Mignucci-Jiménez Giancarlo, Xu Yuan, Houlihan Lena Mary, Benner Dimitri, Jubran Jubran H, Staudinger Knoll Ann J, Labib Mohamed A, Dagi Teodoro Forcht, Spetzler Robert F, Lawton Michael T, Preul Mark C
The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States.
Mayo Medical School, Rochester, MN, United States.
Front Surg. 2022 Jul 27;9:899649. doi: 10.3389/fsurg.2022.899649. eCollection 2022.
The authors investigated perceived discrepancies between the neurosurgical research productivity of international medical graduates (IMGs) and US medical graduates (USMGs) through the perspective of program directors (PDs) and successfully matched IMGs.
Responses to 2 separate surveys on neurosurgical applicant research productivity in 115 neurosurgical programs and their PDs were analyzed. Neurosurgical research participation was analyzed using an IMG survey of residents who matched into neurosurgical residency within the previous 8 years. Productivity of IMGs conducting dedicated research at the study institution was also analyzed.
Thirty-two of 115 (28%) PDs responded to the first research productivity survey and 43 (37%) to the second IMG research survey. PDs expected neurosurgery residency applicants to spend a median of 12-24 months on research (Q-Q: 0-12 to 12-24; minimum time: 0-24; maximum time: 0-48) and publish a median of 5 articles (Q-Q3: 2-5 to 5-10; minimum number: 0-10; maximum number: 4-20). Among 43 PDs, 34 (79%) ranked "research institution or associated personnel" as the most important factor when evaluating IMGs' research. Forty-two of 79 (53%) IMGs responding to the IMG-directed survey reported a median of 30 months (Q-Q: 18-48; range: 4-72) of neurosurgical research and 12 published articles (Q-Q: 6-24; range: 1-80) before beginning neurosurgical residency. Twenty-two PDs (69%) believed IMGs complete more research than USMGs before residency. Of 20 IMGs conducting dedicated neuroscience/neurosurgery research at the study institution, 16 of 18 who applied matched or entered a US neurosurgical training program; 2 applied and entered a US neurosurgical clinical fellowship.
The research work of IMGs compared to USMGs who apply to neurosurgery residency exceeds PDs' expectations regarding scientific output and research time. Many PDs perceive IMG research productivity before residency application as superior to USMGs. Although IMGs comprise a small percentage of trainees, they are responsible for a significant amount of US-published neurosurgical literature. Preresidency IMG research periods may be improved with dedicated mentoring and advising beginning before the research period, during the period, and within a neurosurgery research department, providing a formal structure such as a research fellowship or graduate program for IMGs aspiring to train in the US.
作者从项目主任（PDs）的角度调查了国际医学毕业生（IMGs）和美国医学毕业生（USMGs）在神经外科研究产出方面的认知差异，并对成功匹配的IMGs进行了研究。
分析了对115个神经外科项目及其PDs进行的2项关于神经外科申请人研究产出的独立调查的回复。通过对过去8年内匹配到神经外科住院医师培训项目的住院医师进行的IMG调查，分析了神经外科研究参与情况。还分析了在研究机构进行专门研究的IMGs的产出情况。
115名PDs中有32名（28%）回复了第一次研究产出调查，43名（37%）回复了第二次IMG研究调查。PDs期望神经外科住院医师培训申请人在研究上花费的时间中位数为12 - 24个月（四分位数间距：0 - 12至12 - 24；最短时间：0 - 24；最长时间：0 - 48），发表文章的中位数为5篇（四分位数间距：2 - 5至5 - 10；最少篇数：0 - 10；最多篇数：4 - 20）。在43名PDs中，34名（79%）将“研究机构或相关人员”列为评估IMGs研究时最重要的因素。在回复IMG导向调查的79名IMGs中，42名（53%）报告在开始神经外科住院医师培训前，神经外科研究的时间中位数为30个月（四分位数间距：18 - 48；范围：4 - 72），发表文章12篇（四分位数间距：6 - 24；范围：1 - 80）。22名PDs（69%）认为IMGs在住院医师培训前完成的研究比USMGs多。在研究机构进行专门神经科学/神经外科研究的20名IMGs中，申请的18名中有16名匹配或进入了美国神经外科培训项目；2名申请并进入了美国神经外科临床 fellowship。
与申请神经外科住院医师培训的USMGs相比，IMGs的研究工作在科研产出和研究时间方面超出了PDs的预期。许多PDs认为IMGs在住院医师培训申请前的研究产出优于USMGs。尽管IMGs在受训人员中占比小，但他们在美国发表的神经外科文献中占了很大比例。可以通过在研究期开始前、研究期内以及在神经外科研究部门内提供专门的指导和建议，为有志于在美国培训的IMGs提供诸如研究fellowship或研究生项目等正式结构，来改善IMGs住院医师培训前的研究阶段。
