Pre-Residency Research Engagement and Subsequent Publication Output Among Orthopaedic Surgery Applicants.

Introduction: Competition for orthopaedic surgery residency positions has intensified in recent years, coinciding with the shift of the United States Medical Licensing Examination Step 1 and many medical schools' curricula to pass/fail grading. Consequently, residency programs have placed greater emphasis on applicants' research productivity. The average number of research items listed on applications has quadrupled since 2011. However, it is unclear whether preresidency research productivity predicts long-term research output. This study evaluates the association between preresidency research productivity and future publication output. Methods: A retrospective cohort of 822 applicants to a single US orthopaedic surgery residency program during the 2010 application cycle was evaluated. Electronic Residency Application Service (ERAS) data collected included the number and total hours of research experiences, total research items, oral/poster presentations, and manuscript publications. Each publication was cross-referenced using Scopus and PubMed to determine citation counts and publication in a top-15 orthopaedic journal. Applicants were matched to publicly available Scopus profiles to assess post-ERAS submission research productivity. The primary outcome was the number of post-ERAS publications. The 309 applicants without Scopus records were excluded from the study. Associations between variables were analyzed using Spearman's correlation, with statistical significance set at p < 0.05. Results: Post-ERAS publication count was significantly correlated with the number of poster/oral presentations (P = 0.023) and publication in a top-15 orthopaedic journal (P = 0.027). However, post-ERAS publication count was not significantly associated with the number of research experiences (P = 0.129), research hours (P = 0.501), total research items (P = 0.571), manuscript count (P = 0.713), or cumulative citations from application manuscripts (P = 0.308). Discussion: Poster/oral presentations and publication in a top-15 orthopaedic journal were the only ERAS metrics associated with postapplication publication output. Total research items, manuscripts, and citations were not correlated with continued productivity. Qualitative indicators of research engagement, such as presentations and publication quality, were associated with continued publication output, whereas quantitative metrics were not. These findings suggest that meaningful research involvement, rather than volume alone, better predicts long-term publication output. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.