing at an academic institution.  Conversely, general surgeons may have increased opportunities to publish as a function of larger residency programs with greater numbers of residents available to perform research as well as the higher number of journals and more developed research infrastructures within general surgery departments.

As expected, plastic surgery faculty at institutions with integrated residency programs, hand fellowships, and craniofacial fellowships had increased academic productivity.  A recent study revealed that compared to independent plastic surgery applicants, integrated applicants had greater numbers of pre-residency publications and were more likely to be MD/PhDs3, although this number is small with only 6 applicants in the 2014 match having PhD degrees.  These characteristics are likely to contribute to the continued academic productivity of integrated residents and their research mentors in residency.  Additionally, many academic integrated programs have a well-developed research infrastructure and include a year of training dedicated to research as well as fellowship opportunities in hand and craniofacial surgery.  These programs are likely to recruit and attract applications with a strong propensity to participate actively in research as residents.

The authors conclude that the data unfortunately demonstrate that plastic surgeons are less academically productive than their colleagues in general surgery and other surgical specialties.  Recruiting residents that are interested in participating in research during their training and utilizing funding opportunities such as those from the Plastic Surgery Foundation should remain a priority for academic plastic surgery programs to continue the tradition of research and innovation in the next generation of plastic surgeons.

REFERENCES
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***ARTICLE REVIEWED***
“Do Plastic Surgery Programs with Integrated Residencies or Subspecialty Fellowships Have Increased Academic Productivity?”

Duquette, Stephen P. MD; Valsangkar, Nakul P. MD; Sood, Rajiv MD, FACS; Socas, Juan MD, FACS; Zimmers, Teresa A. PhD; Koniaris, Leonidas G. MD, MBA, FACS. Plastic and Reconstructive Surgery – Global Open 4 (February 2016): 2614.

  1. Charting Outcomes in the Match: Characteristics of Applicants Who Matched to Their Preferred Specialty in the 2014 Main Residency Match.

  2. “So You Want to Become a Plastic Surgeon? What You Need to Do and Know to Get into a Plastic Surgery Residency.”
    Nagarkar, Purushottam, Benson Pulikkottil, Anup Patel, and Rod J. Rohrich.  Plastic and Reconstructive Surgery 131.2 (2013): 419-22.
  3. “Comparison of Quantitative Educational Metrics between Integrated and Independent Plastic Surgery Residents.”
    Guo, Lifei, Judith Friend, Edward Kim, Stuart Lipsitz, Dennis P. Orgill, and Julian Pribaz. Plastic and Reconstructive Surgery 122.3 (2008): 972-78. Web.
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