International medical graduate orthopaedic residents show higher research productivity than United States graduate peers before and during residency.

Purpose: International Medical Graduates (IMGs) have lower match rates than their United States (U.S.)-trained Doctor of Allopathic Medicine (MD) and Doctor of Osteopathic Medicine (DO) peers. This study aims to more completely elucidate the research accomplishments required for IMGs to match into orthopaedic residency and to compare their academic productivity during residency to that of U.S. MD and DO graduates.

Methods: Data from orthopaedic-related journals and ACGME-accredited residency programs were extracted in July of 2024 using Python. Variables included: residency year, publications, first-author publications, citations, journals, h-index, medical school type, and the medical school and residency program locations.

Results: Prior to residency, the 56 matched IMGs had a mean of 32.8 publications, 9.8 first-author publications, and 517.1 citations. Matched U.S. MDs had an average of 3.7 publications, 1.1 first-author publications, and 61.0 citations while DO matched applicants had an average of 3.7 publications, 1.0 first-author publications, and 5.6 citations. During residency, IMG orthopaedic residents averaged 5.2 publications per year and 16.6 citations per year. U.S. MD residents averaged 1.3 publications per year and 3.6 citations per year, while DO residents averaged 0.55 publications per year and 1.1 citations per year. The h-index averaged 9.8 for IMGs, 2.2 for U.S. MDs and 0.7 for DOs. All comparisons for IMGs vs. U.S. MDs and IMGs vs. DOs yielded P < 0.0001.

Conclusion: These findings highlight the significant differences in research output between IMGs and their U.S.-trained counterparts in orthopaedic surgery, and show that these differences continue throughout residency.