A Nationwide Evaluation of Cardiothoracic Resident Research Productivity

Abstract

Background: Evaluating the research productivity of cardiothoracic surgery residents during their training and early career is crucial for tracking their academic development. To this end, the training pathway of residents and the characteristics of their program in relation to their productivity were evaluated.

Methods: Alumni lists from integrated 6-year thoracic surgery (I-6) and traditional thoracic surgery residency programs were collected. A Python script was used to search PubMed for publications and the iCite database for citations from each trainee. Publications during a 20-year time span were stratified by the year of publication in relation to the trainee's graduation from thoracic surgery residency. Trainees were analyzed by training program type, institutional availability of a cardiothoracic surgery T32 training grant, and protected academic development time.

Results: A total of 741 cardiothoracic surgery graduates (I-6, 70; traditional, 671) spanning 1971 to 2021 from 57 programs published >23,000 manuscripts. I-6 trainees published significantly more manuscripts during medical school and residency compared with traditional trainees. Trainees at institutions with cardiothoracic surgery T32 training grants published significantly more manuscripts than those at non-T32 institutions (13 vs 9; P = .0048). I-6 trainees published more manuscripts at programs with dedicated academic development time compared with trainees at programs without protected time (22 vs 9; P = .004).

Conclusions: I-6 trainees publish significantly more manuscripts during medical school and residency compared with their traditional colleagues. Trainees at institutions with T32 training grants and dedicated academic development time publish a higher number of manuscripts than trainees without those opportunities.

Figure 1.

CONSORT Style Diagram of Data Collection and Analysis. A total of 75 traditional 2/3 year thoracic residency programs and 34 Integrated “I-6” programs were queried with 42 traditional programs and 15 I-6 programs having publicly available alumni lists. Our query included 672 traditional trainees and 72 I-6 trainees. Publications records 10 years prior to and following thoracic surgery residency were evaluated.

Figure 2.

Longitudinal Analysis of I-6 vs. Traditional Trainees. Publications per year per surgeon is plotted from 10 years prior to thoracic surgery residency graduation to 10 years following thoracic surgery residency graduation. The number of manuscripts published by each trainee in each year is averaged and plotted with standard deviation. Each phase of training noted on the x-axis is a rough estimate: “Medical School”, “CT Training”, CT residency graduation is year 0, and “Early Career” follows thereafter. The timeline depicted within this Figure are illustrative and meant to represent a trainee’s expected progression. A two-way ANOVA with multiple t-tests was used for statistical analysis. * denotes p < 0.05.

Figure 3.

Distribution of Manuscripts Published by Surgeons. The number of manuscripts published by surgeons (I-6 and Traditional trainees) during their lifetime is binned by 10 manuscript increments and plotted. Traditional trainees are plotted on the left Y-axis and I-6 trainees are plotted on the right Y-axis. The number of manuscripts is plotted on the X-axis. Of note, 15 traditional surgeons have published more than 200 manuscripts and are not plotted.

Figure 4.

NIH T32 Training Grant Institutional Analysis. Trainees were grouped by whether their institution had an NIH Cardiothoracic Surgery T32. The median number of (A) manuscripts or (B) citations for each surgeon during the 21-year analysis period are plotted with corresponding interquartile ranges. (A) Median number of manuscripts for trainees: T32: 13 [5–32], Non-T32 9 [2–23], p = 0.0043). (B) Median number of citations for trainees: T32: 255 [68–640], Non-T32 139.5 [24–578.3]; p = 0.0035. Mann-Whitney U-tests were performed and p-values are noted.

Figure 5.

I-6 Surgery Residency Protected Time. Trainees were grouped by whether their I-6 program provides protected academic development time for research or other academic pursuits. The median number of (A) manuscripts or (B) citations for each surgeon during the 21-year analysis period is plotted with interquartile range. (A) Median number of manuscripts for trainees: Protected time: 22 [9–38], no protected time: 9 [5.5–17.5], p = 0.004). (B) Median number of citations for trainees: Protected time: 379 [80.5–761.5], no protected time: 95 [57.5–224]; p = 0.0038. Mann-Whitney U-tests were performed and p-values are noted.