Geographic differences in academic promotion practices, fellowship training, and scholarly impact




Abstract


Purpose


Previous literature described how clinical fellowship training impacts scholarly production among academic otolaryngologists, finding that fellowship-trained practitioners had higher research productivity than their non-fellowship-trained peers, and head and neck (H&N) surgeons and otologists had the highest scholarly impact. In this analysis we investigate whether geographic differences in academic promotion and scholarly impact exist, and whether such differences are associated with emphasis on regional fellowship training patterns.


Methods


The Scopus database was used to determine scholarly impact (as measured by the h -index) of 1109 academic otolaryngologists from 97 departments. Online faculty listings were organized by fellowship training, academic rank, and location.


Results


Fellowship-trained practitioners had greater research productivity than non-fellowship-trained otolaryngologists ( H = 9.5 ± 0.26 SEM vs. 6.5 ± 0.43, p < 0.001), a finding that persisted throughout except in the Mountain and East South Central Regions. H&N surgeons and otologists had the highest h -indices. Practitioners in the West had the highest h -index, with differences persisting upon examination of junior faculty. The West (62.1%) and Midwest (60.5%) had the highest proportions of senior faculty. Regional differences in scholarly impact and academic promotion were further noted upon organizing faculty by subspecialty fellowship training.


Conclusions


Geographic differences in academic promotion and scholarly impact exist, most markedly among junior faculty. Practitioners in the West had high impact and were more represented at senior ranks. Upon examination by fellowship training status, fellowship-trained otolaryngologists had higher impact in most, but not all, geographic regions. Regional variations in promotion were noted upon organizing faculty by subspecialty, although association with scholarly impact differs by region.



Introduction


Research productivity has historically played an integral role in the appointment and promotion process for academic surgeons . In addition to clinical activity and contributing to medical education, remaining productive in research endeavors is a prerequisite for advancement at many institutions . An important component of this process is the ability to document active participation and excellence in research in an objective manner, with factors such as one’s publication record and/or success in procuring grants . One measure commonly used to assess the former is an author’s total number of publications. While this is objective and easily calculable, it may indicate little about the scholarly impact an author has had on his or her field.


In 2005, Dr. Hirsch proposed a bibliometric, the h -index, which sought to account for the relevance and quality of one’s scholarship in an objective manner. A scientist’s h -index is the number ( h ) of his or her papers that have been cited in the peer-reviewed literature at least h times each, while their remaining papers have been cited less than h times. For example, somebody with an h -index of 50 has had 50 papers cited at least 50 times each. If they have 75 total publications, this means that their other 25 have been cited less than the value of their h -index (i.e. < 50 times). Upon comparison of this individual to another author with 75 total publications but an h -index of 20 (20 papers cited 20 times each), it is presumed that the first individual has had a higher impact upon scholarly discourse within his or her field, even though they have both published an equivalent number of papers.


The h -index has increased in popularity and is now easily calculated using several widely used databases such as Scopus, ISI Web of Knowledge, Publish or Perish, and Google Scholar. There have been several analyses examining the use of this bibliometric in multiple medical specialties , including otolaryngology , that have shown an increase in this measure with successive academic rank.


The authors have previously studied the impact of fellowship training on research productivity, finding that fellowship-trained academic otolaryngologists had higher scholarly impact, as measured by the h -index, than their non-fellowship-trained peers . There has been no analysis, however, of whether regional differences in research productivity exist among otolaryngologists. The presence of such geographic variations may need to be taken into account by appointment and promotion committees, as simply looking at previously described h -index averages nationally may not provide an entirely accurate picture of specific regions. The objectives of this analysis are to describe whether geographic differences in academic promotion patterns and scholarly impact exist, and whether any such differences may be associated with regional emphasis on particular subspecialties and/or regional fellowship training patterns.





Materials and methods


The American Medical Association’s Fellowship and Residency Electronic Interactive Database (FREIDA) was used to obtain a list of academic otolaryngology departments. Out of the 98 civilian programs listed on FREIDA, only those with online faculty listings specifying academic rank and clinical fellowship training status were included in this analysis. Individual listings with incomplete information, non-physician faculty, part-time faculty, and non-academic faculty were excluded from this analysis. Ultimately, 1109 academic otolaryngologists from 97 academic departments were included in this data set.


Practitioners were organized by clinical fellowship training status, academic rank, and geographic location of their department. Faculty that had been previously promoted in their careers (i.e. associate professors and professors) were considered “Senior Faculty” in several comparisons in this analysis. U.S. Census Bureau designated regions and subregions were used for organization, and included the following: (1) Northeast: New England (CT, ME, MA, NH, RI, VT) and Mid-Atlantic (NJ, NY, PA); (2) Midwest: East North Central (IN, IL, MI, OH, WI) and West North Central (IA, KS, MN, MO, NE, ND, SD); (3) South: South Atlantic (DE, DC, FL, GA, MD, NC, SC, VA, WV), East South Central (AL, KY, MS, TN), and West South Central (AR, LA, OK, TX); and (4) West: Mountain (AZ, CO, ID, NM, MT, UT, NV, WY) and Pacific (AK, CA, HI, OR, WA).


The Scopus database ( www.scopus.com ) was used to calculate the h -index for faculty. This database has been proven of value for h -index calculations within otolaryngology as well as in other medical fields . An analysis of its value in neurosurgery found a high degree of correlation between h -index results from Scopus and Google Scholar, another widely used h -index calculator .


When faculty with common surnames are searched for within this database, multiple results may be found. Scopus lists current and previous departmental affiliations, as well as journal source history, both of which were helpful in confirming whether search results represented the appropriate author or another person with a similar name. All data collection was completed in January 2013.



Statistical analysis


Mann–Whitney U -tests and chi-square tests were used for comparison of continuous and categorical variables, where appropriate, with threshold for significance set at p < 0.05. SPSS (v20, IBM Corp., Armonk, NY) was used for statistical calculations.





Materials and methods


The American Medical Association’s Fellowship and Residency Electronic Interactive Database (FREIDA) was used to obtain a list of academic otolaryngology departments. Out of the 98 civilian programs listed on FREIDA, only those with online faculty listings specifying academic rank and clinical fellowship training status were included in this analysis. Individual listings with incomplete information, non-physician faculty, part-time faculty, and non-academic faculty were excluded from this analysis. Ultimately, 1109 academic otolaryngologists from 97 academic departments were included in this data set.


Practitioners were organized by clinical fellowship training status, academic rank, and geographic location of their department. Faculty that had been previously promoted in their careers (i.e. associate professors and professors) were considered “Senior Faculty” in several comparisons in this analysis. U.S. Census Bureau designated regions and subregions were used for organization, and included the following: (1) Northeast: New England (CT, ME, MA, NH, RI, VT) and Mid-Atlantic (NJ, NY, PA); (2) Midwest: East North Central (IN, IL, MI, OH, WI) and West North Central (IA, KS, MN, MO, NE, ND, SD); (3) South: South Atlantic (DE, DC, FL, GA, MD, NC, SC, VA, WV), East South Central (AL, KY, MS, TN), and West South Central (AR, LA, OK, TX); and (4) West: Mountain (AZ, CO, ID, NM, MT, UT, NV, WY) and Pacific (AK, CA, HI, OR, WA).


The Scopus database ( www.scopus.com ) was used to calculate the h -index for faculty. This database has been proven of value for h -index calculations within otolaryngology as well as in other medical fields . An analysis of its value in neurosurgery found a high degree of correlation between h -index results from Scopus and Google Scholar, another widely used h -index calculator .


When faculty with common surnames are searched for within this database, multiple results may be found. Scopus lists current and previous departmental affiliations, as well as journal source history, both of which were helpful in confirming whether search results represented the appropriate author or another person with a similar name. All data collection was completed in January 2013.



Statistical analysis


Mann–Whitney U -tests and chi-square tests were used for comparison of continuous and categorical variables, where appropriate, with threshold for significance set at p < 0.05. SPSS (v20, IBM Corp., Armonk, NY) was used for statistical calculations.





Results


Fellowship-trained practitioners had greater scholarly impact, as measured by the h -index, than non-fellowship-trained otolaryngologists ( H = 9.5 ± 0.26 standard error of mean vs. 6.5 ± 0.43 SEM, p < 0.001). Head and neck surgeons ( H = 11.4 ± 0.60 SEM) and otologists ( H = 10.2 ± 0.52 SEM) had greater scholarly impact than other specialties, although this difference did not reach statistical significance upon comparison of otologists with laryngologists ( p = 0.16) ( Table 1 ). Representation of subspecialties did not differ significantly by region ( Table 2 ).



Table 1

h -Index by subspecialty.




































h-Index (± SEM) n
No fellowship 6.5 (± 0.43) 264
Facial plastics 7.3 (± 0.50) 128
Head and neck 11.4 (± 0.60) 240
Laryngology 8.9 (± 0.91) 60
Otology/Neurotology 10.2 (± 0.53) 176
Pediatric otolaryngology 8.4 (± 0.80) 72
Rhinology 8.6 (± 0.81) 69

SEM = standard error of mean. n represents sample size.


Table 2

Regional subspecialty breakdown (%).


























































Midwest Northeast South West
No fellowship 33.0% 30.1% 32.4% 27.9%
Facial plastics 16.5% 16.4% 14.4% 12.5%
Head and neck 28.5% 26.9% 30.0% 27.2%
Laryngology 4.0% 7.8% 7.2% 10.3%
Otology/Neurotology 23.0% 21.0% 20.7% 17.6%
Pediatric otolaryngology 19.5% 21.0% 19.0% 23.5%
Rhinology 8.5% 6.9% 8.6% 8.8%
Total 100% 100% 100% 100%

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Aug 24, 2017 | Posted by in OTOLARYNGOLOGY | Comments Off on Geographic differences in academic promotion practices, fellowship training, and scholarly impact

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