Quantity versus quality: analysis of research publications in the 2023 neurosurgery match

Prematch research productivity is a heavily utilized metric in evaluating neurosurgery residency applicants. With the rise in research output by successfully matched candidates and the so-called publication arms race, there is a growing interest in understanding the quality and impact of the research conducted by medical students who secure neurosurgery residency positions. This study aimed to characterize the research output of medical students who matched into neurosurgery in 2023, identify predictors of research productivity, and explore the implications of research output on match outcomes.

First-year neurosurgery residents from the 2023 match were identified via program websites. Research output data were collected from the PubMed and Scopus databases, excluding publications released after the 2023 National Resident Matching Program deadline. Predictive analyses were conducted using multiple linear regression models.

Data were obtained for 242 1st-year neurosurgery residents and 2519 PubMed-indexed publications. The median numbers of total and first author publications were 7 (range 0-73) and 2 (range 0-25), respectively. The median number of citations was 28 (range 0-1010), with a median impact factor of 3.1 (range 0-30.43). Most publications represented retrospective clinical research (n = 839). Of the neurosurgery-related publications, spine-related research was most common (n = 410), while peripheral nerve research was the least common (n = 20). Factors associated with higher publication output included attending a top 20-ranked U.S. News & World Report medical school (p = 0.00044), international medical graduate status (p = 1.95e-6), and obtaining a doctor of philosophy degree (p = 0.00582). Applicants who published more than 30 papers averaged 4.16 citations per paper, whereas residents who published fewer than 30 papers averaged 8.34 citations per paper (p = 0.0006).

This study characterizes the research output of successfully matched neurosurgery applicants and identifies medical school ranking and degree status as predictors of research productivity. Interestingly, only the rank of the medical school attended predicted better match outcomes despite an overall shift to utilizing research as a metric of merit in residency applications in reaction to an increase in pass/fail medical school curriculums and changes in United States Medical Licensing Examination Step 1 grading systems. These findings also demonstrate that residents who published the most papers published the lowest-impact research, which aligns with the notion that there is an increased emphasis on publication quantity rather than publication quality.