Does Medical School Pedigree Matter? An Analysis Of Publication Productivity And Institutional Resources For Matched Integrated Plastic Surgery Applicants
Elijah M. Persad-Paisley, BA, Victoria G. Zeyl, BA, Joseph W. Crozier, MA, Amanda R. Laguna, BS, Carole S.L. Spake, MSc, Loree Kalliainen, MD., Mimi R. Borrelli, MBBS, MSc
Division of Plastic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
PURPOSE: Plastic surgery program directors heavily weigh research output when reviewing prospective applicants, with 80% rating its importance 4.2/5.0. U.S. allopathic seniors who are matched into integrated plastic surgery programs produce an average of 19.1 abstracts, presentations, and publications at the time of application submission. However, The NRMP biennial student survey data from which this information was obtained does not distinguish the types of research output. Many studies have explored the average number of publications for plastic surgery residents, but none to date have evaluated other aspects of research productivity that may affect research output and subsequent residency program placement.
METHODS: Matched integrated plastic surgery applicants from the 2020-2021 application cycle were identified. The name of each resident and their medical school was searched on PubMed and the number of publications indexed by October 1, 2021 was determined. The total number of first authorships, as well as the total number of publications in either Plastic and Reconstructive Surgery, or Aesthetic Surgery Journal—the two highest H5-index journals in the field—was recorded. Residency quartile ranking was determined using Doximity Residency Navigator. NIH funding status was obtained from the institute’s website. Univariate and multivariable ordinal logistic regression models were used to identify predictors of residency placement.
RESULTS: 185 incoming residents were analyzed. Univariable analysis revealed that residents who attended a medical school associated with a top-quartile plastic residency program or graduated from a top 40 NIH-funded school were 4.59 (95% CI 2.31-9.50; p<0.001) and 2.54 (95% CI 1.45-4.51; p=0.001) times more likely to match into a top-rated program, respectively. A greater number of manuscripts (OR 1.11; 95% CI 1.05-1.18; p<0.001), first authorships (OR 1.30; 95% CI 1.11-1.54; p<0.01), and publications (OR 1.82; 95% CI 1.30-2.81; p<0.01) were all associated with increased odds of placement in a higher-ranked residency. At 330% higher odds of matching at a top program, matriculation to a medical school associated with a top plastic surgery program was a good predictor of program placement on multivariable analysis (OR 3.33 95% CI 1.45-7.90; p<0.01).
Institutional resources—as measured by NIH funding status and association with a top plastic surgery residency program—and research output were found to be good predictors of matching into a highly-ranked plastic surgery program. This suggests that students from lesser funded schools are less likely to end up in top programs. This becomes more pertinent as students from these schools may find it even more difficult to match into top programs when USMLE Step 1 becomes pass/fail.
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