Arms Race Control Score Standardizes Residency Applicant Publication Assessment.

Abstract

Background and objectives: The publication "arms race" refers to the recent, exponential increase in publications among residency "Match" applicants. Total number of residency applicant publications is the strongest predictor of "Match" success in neurosurgery beyond licensing examination scores. This study sought to introduce an objective metric by which publications may be scored to assess residency applicant authorship effort.

Methods: A retrospective, quantitative assessment of 537 publications by 57 interviewed applicants at a neurosurgery residency program was conducted from the 2022 to 2023 "Match" cycle. A 4-point scale was used to calculate a Publication Effort Score (PES) for each publication, ranging from a letter/editorial/historical commentary (PES = 1) to a high-effort clinical/basic science/cadaveric study (PES = 4). Each PES was subsequently divided by the applicant's authorship position to assign a corresponding publication value unit (PVU), which was calculated for each applicant publication and summated for an applicant's cumulative PVU (cPVU). An Arms Race Control Score (ARCS) was calculated by eliminating all minimal effort publications (PVU ≤ 1) from the cPVU score.

Results: Mean publication number among applicants was 9.28 (±10.7), with approximately one-third (31.8%, N = 169) of publications first-authored by an applicant. Approximately one-quarter (26.1%, N = 140) of publications were minimal effort publications. A minority of publications (41.3%, N = 222) had a PVU of greater than 2. ARCS implementation resulted in a major ranking change (±≥5 positions) for 61.4% (N = 35) of applicants, ranging from an increase in 22 positions to a decrease in 26 positions. Following ARCS, four positions changed among applicants ranked 1 to 10.

Conclusion: ARCS standardizes residency applicant publication assessment by attempting to capture applicant authorship effort. ARCS implementation may drive residency applicants to focus on higher effort publications, offering a novel solution to the publication "arms race." Automated ARCS scoring for the upcoming "Match" cycle may be calculated using an applicant's last name and publications' PubMed IDs using https://arcscalculator.com .