Shoulder and Elbow Surgery Fellowship Applicants with Greater Research Productivity During Residency are Ranked Higher by Fellowship Programs.

Abstract

Introduction: Shoulder and elbow surgery fellowships in the United States are recognized for their academic emphasis, yet the correlation between an applicant's research productivity and fellowship match results remains unclear. This study (1) analyzed temporal trends in research productivity among matched fellowship applicants, (2) evaluated the influence of quantity of publications and first authorships on match positions, and (3) investigated program variations in research productivity.

Methods: This is a retrospective analysis of data from the San Francisco (SF) Match Database for shoulder and elbow surgery applicants matched between 2017 and 2024. Allopathic (MD), osteopathic (DO), and international medical graduates (IMGs) were included. PubMed was queried to quantify publications and first authorship before and during residency, analyzing their association with applicant and fellowship rank. Publication volumes per fellowship program were also calculated for institutions with at least five years of match data.

Results: 290 matched applicants were evaluated across 34 fellowship programs, comprising 229 MDs, 29 DOs, and 32 IMGs. There was almost a five-fold increase in the average number of publications per applicant, from 2.72 ± 3.54 in 2017 to 12.80 ± 15.88 in 2024 (B 1.30; p = 0.001). Similarly, first authorship publication counts increased almost three-fold, from 1.31 ± 2.12 in 2017 to 3.66 ± 5.01 in 2024 (B = 0.29, p = 0.02). Fellowship program analysis revealed wide variation in mean publication counts of matched applicants (p = 0.008), with Rush University Medical Center (27.88 ± 33.86), Massachusetts General Hospital (13.65 ± 26.62), Mayo Clinic (13.06 ± 14.77), Thomas Jefferson University Hospital (12.19 ± 10.64) exhibiting the highest averages. Candidates with more publications (p = 0.04), first authorships(p = 0.02), and total first authorships (p = 0.04) during residency were ranked higher by fellowship programs. There was a significant correlation between greater publication count during residency and more favorable fellowship rank (-0.15, p = 0.02) and applicant match position (-0.12, p = 0.049). No significant associations were found between pre-residency publications (p = 0.38), total publications (p = 0.13), and pre-residency first authorships (p = 0.20) with fellowship rank positions.

Conclusion: Research productivity has increased substantially among matched applicants. The more academically productive residents tend to be ranked more favorably by fellowship programs and match higher on their list. However, these associations were relatively weak, highlighting the complexity of the fellowship selection process and the notion that research productivity alone does not guarantee placement in preferred programs.