Early Engagement, Lasting Impact: Predictors of Scholarly Activity in Orthopaedic Sports Medicine Fellowship Applicants.

Background: Scholarly activity has become increasingly important for securing competitive orthopaedic sports medicine fellowship positions. However, it is not yet known whether the number of publications that an applicant has before a fellowship correlates with early career publication productivity. Purpose: To evaluate the association between publication output at the time of the sports medicine fellowship application and subsequent early career publication trajectory as well as to examine disparities in research productivity based on applicant characteristics. Study Design: Cross-sectional study. Methods: Publication counts were determined through PubMed queries at the time of fellowship application and follow-up (median, 10 years). Applicant data, including sex, degree type (Doctor of Osteopathic Medicine [DO] and Doctor of Medicine [MD]), and medical school location (United States vs international medical graduate), were collected. Current board certification and American Academy of Orthopaedic Surgeons (AAOS) membership were assessed. Negative binomial regression was used to identify predictors of current publication productivity. Results: A total of 305 orthopaedic sports medicine fellowship applicants to a single institution from 2011 to 2013 were analyzed. The cohort was predominantly male (94.8%) with MD degrees (89.8%). At the time of application for a fellowship, the median number of publications was 1.00 (interquartile range [IQR], 0.00-2.00), increasing to 4.00 (IQR, 2.00-12.00) at follow-up. Gender-based disparities persisted, with women averaging 5.75 current publications versus 12.13 for men. Multivariable analysis demonstrated that publication count at the time of application was associated with future productivity (incidence rate ratio [IRR], 1.23 per additional publication [95% CI, 1.18-1.30]; Conclusion: Our study demonstrated that early research engagement resulted in a trajectory toward sustained scholarly activity in orthopaedic sports medicine. Each additional publication at the time of the fellowship application increased future research output by 23%, while AAOS membership provided an additional 54% boost in productivity. Significant disparities persisted, with DO graduates producing 48% fewer publications than MD graduates and women averaging half the output of men, highlighting the need for equitable research opportunities across all training pathways.