Analyzing international medical graduate research productivity for application to US neurosurgery residency and beyond: A survey of applicants, program directors, and institutional experience

Abstract

BackgroundThe 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.MethodsResponses 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.ResultsThirty-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 (Q1-Q3: 0–12 to 12–24; minimum time: 0–24; maximum time: 0–48) and publish a median of 5 articles (Q1-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 (Q1-Q3: 18–48; range: 4–72) of neurosurgical research and 12 published articles (Q1-Q3: 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.ConclusionThe 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.

Evaluating PubMed-Indexed Publications of Applicants Successfully Matching into the Top 50 Urology Residency Programs in the 2021-2023 Cycles

“…Although IMGs were excluded from data analysis due to their research fellowships already being completed, we found that on average they had 24.4 publications that were PubMed-indexed, which shows the need for stronger application credentials given the lower match rate for IMGs. Mignucci-Jiménez et al showed that the research productivity of IMGs is considered superior to US graduates in the field of neurosurgery [10].…”

International Medical Graduates in Otolaryngology Education: The Overlooked Path to Diversity and Inclusivity

“…The current literature includes several recent studies and commentaries identifying the impact of IMGs in Dermatology and voices the need for a strategy to promote their inclusion in Dermatology residency programs 5‐7 . Additionally, a number of publications assessing recruitments of IMGs in General Surgery and Neurosurgery, report not only comparability in performance between IMGs and US graduates, 8 but also significantly longer periods invested in dedicated research and more published articles for the IMG pool 9 …”

“…[5][6][7] Additionally, a number of publications assessing recruitments of IMGs in General Surgery and Neurosurgery, report not only comparability in performance between IMGs and US graduates, 8 but also significantly longer periods invested in dedicated research and more published articles for the IMG pool. 9 The inclusion of IMGs in a competitive residency like Otolaryngology encounters specific barriers. The prospective residents face the burden of immigration and undergo a period of personal adjustment.…”

Residency Research Fever Across the World—Reply

“…In the data we reported using the National Resident Matching Program Charting Outcomes, IMGs were not included. However, it is well known that IMGs often have years of research experience and a curriculum vitae brimming with abstracts, presentations, and publications, especially when applying to competitive specialties . From anecdotal and survey evidence, program directors are keenly aware of the higher research output from IMGs compared with the output of their US medical graduate counterparts .…”

“…However, it is well known that IMGs often have years of research experience and a curriculum vitae brimming with abstracts, presentations, and publications, especially when applying to competitive specialties . From anecdotal and survey evidence, program directors are keenly aware of the higher research output from IMGs compared with the output of their US medical graduate counterparts . Without a numerical United States Medical Licensing Examination Step 1 score available to report, this trend will only intensify.…”