The Absence of International Standardized Quality Criteria in Doctorate Programs in Surgery: A Survey Study.

Purpose: A doctorate degree in surgery is awarded by universities in recognition of high-standard academic research. This study explores the global heterogeneity of PhD programs in surgery and evaluates them using a standardized rating scale. Method: A cross-sectional survey was distributed electronically to surgical doctoral programs worldwide. A 25-point rating scale was developed to assess program quality across domains such as dissertation requirements, number and type of publications, journal quartiles, and authorship position. Programs achieving ≥15 points were classified as "excellence-PhD" (e-PhD). Scores were compared across world regions and by university ranking (Shanghai Ranking). Results: A total of 949 PhD programs from the 193 United Nations member countries were contacted. Completed questionnaires were returned by 187 departments (response rate 19.7%) from 52 countries. Most departments, 138 out of 187 (73.9%) lacked clear requirements for dissertations based on a single research project, while more explicit criteria existed for thesis by publications: originality 77 out of 187 (41.2%), journal metrics 126 out of 187 (67.9%), and candidate authorship. Program scores showed wide heterogeneity, with higher scores more frequently associated with universities ranked higher in the Shanghai classification. Regional differences were also noted in funding opportunities and evaluation processes. Conclusions: Global PhD programs in surgery demonstrate substantial variability in structure and quality, as measured by a newly developed rating scale. While the scale shows promise in identifying high-quality (e-PhD) programs, its practical application may be limited by response bias and differing academic norms. Nonetheless, these findings offer a framework for benchmarking and improving doctoral training in surgical research globally.