Research Productivity and Fellowship Training in Neurosurgery

Abstract

n the article by Agarwal et al. in this issue of WORLD NEUROSURGERY, the authors conclude that there is no I difference in research productivity—as measured by the h index—between those with and without fellowship training. Interpretation of the study findings must be made in the context of the evolving role of fellowship training in neurosurgery. Fellowship training is a relatively recent phenomenon in neurosurgery compared with other medical and surgical disciplines. The spectrum of diseases with potential neurosurgical interventions and the complexity of the requisite techniques for a given disease have led to the need for subspecialization and, consequently, subspecialty fellowship training. Senior faculty members are less likely to have undergone fellowship training than junior faculty members, simply because of the fact that fellowship training was much less common 20 years ago. As the study shows, the group of nonfellowship-trained neurosurgeons contained the greatest proportion of senior faculty members. Because senior faculty members also are more likely to have amassed substantial research work over their career than junior faculty, this confounds any true effect of fellowship training on research productivity.