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Mededworld Publish Title: Publish Or Perish – How to Avoid Perishing? an Analysis of Factors Affecting Peer Publish or Perish – How to avoid perishing? An analysis of factors affecting peer-reviewed publication Title: Publish or Perish – How to avoid perishing? An analysis of factors affecting peer-reviewed publication Short title: Publish or Perish Authors: P.A.G Torrie, J.R Berstock, E.B.S Hayward, G.C Bannister Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB Corresponding author: Mr P.A.G Torrie - Email – [email protected]. Authors’ addresses: 1. P.A.G Torrie – Trauma and Orthopaedic registrar – Severn Deanery. Flat 12, Muller House, Ashley Down Road, Bristol, BS7 9DA. 2. J.R Berstock - Trauma and Orthopaedic registrar – Severn Deanery. First Floor Flat, 16 Durdham Park, BS6 6XB. 3. E.B.S Hayward – Anaesthetics registrar – Severn Deanery. Flat 12, Muller House, Ashley Down Road, Bristol, BS7 9DA. 4. G.C Bannister – Professor of Orthopaedics – Bristol. Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB. 1 | P a g e Torrie P.A.G, Berstock J.R, Hayward E.B.S and Bannister G.C MedEdWorld Publish www.mededworld.org Publish or Perish – How to avoid perishing? An analysis of factors affecting peer-reviewed publication Abstract The purposes of this study were to determine whether the senior author affects the probability of achieving a peer-reviewed publication and the effect the senior author has upon the quality of publication. This is an observational study of all 54 orthopaedic registrars in one deanery. All papers identifiable on Pubmed by each registrar and their senior author were documented. Quality of paper was assessed by the impact factor of the research journal. Logistic regression was assessed using Spearman correlation for year of training vs. number of publications, number of publications vs. average number of senior author publications, average number of senior author publications vs. mean trainee impact factor score and number of publications vs. number of collaborative publications with current rotational registrar. P=0.05 was considered statistically significant. Success rate and quality of trainees in peer-reviewed publication was highly significantly associated with their undertaking projects supervised by a senior author with a strong publication record (P=< 0.0001) and (P=0.0002) respectively. Collaboration with a fellow registrar was also highly significant (P=< 0.0001). Trainees are more likely to achieve a quality peer-reviewed publication if they engage in research with a senior author with a strong publication record and collaborate with a fellow registrar. 2 | P a g e Torrie P.A.G, Berstock J.R, Hayward E.B.S and Bannister G.C MedEdWorld Publish www.mededworld.org Publish or Perish – How to avoid perishing? An analysis of factors affecting peer-reviewed publication Introduction Competition for a higher surgical national training number (NTN) and subsequent consultant post has always been high. Surgery continues to have the highest number of UK applicants per vacancy for entry to specialty training (Fazel 2009). The European working time directive (EWTD) has increased the number of junior trainees (Elbadrawy 2008) required to run on-call rotas and results in a reduction of about 30-35% of clinical and operative experience acquired during the usual 6 yrs of training (Benes 2006), which is further compounded by many fewer Specialist Registrar posts into which they can advance. Furthermore the college’s medical workforce unit has shown that the proportion of CCT holders who achieved a substantive consultant post on qualification has dropped from 59.3% in 2009 to 55.7% in 2011 (Goddard 2011), with the estimated balance of supply and demand for surgical consultant posts to be balanced in 2012 (Royal College of Surgeons of England 2004) 5 thus leaving increasing numbers of orthopaedic surgeons with certificates of completion of training (CCT) but without consultant posts to enter. The prospective orthopaedic surgeon therefore now has two bottlenecks to negotiate and needs to identify objective discriminators that will help overcome both of these. Peer-reviewed publications have always been a strong differentiator and an important prerequisite amongst surgical candidates applying at all grades (Dawson 1996; Evans 2007; Soyer 2011). With increasing competition amongst junior and middle grade trainees, there is an ever-growing expectation and requirement for publication (George 2009). 9 Currently Trauma and Orthopaedic trainees in our region are recommended by their ARCP panels to achieve at least one publication per year of training. The aims of this study were to identify whether the choice of senior author affects a trainee’s chance of achieving a peer-reviewed publication, the quality of the publication and to identify whether the number of absolute publications when applying for consultancy has changed. Methods All the peer-reviewed publications on Pubmed of 54 registrars with a National Training Number on a Trauma and Orthopaedic rotation were recorded during the month of January 2012. The senior author on each identifiable trainee publications was also recorded. The total number of publications achieved by each senior author and trainee was then identified. 3 | P a g e Torrie P.A.G, Berstock J.R, Hayward E.B.S and Bannister G.C MedEdWorld Publish www.mededworld.org Publish or Perish – How to avoid perishing? An analysis of factors affecting peer-reviewed publication Each trainee was then assigned an overall mean senior authors publication score. Determining all publications that each senior author on each of the registrar publications had produced that were identifiable on Pubmed derived this score. Then the sum of all of the senior author’s publications on each registrars identified publications was calculated. The total number of registrar publications then divided this sum, providing the mean senior authors publication score. E.g. Registrar 1 has 2 publications on Pubmed, the 2 seniors authors on each of the publications have 14 and 20 publications on Pubmed respectively. Therefore registrar 1 has a mean senior author publication score of 14+20 = 34/2, therefore 17. Each trainee was also assigned a mean journal impact factor score, and this score was correlated with the mean senior author publication score. The aim was to determine whether trainees were more likely to publish in a more prestigious journal if they achieved publication with a senior author with a better publication track record. The quality of each trainee publication was established by identifying the impact factor (IF), as published in the Thomson Reuters Journal Citation Reports, for each trainee publication. Each trainee was then assigned a mean publication impact factor score. E.g. registrar 1 has 2 papers identified on Pubmed. Paper 1 is published the annals of the Royal College of Surgeons of England and paper 2 is published in the Journal of Bone and Joint Surgery (Br), with impact factors of 1.093 and 2.351 respectively. Registrar 1 mean impact publication impact factor score is therefore 1.093 + 2.351 = 1.722. This score was then correlated with the mean senior author publication score. The number of publications with a concurrent rotational registrar colleague was identified for each trainee. The type of publication, grouped by orthopaedic subspecialty, was also determined. Similar data were collected on all current 33 trauma and orthopaedic consultants based in two rotational hospital trusts in the same deanery. One of the hospitals assessed was from the centre of the Deanery’s rotation and the second a peripheral hospital. The year of consultant appointment was identified. All consultant publications up to and including the year of consultant appointment were considered as publications related to their consultancy application. The number of publications subsequent to their year of appointment was also documented. Data were analysed by logistic regression remodeling using the Spearman correlation to define the association between the numbers of registrar publications and the mean number of senior author publications and the number of collaborative rotational registrar publications and the number of consultant publications and their year of appointment to consultancy. Continuous non-parametric data were compared using Wilcoxon 4 | P a g e Torrie P.A.G, Berstock J.R, Hayward E.B.S and Bannister G.C MedEdWorld Publish www.mededworld.org Publish or Perish – How to avoid perishing? An analysis of factors affecting peer-reviewed publication rank sum test. We used the computer program GraphPad InStat 3 (San Diego, CA). The significance level was defined at a probability value less than 0.05. Results There were 54 Trauma and Orthopaedic registrars with national training numbers and 33 consultants. The 54 Trauma and Orthopaedic registrars had achieved 174 publications. Their mean number of publications was 3.26 and range 0-9. The mean number of publications prior to ST3 appointment was 1.24 (0-4). The mean number of publications achieved by collaboration with a fellow Trauma and Orthopaedic registrar was 1.22. There was a statistically significant correlation between the year of training, the mean senior authors publication score, number of collaborative publications and the total number of registrar publications. There was no statistically significant correlation between the number of first author registrar publications and their year of training. There was significance for the median number of senior author publications between the trainees. The median number of senior author publications was 16.5 amongst trainees with <5 and 46.2 amongst those with >5 publications (Table 1). A statistically significant correlation was also established between the mean trainee impact factor score and the mean senior author publication score. Hip, shoulder and elbow and knee publications were the orthopaedic subspecialties that yielded the most trainee publications with 32, 24 and 21 publications respectively (Figure 1). Among consultants assessed over a mean of 11.7 years since appointment (range 0-23), there were a total number of 453 publications identified on Pubmed.
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