Longitudinal Academic Productivity of Complex General Surgical Oncology Fellowship Graduates: Misalignment Between...

Securing a position in a complex general surgical oncology (CGSO) fellowship requires significant academic productivity, often including dedicated research time during surgical residency. However, it remains unclear whether this research translates into continued scholarly activity post-fellowship. This study aimed to evaluate longitudinal academic productivity among CGSO fellowship graduates and assess their perspectives on the current training paradigm.

The study identified 483 CGSO fellowship graduates (2006-2016) from 20 U.S. fellowship training programs. Academic productivity was assessed using publication count, h-index, and m-index. The study queried National Institutes of Health (NIH) and United States Department of Defense individual research funding through NIH reporter and Congressionally Directed Medical Research Program databases. A survey was distributed to assess career paths, practice settings, and opinions on training structure. Multivariable regression was used to identify predictors of sustained research activity.

Although 71% of the CGSO graduates completed dedicated research time during residency, only 9% received extramural funding, and 60% had an m-index lower than 1, indicating limited long-term academic productivity. Multivariate regression analysis showed that fellowship training institution and attainment of advanced degrees were associated with higher m-index values, whereas residency research time was not. Survey responses (n = 181, 47% response rate) showed that most graduates devote the majority of their careers to clinical work and support restructuring the training model to align with actual practice patterns.

Despite research serving as a de facto prerequisite for CGSO fellowship admission, few graduates maintain academic productivity after training. These findings underscore the need to re-evaluate the current CGSO training paradigm, with consideration for clinically focused and research-intensive fellowship tracks that better align with trainee goals and workforce needs.