A meta-analysis of studies of publication misrepresentation by applicants to residency and fellowship programs

Many studies from various fields of medicine about the accuracy of residency and fellowship applications have reported disturbing percentages of candidates with publication misrepresentation on their applications. However, other similar studies have found much lower percentages. No evaluation of these types of studies is currently available to explain this disparity. Therefore, this study evaluated the wide range of percentages of applicants with publication misrepresentation reported in the literature.

Studies of residency and fellowship applicant misrepresentation were identified and reviewed. Using uniform inclusion criteria, the data reported by each study were recalculated to determine the percentage of candidates with misrepresentation.

Thirteen out of 18 studies (eight residency and five fellowship) found in the literature from 1995 to 2008 reported sufficient details to perform a recalculation. The most common type of misrepresentation reported was listing nonexistent articles, followed by errors in authorship order and nonauthorship. After recalculation, the mean percentage of candidates with misrepresentation per applicant pool decreased significantly (7.2% to 4.9%, P = .03048). No study characteristic, such as sample size, was found to be predictive of the percentage of applicants with misrepresentation. No difference was found in the percentage of applicants with misrepresentation in residency versus fellowship programs.

The variance in study results of misrepresentation decreases when uniform inclusion criteria are applied. Caution must be used in directly comparing the results of these studies as originally reported. Program directors should be aware that self-promotion in the authorship list is a common form of misrepresentation.