Factors Determining Scientific Paper Productivity by Neuroradiology Fellows

Rationale and Objectives

We sought to determine (1) whether United States Medical Licensing Examination (USMLE) scores predict academic productivity in neuroradiology fellows as measured by publications and citations, and (2) what factors predict such productivity.

Materials and Methods

We reviewed the USMLE scores, gender, medical school location attended, publication record before and during fellowship, fellowship evaluation ratings and subsequent practice site (private vs academic) of neuroradiology fellows from 2004 to 2014 to determine relationships with publications and citations after fellowship. Spearman’s correlation and Poisson regression analyses were performed to assess the association between these factors and quantity of publications and citations per year after fellowship.

Results

USMLE scores and fellowship evaluation scores correlated inversely with radiology publications and citations. There were strong correlations between publication records before or during fellowship and after fellowship. Fellows from international medical schools, with PhD degrees, and those fellows proceeding to academic practice had more publications before or during and after neuroradiology fellowship.

Conclusions

The best predictors of whether a graduating neuroradiology fellow will publish and have high citation rates is prior publication record, a PhD degree, and staying in academics. USMLE scores and evaluations during the fellowship were inversely correlated with publication measures of academic productivity.

Introduction

Components of the United States Medical Licensing Examination (USMLE) are taken at various stages in a medical trainee’s career and are one way that residency and fellowship applicants, in most medical specialties, are evaluated and ranked . Step 1 of the test is essentially a general medical knowledge test and is usually taken after the second year of medical school for American students. International graduate students applying to American training programs typically take Step 1 as the first part of the USMLE, but it can also be taken years after their medical school training. American students usually take the two components of Step 2 of the USMLE, Clinical Knowledge and Clinical Skills, in their final year of medical school. Most Accreditation Council for Graduate Medical Education (ACGME) residency programs require passing Steps 1 and 2 before acceptance. However, Step 3, a test of patient management and decision-making, can be taken during internship or residency, although it is usually completed before the end of postgraduate training. All of the Steps are offered to international medical graduates at any time during their medical career.

A previous publication reported that the USMLE Steps 1 and 2 were correlated with core competency evaluations of neuroradiology fellows . It was concluded that there is justification for using USMLE scores as part of the screening or acceptance criteria for evaluating neuroradiology fellowship candidates. However, the criteria for judging a successful graduate of a neuroradiology fellowship program may extend beyond the fellowship itself. Passing the neuroradiology subspecialty boards after fellowship is not considered a good marker for career success because the pass rate is so high. Subspecialty certification scores are unlikely to tease out the relationship between “success” and USMLE scores because the examination scores are no longer provided to fellowship programs with a numerical value, just pass or fail.

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Methods

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Results

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Table 1

Characteristics of Neuroradiology Fellows Evaluated for the Study

Characteristics_n_ (%)/Median (IQR) Gender Male 51(70.8) Female 21(29.2) Medical school American 47(65.3) Foreign 25(34.7) Possession of academic degree MD 66(91.7) MD and PhD 6(8.3) Residency training US university hospital 39(54.2) \* US community hospital 20(27.8) Non-US hospital 13(18.1) Practice Academic 42(58.3) Private 30(41.7) USMLE score Step 1 231(215–245) Step 2 231(216–244) Step 3 217(200–229) Productivity after fellowship Publications in all topics 2.5(1–11) Publications in radiology 2(0–9) Citations in all topics 4.5(0–37.5) Citations in radiology 2(0–27.5)

IQR, interquartile range; USMLE, United States Medical Licensing Examination.

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Table 2

Average Number of Publications and Citations Per Person After Fellowship in Subgroups \*

Characteristics Group_P_ Value Gender Male Female Publications in all area 9.9 9.2 0.822 Publications in radiology 8.0 7.9 0.969 Citations in all area 35.0 41.6 0.696 Citations in radiology 22.0 30.6 0.423

Medical School Attended United States Foreign_P_ Value Publications in all area 6.8 13.6 0.029 Publications in radiology 5.1 11.9 0.012 Citations in all area 36.4 38.6 0.894 Citations in radiology 22.7 28.2 0.592

Possession of Academic Degree MD MD and PhD_P_ Value Publications in all area 8.0 21.7 <0.001 Publications in radiology 6.8 14.4 0.034 Citations in all area 23.6 186.6 <0.001 Citations in radiology 19.2 84.6 <0.001

Practice Area Academic Private_P_ Value Publications in all area 14.2 2.0 <0.001 Publications in radiology 11.8 1.2 <0.001 Citations in all area 58.3 7.6 <0.001 Citations in radiology 39.1 4.1 <0.001

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Table 3

Correlation and Predictability of the Quantity of Publications and Citations Before and During Fellowship with Subsequent Publications and Citations After Fellowship

Publications or Citations Spearman’s Correlation Coefficient P Value \* Unadjusted IRR (95% CI) † Adjusted IRR (95% CI) Publications in all area 0.361 0.015 1.05 (1.01, 1.11) 1.02 (0.99, 1.05) Publications in radiology 0.384 0.001 1.16 (1.04, 1.20) 1.03 (0.98, 1.09) Citations in all area 0.489 <0.001 1.02 (1.00, 1.03) 1.01 (1.00, 1.01) Citations in radiology 0.505 <0.001 1.04 (1.01, 1.07) 1.02 (1.00, 1.03)

IRR, incident rate ratio.

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Table 4

Predictability of USMLE Scores on the Productivity of Publications in the Fellows Going Into Academia

IRR (95% CI) \* P ValueUSMLE-1 Publications in all area 1.02 (0.88, 1.18) 0.787 Publications in radiology 1.06 (0.93, 1.22) 0.391 Citations in all area 0.69 (0.58, 0.83) <0.001 Citations in radiology 0.72 (0.60, 0.86) <0.001USMLE-2 Publications in all area 1.00 (0.89, 1.11) 0.963 Publications in radiology 1.04 (0.93, 1.17) 0.509 Citations in all area 0.66 (0.56, 0.79) <0.001 Citations in radiology 0.70 (0.59, 0.83) <0.001USMLE-3 Publications in all area 1.01 (0.84, 1.22) 0.898 Publications in radiology 0.99 (0.82, 1.20) 0.936 Citations in all area 0.69 (0.54, 0.88) 0.003 Citations in radiology 0.69 (0.56, 0.86) 0.001

IRR, incident rate ratio; USMLE, United States Medical Licensing Examination.

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Discussion

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Conclusion

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Supplementary Data

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Appendix S1

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References

1. Green M., Jones P., Thomas J.X.: Selection criteria for residency: results of a national program directors survey. Acad Med 2009; 84: pp. 362-367.
2. Yousem I.J., Liu L., Aygun N., et. al.: United States medical licensing examination step 1 and 2 scores predict neuroradiology fellowship success. J Am Coll Radiol 2016; 13: pp. 438-444. e2
3. Egol K.A., Collins J., Zuckerman J.D.: Success in orthopaedic training: resident selection and predictors of quality performance. J Am Acad Orthop Surg 2011; 19: pp. 72-80.
4. Berry C.M., Ones D.S., Sackett P.R.: Interpersonal deviance, organizational deviance, and their common correlates: a review and meta-analysis. J Appl Psychol 2007; 92: pp. 410-424.
5. McGaghie W.C., Cohen E.R., Wayne D.B.: Are United States Medical Licensing Exam Step 1 and 2 scores valid measures for postgraduate medical residency selection decisions?. Acad Med 2011; 86: pp. 48-52.
6. Kenny S., McInnes M., Singh V.: Associations between residency selection strategies and doctor performance: a meta-analysis. Med Educ 2013; 47: pp. 790-800.
7. Raman T., Alrabaa R.G., Sood A., et. al.: Does residency selection criteria predict performance in orthopaedic surgery residency?. Clin Orthop Relat Res 2016; 474: pp. 908-914.
8. Brothers T.E., Wetherholt S.: Importance of the faculty interview during the resident application process. J Surg Educ 2007; 64: pp. 378-385.
9. Mills O.F., Zyzanski S.J., Flocke S.: Factors associated with research productivity in family practice residencies. Fam Med 1995; 27: pp. 188-193.
10. Lubelski D., Healy A.T., Friedman A., et. al.: Correlation of personality assessments with standard selection criteria for neurosurgical residency applicants. J Neurosurg 2016; pp. 1-9. [Epub ahead of print]
11. Hellenthal N.J., Ramírez M.L., Yap S.A., et. al.: Manuscript publication by urology residents and predictive factors. J Urol 2009; 181: pp. 281-286.
12. Lawton M.T., Narvid J., Quiñones-Hinojosa A.: Predictors of neurosurgical career choice among residents and residency applicants. Neurosurgery 2007; 60: pp. 934-939.
13. Brancati F.L., Mead L.A., Levine D.M., et. al.: Early predictors of career achievement in academic medicine. JAMA 1992; 267: pp. 1372-1376.
14. Patterson S.K., Fitzgerald J.T., Boyse T.D., et. al.: Is past academic productivity predictive of radiology resident academic productivity?. Acad Radiol 2002; 9: pp. 211-216.
15. Rezek I., McDonald R.J., Kallmes D.F.: Pre-residency publication rate strongly predicts future academic radiology potential. Acad Radiol 2012; 19: pp. 632-634.
16. Grimm L.J., Shapiro L.M., Singhapricha T.: Predictors of an academic career on radiology residency applications. Acad Radiol 2014; 21: pp. 685-690.
17. Yang G., Zaid U.B., Erickson B.A., et. al.: Urology resident publication output and its relationship to future academic achievement. J Urol 2011; 185: pp. 642-646.

Factors Determining Scientific Paper Productivity by Neuroradiology Fellows

Rationale and Objectives

Materials and Methods

Results

Conclusions

Introduction

Methods

Results

Discussion

Conclusion

Supplementary Data

References

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