Khalafallah Adham M, Jimenez Adrian E, Daniels Marcus, Bydon Ali, Cohen Alan R, Tamargo Rafael J, Witham Timothy, Huang Judy, Brem Henry, Mukherjee Debraj
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Surg Educ. 2020 Sep-Oct;77(5):1312-1320. doi: 10.1016/j.jsurg.2020.03.004. Epub 2020 Apr 1.
Many studies have sought to determine predictors of academic career placement in surgical subspecialities. However, previous research has yet to establish whether the ranking of a surgeon's undergraduate institution or medical school is significantly associated with pursuit of an academic career. The purpose of this study was to investigate these novel factors' predictive impact on an academic career in the surgical subspeciality of neurosurgery. Factors investigated included undergraduate university rankings, medical school rankings, and residency program rankings.
Data were retrospectively collected for 884 alumni of Accreditation Council for Graduate Medical Education neurological surgery residency programs. Bivariate analyses were conducted to determine covariates for a logistic regression model, and multivariate analysis was performed with 13 covariates to determine which factors were independently associated with academic career trajectory.
In multivariate analysis, factors that were independently associated with an academic career in neurological surgery included having 1 year or more of protected research time during residency (odds ratio [OR] =1.96, p = 0.020), attending a "top" undergraduate university (OR =1.88, p = 0.00033), attending a "top" research medical school (OR = 1.53, p = 0.031) attending a residency program affiliated with a "top" research medical school (OR = 1.78, p = 0.012), possessing a Master of Science (OR = 3.46, p = 0.00097), or Doctor of Philosophy (OR = 2.05, p = 0.0019) degree, and completing a clinical fellowship (OR = 2.56, p = 1.90 × 10).
Our study establishes 3 novel factors for predicting residents' choice of pursuing an academic career in neurological surgery, namely undergraduate university rank, medical school rank, and completing residency at a program affiliated with a "top" research medical school. Such findings reinforce the notion that educational and training environments are key in shaping the career trajectory of future academic surgical subspecialists.
许多研究试图确定外科亚专业学术职业定位的预测因素。然而,以往的研究尚未确定外科医生本科院校或医学院的排名是否与追求学术职业显著相关。本研究的目的是调查这些新因素对神经外科这一外科亚专业学术职业的预测影响。所调查的因素包括本科大学排名、医学院排名和住院医师培训项目排名。
回顾性收集了884名毕业后医学教育认证委员会神经外科住院医师培训项目校友的数据。进行双变量分析以确定逻辑回归模型的协变量,并对13个协变量进行多变量分析,以确定哪些因素与学术职业轨迹独立相关。
在多变量分析中,与神经外科领域学术职业独立相关的因素包括在住院医师培训期间有1年或更长时间的受保护研究时间(优势比[OR]=1.96,p=0.020)、就读于“顶尖”本科大学(OR=1.88,p=0.00033)、就读于“顶尖”研究型医学院(OR=1.53,p=0.031)、就读于与“顶尖”研究型医学院相关的住院医师培训项目(OR=1.78,p=0.012)、拥有理学硕士学位(OR=3.46,p=0.00097)或哲学博士学位(OR=2.05,p=0.0019),以及完成临床专科培训(OR=2.56,p=1.90×10)。
我们的研究确定了3个预测住院医师选择在神经外科追求学术职业的新因素,即本科大学排名、医学院排名以及在与“顶尖”研究型医学院相关的项目中完成住院医师培训。这些发现强化了这样一种观念,即教育和培训环境对于塑造未来学术外科亚专科医生的职业轨迹至关重要。