Cross-Sectional Study of Osteopathic General Surgeons in University-Based General Surgery Departments

Abstract

Introduction: Discrepancy between osteopathic (DO) and allopathic (MD) graduates in general surgery spans across all levels of training. In this cross-sectional study, we characterized DO surgeons who serve as faculty at university-based general surgery departments.

Methods: Overall, 106 university-based surgery departments were reviewed. DO and MD surgeons from the same institutions were identified, and demographic data were tabulated. MD surgeons were the control group. Univariate analysis and multivariate regression models were used to compare total publications, h-index, and citations.

Results: A total of 70 DO surgeons from 34 institutions were identified: 53 assistant professors, 16 associate professors, and one full professor. Of the DO surgeons, 35.7% completed residency at a university-based program, and 92.9% completed a fellowship, with surgical critical care and trauma being the most common. They were compared to 1,307 MD surgeons from the same institutions. Univariate analysis showed that MD faculty graduated medical school earlier (mean years (standard deviation (SD)): 14.8 (6.0) versus 23.3 (10.6); p<0.0001), had more total publications (median (interquartile range (IQR)): 5 (2.0-18.3) versus 35 (15.0-79.0); p<0.0001), had higher number of citations (median (IQR): 61.0 (14.0-265.0) versus 655.0 (155.0-2267.0); p<0.001), and had a higher h-index (median (IQR): 3 (1.0-8.0) versus 12 (6.0-24.0); p<0.001). Negative binomial regression models accounting for years since graduation, gender, and degree were performed. At the assistant professor rank, MD surgeons had more total publications (exponential coefficient (CI): 2.24 (1.67-3.02); p<0.001), more citations (3.10 (2.20-4.11); p<0.001), and a higher h-index (1.93 (1.36-2.73); p<0.001). Similar trends were noted at the associate professor level with MD surgeons having more total publication (1.67 (1.00-2.79); p=0.049), more citations (3.63 (2.13-6.18); p<0.001), and higher h-index (1.93 (1.10-3.39); p=0.022).

Conclusions: To address this discrepancy between DO and MD faculty surgeons, action must begin at the medical school and continue through residency. DO trainees need better access to mentorship and research support to foster an academic career.

Keywords: academic productivity; academic surgery; general surgery; medical education; osteopathic medicine; osteopathic surgery; publication; surgical education.

Figure 1. DO surgeon residency and fellowship training

A: Percentage of DO faculty who completed their residency at university-based academic centers (black) versus community or university-affiliated center (pink). B: Percentage of DO faculty who completed a surgical fellowship (black) versus did not finish a surgical fellowship (pink).