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. 2025 Aug 18;17(8):e90388.
doi: 10.7759/cureus.90388. eCollection 2025 Aug.

PubMed-Indexed Productivity of Matched Orthopedic Surgery Applicants Before and After Step 1 Scoring Transition

Yagni Patel  1 , Akshar Patel  1 , Arjun Bhatt  1 , Abdullah B Chandasir  1 , Thomas Drake  1 , Ali Abolhassani  1 , Jackson McClain  1 , Asim Ahmed  1 , Uzondu Agochukwu  1
Affiliations

PubMed-Indexed Productivity of Matched Orthopedic Surgery Applicants Before and After Step 1 Scoring Transition

Yagni Patel et al. Cureus. .

Abstract

Introduction: While research productivity surrounding the Step 1 scoring transition has been assessed, the specific impact on verified PubMed-indexed publications (PMIDs) has not been assessed. No study has quantified what proportion of self-reported research items reported in National Resident Match Program (NRMP) data is actually PubMed-indexed. Addressing these gaps is essential to understanding how research output is evolving and represented in residency applications.

Objectives: The objective of this study is to evaluate how the Step 1 pass/fail transition affected pre-residency research output among matched orthopedic surgery residents and whether medical school National Institutes of Health (NIH) funding independently predicts research productivity.

Methods: This retrospective cohort study included 1,441 matched orthopedic surgery residents across two cycles: pre-transition (class of 2026) and post-transition (class of 2029). PubMed was used to identify total, first-author, in-specialty publications, and citation rates. Residents were categorized by medical school NIH funding and program tier. Mann-Whitney U tests compared groups, and negative binomial regression identified independent predictors.

Results: Research productivity increased significantly following the Step 1 transition. Post-transition residents published nearly twice as many PubMed-indexed articles as their pre-transition peers (IRR = 2.13, p < 0.001), with similar gains in first-author and in-specialty work. NIH funding and program tier were independent predictors across all metrics. Citation rates did not differ. Only 12-15% of reported abstracts, presentations, and publications (APPs) were PMIDs.

Conclusion: This study provides the first validated analysis of PubMed-indexed research output before and after the Step 1 transition. These findings can inform future studies across specialties as research output becomes increasingly central to residency selection.

Keywords: orthopedic surgery; publications; pubmed; research productivity; residency.

PubMed Disclaimer

Conflict of interest statement

Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Research Output by Transition Phase
Mean number of PubMed-indexed total publications, first-author publications, in-specialty publications, and normalized citations per year among orthopedic surgery residents in the pre-Step 1 (numeric score) and post-Step 1 (pass/fail) cohorts. Asterisks (*) denote statistically significant differences between groups (p < 0.05). All values represent verified publication metrics extracted from PubMed prior to residency start.
Figure 2
Figure 2. Estimated Proportion of PubMed-Indexed Publications Among Reported APPs
Estimated proportion of total research items (APPs) that were PubMed-indexed publications (PMIDs) among matched orthopedic surgery applicants in the pre- and post–Step 1 transition cohorts. APP values were obtained from National Resident Match Program (NRMP) Charting Outcomes; PMID counts were extracted via structured search. This figure highlights a potential disconnect between rising APP totals and growth in peer-reviewed, indexed scholarship.
See this image and copyright information in PMC

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