Academic Productivity at Orthopedic Spine Surgery Fellowships Is Positively Correlated With Nonresearch Lifetime Industry Earnings: A Retrospective Study.

Study design: Retrospective Analysis.

Objective: The objective of the study was to assess the impact of academic productivity at both individual and program levels on lifetime industry earnings within US orthopedic spine fellowships.

Summary of background data: Physician-industry transparency was codified by the Physician Payments Sunshine Act (PSSA) in 2010. No study has explored the relationship between academic productivity and industry earnings at the fellowship level.

Methods: Inclusion criteria encompassed physicians with complete academic and industry data from orthopedic spine fellowship programs listed on the North American Spine Society (NASS) 2022-2023 fellowship directory. Academic productivity was defined via H-index on the Scopus website, and industry productivity by total lifetime earnings on the Open Payments Database (OPD).

Results: This analysis included 75 orthopedic spine fellowship programs with 320 individual physicians. Median individual physician lifetime earnings were $86,852.71 (mean: $666,580.23 ± $1,887,734.64; minimum-maximum: $10.86-$27,164,431.49) and the median individual physician (n=320 physicians) H-index was 17.0 (mean: 21.82 ± 19.28; minimum-maximum: 0-109). Median combined physician H-index per fellowship (n=75 fellowships) was 65.0 (mean: 93.08 ± 85.67; minimum-maximum: 3-434) and median combined physician lifetime earnings was $927,771.60 (mean: $2,844,075.64 ± $4,942,089.56; minimum-maximum: $1,112.32-$29,983,900.69). A positive correlation was observed between academic productivity and industry productivity at an individual level ( P <0.001; Spearman's rho = 0.467). This correlation was stronger at the fellowship level ( P <0.001; Spearman's rho = 0.734). There was no significant difference in total lifetime earnings ( P =0.369) or H-index per fellowship ( P =0.232) when stratified by region of the fellowship program in the United States.

Conclusion: Orthopedic spine surgery fellowship programs in the United States exhibit a positive correlation between academic productivity and nonresearch industry lifetime earnings at both individual and program levels. This correlation is stronger at the program level, and regional differences among fellowship programs do not significantly impact academic or industry productivity.