Mean H-index Research Articles

Trends in Leadership at Spine Surgery Fellowships.

Cross-sectional study. To illustrate demographic trends among spine fellowship leaders (FLs). No previous study in the orthopedic literature has analyzed the demographic characteristics or past surgical training of FL in an orthopedic sub-specialty. We attempt to illustrate demographic trends among spine fellowship leadership including fellowship directors (FDs) and co-fellowship directors (co-FDs). We also highlight the institutions that have trained these leaders at various levels. Our search for FDs was constructed from the 2018 to 2019 North American Spine Surgery (NASS) Fellowship Directory. Datapoints gathered included: age, sex, residency/fellowship training location, time since training completion until FD appointment, length in FD role, and personal research H-index. We identified 103 FLs consisting of 67 FDs, 19 co-FDs, and another 16 individuals with a synonymous leadership title. 96.1% (99) of the leadership consisted of males while 3.9% (4) were female. The mean age was 52.9 years old and the mean h-index of the FLs was 23.8. FLs were trained in orthopedic surgery (n = 89), neurosurgery (n = 13), or combined orthopedic surgery and neurosurgery training (n = 1). The top fellowships programs producing future FLs were: Case Western Reserve University, Cleveland (n = 10), Washington University, St. Louis (n = 9), and Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia (n = 7). Spine surgery fellowship directors are more likely to have graduated from certain residency and fellowship programs. This finding could be a result of the training provided by these centers or the institution's predilection to select applicants that are more likely to later seek academic leadership roles post-training. 4.

Twitter Activity Is Associated With a Higher Research Citation Index for Academic Thoracic Surgeons

Academic surgeons are encouraged to promote their work on social media. We hypothesized that thoracic surgeons who are active on Twitter have a higher research citation index (Hirsch index [h-index]) than their counterparts who are not. Thoracic surgeons on CTSNet.org in Canada and the United States were queried for profiles with an h-index on Google Scholar and/or Research Gate in July 2018. Surgeons were categorized by whether they possessed a Twitter account (T+) or not (T-), and h-index values were compared. Within the T+ cohort a multivariate regression model was used to identify independent predictors of increased h-index among variables related to Twitter activity. Of 3741 surgeons queried, 19.3% (722) had a known h-index. The mean h-index for the entire cohort was 14.54 (SD, 15.73). The median h-index was 10 (range, 0-121), and the 75th percentile h-index was 20. T+ surgeons had a median h-index of 10 (range, 0-66), and T- surgeons had a median h-index of 10 (range, 0-72; P= .25). The 75th percentile h-index for T+ surgeons was 23 compared with 20 for T- surgeons (P= .24). For T+ surgeons the regression model identified the number of followers (P= .029), the number of people followed (P= .048), and the frequency of tweeting (P= .046) as independent predictors of a higher h-index. The median h-index for an academic thoracic surgeon in Canada and the United States is 10. Surgeons who engage in Twitter activity are more likely to have their research cited by others.

Research productivity across different ophthalmic subspecialties in the United States

BackgroundThe purpose of this study was to compare the h-index, and subsequently the research productivity, among different ophthalmic subspecialties in the United States.MethodsA cohort of over 15,000 academic ophthalmologists residing in the United States (US) was identified out of the physician list of the American Academy of Ophthalmology. Of them, 1000 ophthalmologists with at least one publication were randomly retrieved, 100 in each of the following 10 subspecialties: cataract, cornea/external disease, glaucoma, medical retina, neuro-ophthalmology, pediatric ophthalmology, plastic/reconstructive ophthalmology, refractive surgery, retina/vitreous surgery and uveitis. Data collected included: number of published papers, h-index score, annual increase in h-index and the mean number of authors on each paper.ResultsThe mean h-index amongst all subspecialties was 9.87 ± 13.90, and the mean average annual increase in h-index was 0.22 ± 0.21. The mean number of papers published was 37.20 ± 80.08 and the mean number of authors on each paper was 3.39 ± 0.84. Uveitis was the most prolific subspecialty in mean number of papers (74.78 ± 131.37), in mean h-index (16.69 ± 20.00) and in mean annual increase in h-index (0.35 ± 0.28). The least fertile subspecialty with regards to research was cataract with 11.06 ± 27.65 mean number of papers, a mean h-index of 3.89 ± 5.84, and a mean annual increase in h-index of 0.11 ± 0.11.ConclusionsThis study describes the research productivity in each ophthalmic subspecialty in the US, thus providing information on the research performance of each field and on the expected academic accomplishments within it.

Female Representation in Otolaryngology Leadership Roles.

Characterization of leadership within otolaryngology is key to evaluating trends and promoting program advancement. This study evaluates representation of women in otolaryngology holding residency and fellowship directorships, or chair positions, comparing sex differences in academic rank, years in practice, and scholarly activity. Cross sectional analysis. A comprehensive list of otolaryngology residency and fellowship directors from Accreditation Council for Graduate Medical Education-accredited programs in 2017 to 2018 was compiled. Academic rank and years in practice were determined from departmental websites, with online search tools used as secondary resources. The h-index was utilized as a measure of research productivity. Regression analysis was performed to analyze these variables. Among the 306 directorships, women held 57 (18.6%) of these positions, 27 (26.5%) residency and 30 (14.7%) fellowship directorships. Of the 99 chair positions, five (5.1%) were held by women. The majority (53.6%) of male directors were full professors, whereas only 26.3% of females were full professors (P = .04). Mean years in practice for female directors (13.9 ± 6.8) was less than that of male directors (20.3 ± 9.4, P < .0001). Similarly, mean h-index for female directors (11 ± 7.2) was lower than for males (17.5 ± 12.5, P = .0001). After controlling for academic rank and years of practice in a multivariable regression, the h-index remained lower for women than for men (P = .03). Women are disproportionately underrepresented in positions of residency and fellowship directorships, and chair positions, consistent with other specialties. Women in leadership had lower academic ranks, fewer years of practice, and lower h-indices than their male counterparts. This may represent a shift in academic otolaryngology as female otolaryngologists seek early involvement in leadership. 4 Laryngoscope, 130:1664-1669, 2020.

Standing on the Shoulders of Giants: Dental Students Seek Academically Productive Mentors

The purpose of this study was to determine whether a strong statistical correlation exists between the involvement of trainee groups and the academic productivity of the senior author. A retrospective cohort study of publications in the Journal of Oral and Maxillofacial Surgery from 2002 to 2016 was designed and implemented. The primary predictor variables were the presence of a trainee (dental student or oral and maxillofacial surgery [OMS] resident), year of publication, and study design and topic. The outcome variable was the Hirsch index (h-index) of the senior author. Author affiliations were queried using ScienceDirect, and the Scopus database was used to identify the h-index of the senior author from each publication spanning the previous 15years. Descriptive statistics and t tests were performed to determine significance. Of the 6,398 articles published in the Journal of Oral and Maxillofacial Surgery from January 2002 to December 2016, 1,341 (21.0%) met the inclusion criteria. The mean h-index of senior authors of articles with trainees or OMS residents was not significantly different from the mean h-index of senior authors without trainees (P=.50) or OMS residents (P=.37), whereas the mean h-index of senior authors working with dental students was significantly greater than the h-index of those not working with dental students (P<.01). Dental student mentors had a mean h-index that was below the sample mean from 2002 to 2007 but rose above the sample mean from 2010 to 2016. Trainees were more likely to work with academically productive mentors in orthognathic surgery (P<.01), temporomandibular joint (P<.05), retrospective cohort (P<.05), and innovative technique (P<.05) studies but less likely in randomized controlled trials (P<.05). Dental students seek more academically productive mentors to a greater degree. More studies should be conducted to elucidate the attributes of the ideal mentor in academic OMS and to determine whether differences in mentorship exist between domestic and foreign OMS programs.

Deconstructing a Leader: An In-Depth Analysis of the Commonalities between Plastic Surgery Chiefs and Chairmen.

The authors sought to identify factors associated with current chiefs and chairpersons in academic plastic surgery to encourage and shape future leaders of tomorrow. Academic chairpersons in plastic surgery (n = 94) were identified through an Internet-based search of all Accreditation Council for Graduate Medical Education-accredited residency training programs during the year 2015. Sex, ethnicity, academic rank, board certification, time since certification, medical school attended, residency program attended, fellowships training, advanced degrees, obtaining leadership roles at trainee's institution, and h-index were analyzed. Of the 94 chiefs and chairpersons, 96 percent were male and 81 percent obtained full professor status, and 98 percent were certified by the American Board of Plastic Surgery. Mean time since certification was 22 years (range, 7 to 45 years). Fifty-one percent graduated from 20 medical schools, whereas 42 percent graduated from only nine plastic surgery training programs. Fifty-six percent had pursued fellowship beyond their primary plastic surgery training. Eighteen percent had obtained advanced degrees. Twenty-nine percent of chiefs and chairpersons obtained leadership roles at the institution where they had completed plastic surgery training. The mean h-index was 17.6 (range, 1 to 63). Graduates of the nine most represented residency programs had a mean h-index of 21 versus 15 when compared with the remaining chief/chairpersons (p < 0.0062). Leaders in plastic surgery are more likely to be male, hold academic rank of professor, and have completed a fellowship after residency.

The research output from medical institutions in South Asia between 2012 and 2017: An analysis of their quantity and quality

IntroductionThe eight countries of South Asia share similar backgrounds, together with similar health care related problems and a lack of medical facilities. They also have a total of 828 medical institutions both in the public and private sectors but sadly, their research output is generally thought to be poor both in quality and quantity. MethodsWe analyzed the research output from this region in terms of the number of publications in indexed journals, their citations and the h-index of the institutions using the Scopus database between 201217. These were compared with ten randomly selected leading institutes of the world. ResultsOnly 353 (42.7%) had produced a single indexed research article in the six years of the study period. The cumulative research output of all the countries during this period was 97,170, the biggest contributor being India (86.3%) followed by Pakistan (9.9%) and Bangladesh (1.4%). In terms of the mean number of the citations and h-index, India led with 1775 citations per institute with a mean h-index of 12.1. ConclusionDespite the immense health problems facing the countries, the overall research output from the South Asian countries is poor as evidenced by the cumulative number of publications or a comparison on a global scale. This needs urgent and serious attention. We suggest that intercountry research collaborations, student exchanges, compulsory research projects in undergraduate and postgraduate curricula, adequate funding, and incentives for research publication may be some of the ways forward.

Industry Consulting Payments to Orthopedic Surgeons Are Associated With Increased Publications.

In accordance with the Physician Payment Sunshine Act, all industry payments to physicians in the United States have become publicly available. Previous research has indicated that orthopedic surgeons receive the greatest amount of industry compensation compared with other surgical subspecialists. However, the relationship between this compensation and research productivity is less clear. This study sought to investigate the relationship between consulting fees paid to orthopedic surgeons and academic productivity. Using the Centers for Medicare & Medicaid Services Open Payments Database, this study identified 2555 orthopedic surgeons who received at least one industry consulting fee in 2015. Physicians who received total consulting fees of at least $20,000 (US) were stratified into the high payment group. The number of publications and the h-index for each physician were used as metrics of scholarly impact. Mean publication number and h-index for the high payment group were compared with all other physicians in the sample using an independent-samples t test. A total of 2555 orthopedic surgeons received consulting payments totaling $62,323,143 in 2015. The mean consulting payment was $24,393 (SD, $45,465). The publication number was greater for the high payment group (mean, 61.6; SD, 135.6) compared with all other physicians in the sample (mean, 36.1; SD, 95.6). Additionally, the mean h-index for the high payment group was 13.7 (SD, 14.3) compared with 10.0 (SD, 11.6) for all other orthopedic surgeons. These findings indicate that the orthopedic surgeons who receive more in industry consulting fees are also those who contribute most substantially to the body of orthopedic literature. [Orthopedics. 2019; 42(3):137-142.].

National criteria for academic appointment in vascular surgery

ObjectiveAdvancement in academic medicine is multifactorial. Our objectives were to characterize academic appointments in vascular surgery and to investigate what factors, particularly publications, influenced academic appointment. MethodsAcademic vascular surgeons at Accreditation Council for Graduate Medical Education vascular training programs or at primary sites of U.S. allopathic medical schools were included. Those with qualified titles, such as “adjunct” or a “clinical” prefix, were excluded. Sex, education, region, board certification, and affiliation details were recorded. Web of Science was queried for publication details and h-index. The h-index is a “personal impact factor” defined as “x” number of publications cited at least “x” number of times. After surgeons' information was deidentified, univariate and multivariable analyses were completed for academic appointment and appointment as division chief. ResultsThere were 642 vascular surgeons who met criteria: 297 (46.3%) assistant professors, 150 (23.4%) associate professors, and 195 (30.4%) professors. There were 96 (15%) division chiefs and 10 (1.6%) chairs of surgery, and 83.2% were male. Surgeons worked in the Northeast (33.5%), Southern (32.6%), Central (20.1%), and Western (13.9%) United States. The mean (±standard deviation) number of publications was 13.7 ± 15.4 for assistant professors, 33.9 ± 28.8 for associate professors, and 86.8 ± 63.6 for professors (P < .001). Mean number of first or last author publications was 5.3 ± 6.4 for assistant professors, 12.2 ± 12.7 for associate professors, and 38.7 ± 35.3 for professors (P < .001). Mean h-index was 5.9 ± 5.4 for assistant professors, 12 ± 7.7 for associate professors, and 24.9 ± 12.6 for professors (P < .001). In multivariable analysis, vascular surgery board certification (adjusted odds ratio [OR], 6.08; 95% confidence interval [CI], 1.15-32.2; P = .03), academic appointment at a public medical school (OR, 1.99; 95% CI, 1.18-3.37; P = .01), years since medical school graduation (OR, 1.13; 95% CI, 1.09-1.18; P < .001, per year), and number of publications (OR, 1.05; 95% CI, 1.03-1.06; P < .001, per publication) were independently associated with associate professor. Factors independently associated with professor were years since medical school graduation (OR, 1.18; 95% CI, 1.12-1.24; P < .001, per year) and number of first or last author publications (OR, 1.05; 95% CI, 1.02-1.09; P = .003, per publication). Appointment as division chief was independently associated with h-index (OR, 1.04; 95% CI, 1.01-1.08; P = .016, per point). ConclusionsTotal number of publications was independently associated with associate professor, with number of first or last author publications particularly important for professor. The h-index was not independently associated with academic appointment, but it was for appointment as division chief. This study provides relevant data for promotional guidance in academic vascular surgery.

Gender Differences in Research Productivity among Academic Psychiatrists in Canada.

Gender inequity in academic medicine persists despite increases in the number of women physicians. We sought to explore gender differences in research productivity for academic psychiatrists in Canada. In a cross-sectional study of the 3379 psychiatrists in all 17 university departments of psychiatry in Canada, research productivity, as measured by the h-index and number of publications, was compared between women and men using a negative log binomial regression model to generate relative rates (RRs), adjusted for career duration (aRR). Findings were stratified by academic rank, institution region, and institution size. A subanalysis of those with 10 or more publications was conducted as a proxy for identifying physicians on a research track. Women (43% of the sample) had a lower mean (standard deviation) h-index than men (2.87 [6.49] vs. 5.31 [11.1]; aRR, 0.62; 95% confidence interval [CI], 0.54 to 0.72). Differences were significant only for junior faculty and not for associate and full professors. Comparison by number of publications followed a similar pattern (aRR, 0.46; 95% CI, 0.39 to 0.55). Among those with 10 or more publications (n = 721), differences between men and women were smaller than in the overall cohort for both the h-index (aRR, 0.77; 95% CI, 0.68 to 0.87) and number of publications (aRR, 0.62; 95% CI, 0.53 to 0.72). Gender differences in research productivity at the national level in academic psychiatry in Canada support a call to adopt a more systematic approach to promoting equitable opportunities for women in research, especially in early career, to improve diversity and enhance future psychiatric research and discovery.

Association between Industry Payments and Scholarly Impact among Academic Ophthalmologists

Purpose The aim of this article is to examine the association between industry payments to ophthalmologists and scholarly impact. Design Retrospective cross-sectional study. Methods All ophthalmology faculty at United States accredited ophthalmology residency programs were included in this study. The main exposure was industry payments to ophthalmologists in 2016, as reported in the Centers for Medicare and Medicaid Services Open Payments Database. The primary outcome was Hirsch index (H-index), a measure of scholarly impact. Results Among 1,653 academic ophthalmologists in our study, 1,225 (74%) received industry payments in 2016. We did not observe a difference between the mean H-index of ophthalmologists receiving any industry payments versus those not receiving any payments (p = 0.68). In analysis including only ophthalmologists who received industry payments, H-index differed significantly by payment amount: 12.6 for ophthalmologists receiving less than $100, 12.2 for those receiving $100 to 1,000, 18.8 for those receiving $1,000 to 10,000, 21.3 for those receiving $10,000 to 100,000, and 29.4 for those receiving greater than $100,000 (p &lt; 0.001). Within each academic rank and gender, industry payments greater than $1,000 were associated with a higher H-index (p &lt; 0.05). Conclusions Although our analysis cannot prove causality, we observed a significant association between industry payments and scholarly impact among academic ophthalmologists, even after adjusting for gender, academic rank, and subspecialty. Prospective studies should further evaluate this relationship.

Leadership Gender Disparity Within Research-Intensive Medical Schools: A Transcontinental Thematic Analysis.

The underrepresentation of women in senior leadership positions of academic medicine continues to prevail despite the ongoing efforts to advance gender parity. Our aim was to compare the extent of gender imbalance in the leadership of the top 100 medical schools and to critically analyze the contributing factors through a comprehensive theoretical framework. We adopted the theoretical framework of the Systems and Career Influences Model. The leadership was classified into four tiers of leadership hierarchy. Variables of interest included gender, h-index, number of documents published, total number of citations, and number of years in active research. A total of 2448 (77.59%) men and 707 (22.41%) women met the inclusion criteria. Male majority was found in all regions with a significant difference in all levels of leadership (chi square = 91.66; P value = .001). Women had a lower mean h-index across all positions in all regions, and when we adjusted for number of years invested, M Index for women was still significantly lower than men (T test = 6.52; P value = .02). Organizational and individual influences are transcontinental within the top 100 medical school leadership hierarchy. Those factors were critically assessed through in-depth analysis of the Systems and Career Influences Model. Evidence-driven actionable recommendations to remedy those influences were outlined.

Research Productivity of Directors of U.S. Advanced Education in Prosthodontics Programs.

The aims of this study were to measure the research productivity of directors of U.S. advanced education in prosthodontics programs (AEPP) and to identify associations between the directors' publication metrics and professional characteristics. A list of AEPP directors was obtained from the American College of Prosthodontists website in December 2015. Information on gender, academic rank, and highest degree was collected from the institutional website for each individual. Citation databases (Scopus and Google Scholar) were searched for each director's h-index and i10-index (both indexes are based on numbers of citations of the author's articles) and total numbers of publications and citations. The search identified 50 AEPP directors. The majority were male and had a primary appointment at a university. Most held the rank of associate professor or professor and held both DDS and MS degrees. The mean h-index and i10-index of all directors were 6.32±6.97 and 6.84±10.77, respectively. Their mean numbers of publications and citations were 24.60±31.21 and 288.40±625.97, respectively. The analysis showed that the program directors affiliated with a university had significantly higher mean values for all indexes than those of non-university-affiliated program directors. Professors had productivity metrics significantly higher than those of other ranks in all measures of research productivity.

Relationship between Citation-Based Scholarly Activity of United States Radiation Oncology Residents and Subsequent Choice of Academic versus Private Practice Career

Citation-based scholarly activity of physicians has become increasingly evaluated via the Hirsch index (h-index), which assesses the number of manuscripts (h) that have been cited at least h times. However, such evaluation involving Radiation Oncology residents is lacking in the peer-reviewed literature. The objective of this study was to assess h-index data and its association with resident choice of academic versus private practice career. A combination of internet searches, telephone interviews, and the 2015 Association of Residents in Radiation Oncology (ARRO) directory was used to compile a list of 2016 radiation oncology resident graduates (163 residents from 76 Accreditation Council for Graduate Medical Education-certified programs) and their post-residency career choice (academic versus private practice) as previously described (McClelland et al., Practical Radiation Oncology 2017). The Scopus bibliometric citation database was then searched to collect h-index data for each resident. Demographics included in analyses were gender and PhD degree status. The mean h-index score for all resident graduates was 4.15. Residents with a PhD had significantly higher h-index scores (6.75 versus 3.42; p<0.01), while there was no statistically significant difference in h-index scores between male and female residents (4.38 versus 3.36; p=0.14). With regard to career choice, residents choosing academic careers had higher h-index scores than those choosing private practice (5.41 versus 2.96; p<0.01). There was no significant difference in mean h-index scores between male and female residents regardless of private practice (3.15 versus 2.19; p=0.25) or academic (5.80 versus 4.30; p=0.13) career choice. Twenty-one of the 23 residents (91.3%) with an h-index of zero went into private practice, while 13 of the 18 residents (72.2%) with an h-index of at least 10 went into academics. Of the 17 residents with an h-index of one, 12 (70.6%) went into private practice. The average radiation oncology resident graduate has published a minimum of four manuscripts cited at least four times. Graduates with a PhD are significantly more likely to have higher h-index scores, as are residents who choose academic over private practice careers. Eighty-three percent of residents with an h-index score less than two chose private practice careers. There is no significant difference in h-index score between male and female residents regardless of career choice. These results offer up-to-date benchmarks for evaluating radiation oncology resident productivity and have potential utility in predicting career choices post-residency.

The Congress Impact Factor: A proposal from board members of the World Society of Emergency Surgeons.it (WSES) and Academy of Emergency Medicine and Care (AcEMC).

Many scientific congresses and conferences are held every year around the world. The aim of the World Society of Emergency Surgeons.it (WSES) and Academy of Emergency Medicine and Care (AcEMC) was to develop a simple mathematical parameter as an indicator of academic quality and scientific validity of a congress. In this opinion article, a new metric, the Congress Impact Factor (IFc), is proposed taking into consideration the widely used Impact Factor as an indicator of journals' prestige and using H-index analysis. The IFc is derived from the mathematical ratio between the mean H-index of invited lecturers normalized for lecture topic and number of lectures in the conference. In case of multiple sessions, the mean of all IFc is calculated along with its standard deviation. We conclude that the IFc can be a useful measure for evaluating and comparing congress prestige, and may also represent a potentially useful parameter for improving academic curriculum and helping participants to choose the more prestigious meetings for their education.

The Congress Impact Factor: A proposal from board members of the World Society of Emergency Surgeons.it (WSES) and Academy of Emergency Medicine and Care (AcEMC)

Many scientific congresses and conferences are held every year around the world. The aim of the World Society of Emergency Surgeons.it (WSES) and Academy of Emergency Medicine and Care (AcEMC) was to develop a simple mathematical parameter as an indicator of academic quality and scientific validity of a congress. In this opinion article, a new metric, the Congress Impact Factor (IFc), is proposed taking into consideration the widely used Impact Factor as an indicator of journals’ prestige and using H-index analysis. The IFc is derived from the mathematical ratio between the mean H-index of invited lecturers normalized for lecture topic and number of lectures in the conference. In case of multiple sessions, the mean of all IFc is calculated along with its standard deviation. We conclude that the IFc can be a useful measure for evaluating and comparing congress prestige, and may also represent a potentially useful parameter for improving academic curriculum and helping participants to choose the more prestigious meetings for their education.

Is Sex Associated With Differences in Academic Productivity Among Gastroenterologists at U.S. Training Programs?: ACG Auxiliary Award (Trainee): Presidential Poster Award

Introduction: Women have historically been underrepresented in gastroenterology (GI). There have been few to no analyses of female representation within the academic ranks in GI, much less a comparison of academic productivity between men and women in the field. Methods: We did a Google search of each ACGME-accredited program to identify faculty members, trainees, and program directors (PDs) as of December 2017. We found PDs and program sizes on the ACGME site. We used Scopus to find each person's h-index and publications, and confirmed their year of certification on the ABIM website. We used Poisson regression models to plot mean h-index and total publications as well as predicted ranges for each based on categorical variable. All analyses were conducted in R version 3.4.2 (R Core Team 2017, Vienna, Austria). Results: We gathered information on 3673 people including 164 PDs, 2499 non-PD faculty, and 1010 trainees (Table 1). Women comprised 22% (37/164) of PDs, 27% (675/2499) of non-PD faculty, and 34% (341/1010) of all trainees. They make up under 14% (71/520) of full professors and less than 17% (24/143) of GI chairs or chiefs. Around one-fifth (37/174) of MD-PhDs in GI are women, and while they comprise about half of subspecialists in hepatology, IBD, oncology, and motility, they barely make up over 10% (34/280) of advanced endoscopists. While mean h-indices (16.4 vs. 8.9) and publications (52.1 vs. 20.7) are higher for men overall (Table 2), the predicted ranges in metrics have largely closed in recent years as more women have entered the field (Figure). Male MD-PhDs have higher productivity, likely due to their 4:1 majority, but the metrics are mostly comparable when isolating for academic ranking (Table 2). The differences are more pronounced when comparing geography and subspecialties (Table 2). Conclusion: Women remain underrepresented at all levels in GI, though this has somewhat improved among current trainees. The imbalance is most pronounced among PDs, professors, chairs or chiefs, MD-PhDs, as well as in advanced endoscopy. This may reflect lack of mentorship for women to rise to these positions. Moreover, academic productivity still appears weighted toward men when looking at geography and subspecialty, but this is most likely due to men having had more time and opportunities to generate GI research. Indeed, the differences decrease when looking at academic ranking and younger practitioners. More effort must be undertaken to recruit women into GI and into more senior positions.1089_A Figure 1. Baseline Characteristics based on Sex1089_B Figure 2. Overall Metrics Comparison based on Sex1089_C Figure 3. Poisson Regression Model for h-index and Sex over Time

Academic Productivity of Spine Surgeons at United States Neurological Surgery and Orthopedic Surgery Training Programs

Spinal surgery is taught and practiced within 2 different surgical disciplines, neurological surgery and orthopedic surgery. We have provided a unified analysis of academic productivity measured using the h-index attributable to spine-focused faculty at U.S. residency programs. A total of 278 Accreditation Council for Graduate Medical Education training programs were assessed to identify 923 full-time faculty members with a spinal surgery designation, as defined by spine fellowship training or case volume >75% in spine surgery. The faculty were assessed with respect to academic rank, duration of practice in years, and academic productivity (h-index). The comparison showed a significantly greater mean h-index for neurological spine surgeons. The mean h-index for both disciplines increased significantly as faculty rank increased. Within the academic ranks of assistant and associate professor, neurological spine surgeons had significantly greater mean h-indexes. Neurological spine surgeons had a significantly lower practice duration. At all ranks except for assistant professor, the mean practice duration was not significantly different statistically between the neurological spine and orthopedic spine surgeons. A positive correlation between the h-index and practice duration was found for both spine surgical disciplines. The proportional odds models for neurological and orthopedic spine surgeons were moderately successful at predicting faculty rank according to the h-index. We present a unified view of academic productivity as measured by the h-index among neurosurgical and orthopedic surgery spine faculty, with some noticeable differences. These results can be used for benchmark purposes to assess the relative productivity of its faculty and could be of interest to those pursuing academic opportunities in spine surgery.

Chairs of United States Academic Ophthalmology Departments: A Descriptive Analysis and Trends

To characterize and analyze the profile of United States (US) academic ophthalmology department chairs. Cross-sectional study. Setting: Web search of publicly accessible sources. One hundred and eleven USophthalmology chairs. Demographic and academic data. Of the 111 chairs reviewed, 90% are male. Mean age of chairs is 59 years, and mean age at time of appointment is 47 years. Ninety-two percent of chairs graduated from an American medical school. Twenty-eight percent of chairs also have additional graduate degrees: 8% a Doctor of Philosophy (PhD) degree, 15% a master's degree, and 5% both. Ninety-five percent of chairs completed a clinical fellowship, most frequently in cornea (25%), vitreoretinal surgery (23%), and glaucoma (21%). The 3 programs that trained the largest number of chairs are Massachusetts Eye and Ear Infirmary, Wilmer Eye Institute, and Bascom Palmer Eye Institute. Thirty-two percent of chairs were previously trained in the program they currently head, more commonly as a resident (28%) than as a fellow (5%). The estimated mean number of publications per chair is 108 (range, 0-850) and the mean h-index is 24. Twenty-seven programs exchanged chairs from 2014 to 2017. The characteristics of appointed chairs are no different than those of recently retired chairs. Ophthalmology chairs remain predominately male, most often specializing in cornea, vitreoretinal surgery, or glaucoma. Most chairs tend to be prolific authors whose careers have placed an emphasis on research; however, a lack of demonstrated research experience does not preclude chairmanship in certain US programs.

Physician-scientists in neurology

The objective of this study was to evaluate the methods by which neurology physician-scientists are quantified through applying author-level metrics to commonly used definitions when discussing funding efforts aimed at the attrition of the physician-scientist workforce. Neurology residency alumni from institutions with the highest National Institute of Neurological Disorders and Stroke funding were identified for 2003-2005, and their funding records, publishing history, and impact factor (h-index) were obtained via the NIH Research Portfolio Online Reporting Tools and Scopus Author Profile. The group differences of total publications, yearly publication rate, and h-index between R01-funded, non-R01-funded, and nonfunded individuals were analyzed via analysis of variance models, and a publications-per-research hour rate was calculated and similarly compared across groups. From 15 programs, and from a total of 252 neurologists, 186 were identified as having demonstrated an interest in research. The mean h-index, yearly publication rate, and cumulative number of publications were significantly higher in those who eventually received an R01 grant compared to those without R01 funding and those with no research funding. Within the top 50 performers by yearly publication rate, there was an equal mix of the 3 groups of neurologists: R01 (19, 38%), non-R01 (15, 30%), and nonfunded (16, 32%). Those who were nonfunded (10% research effort) had an estimated 4.9 publications per 1,000 research hours compared to 3.0 for those with non-R01 (40% research effort) funding and 3.2 for those with R01 funding (80% research effort). While eventual R01 grant and early career funding pathways were confirmed as important components of higher h-index and larger publication numbers, the classic definition of a physician-scientist was questioned through these findings. Those presumed to be without funding and generally excluded from the physician-scientist pool because of lack of protected research time, in some instances, outperformed their R01-funded colleagues and had a higher publications-per-research hour than those with an R01 and those with non-R01 funding, when estimating a 10% research effort. This reflects a potentially erroneous assumption and indicates the important contribution of these neurologists.