ObjectivesA major critique of the h-index is that it may be inflated by non-critical authorship. We propose a modified h-index (hm), incorporating critical authorship, complementary to the h-index. We analyze its relationship to the traditional h-index, and how each varies across professional categories relevant to academic neurosurgery. This analysis is absolutely not meant to critique authorship decisions, affect career development, alter academic legacy or imply that the concepts of team science or mid-level authorship contributions are not valuable. MethodsH-indices and hm’s were gathered and computed for clinical neurosurgical faculty at the top 32 ranked academic neurosurgical programs based on current literature. Hm was computed for faculty at each program, using publications where the individual was first, second, last, or co-corresponding author. Individuals were further identified based on chair status, leadership status, neurosurgical sub-specialty and NIH funding status. Further analysis was performed to determine factors influencing h-index and hm. ResultsThe median h-index for the 225 physicians included in the final dataset is 48 [IQR: 39−61], while median hm was 32 [24−43]. The median difference between h-index and hm is 15 [10−23]. The median hm/h was 64% [57-74]. NIH funding, and sub-specialty (Neurosurgical Oncology, Neurocritical Care and Cerebrovascular) were associated with significant change from h to hm. ConclusionsThe H-index can be influenced by non-critical authorship and hm, using critical contributions, can be used as a complement reflecting critical academic output in neurosurgery. Leaders deciding on hiring or promotion should consider disparities in productivity predicated on non-critical authorship contributions.