Prevalence and Impact of MD PHD Training in Academic Orthopedic Surgery

The prevalence of surgical scientists is decreasing due to rising complexities associated with these careers. This study determines the prevalence and impact of MD PhD training in academic orthopedic surgery. This was a cross-sectional study of faculty with MD PhD training at departments of orthopedic surgery in the United States. A control group of MD-only faculty was generated via propensity matching in a 3:1 ratio based on MD degree, institutional affiliation, academic rank, and subspecialty training. Study outcomes were peer-reviewed publication volume, h-index, National Institutes of Health (NIH) grant funding totals, and obtainment of department leadership positions. Comparisons were made with non-parametric and Chi-squared tests. There were 108 clinical faculty with MD PhD training at departments of orthopedic surgery (108/2775, 3.9%). In aggregate, MD PhD trained faculty had more peer-reviewed publications (55, IQR (114) vs. 42, IQR (94), p = 0.024), citations (1521, IQR (3122) vs. 738, IQR (2168), p < 0.001), and higher h-index values (18.0, IQR (23) vs. 14.0, IQR (19), p = 0.005) than controls. MD PhD faculty were more likely to obtain NIH research funding (27.8% vs. 3.7%, p < 0.001) and had higher NIH grant funding totals than MD faculty ($131,347,304 vs. $41,964,766). There were similar rates of promotion to department chair, service line chief, residency program director, and fellowship program director between the two cohorts (p > 0.05). Surgical scientists with MD PhD training account for a small percentage of clinical faculty at departments of orthopedic surgery, but have outsized scholarly influence as measured by peer-reviewed publication volume and NIH research grant funding totals.