In-training factors predictive of choosing and sustaining a productive academic career path in neurological surgery

BACKGROUND: Factors during neurosurgical residency that are predictive of an academic career path and promotion have not been defined. OBJECTIVE: To determine factors associated with selecting and sustaining an academic career in neurosurgery by analyzing in-training factors for all graduates of American College of Graduate Medical Education (ACGME)-accredited programs between 1985 and 1990. METHODS: Neurological surgery residency graduates (between 1985 and 1990) from ACGME-approved training programs were analyzed to determine factors associated with choosing an academic career path and having academic success. RESULTS: Information was available for 717 of the 720 (99%) neurological surgery resident training graduates (678 male, 39 female). One hundred thirty-eight graduates (19.3%) held full-time academic positions. One hundred seven (14.9%) were professors and 35 (4.9%) were department chairs/chiefs. An academic career path/success was associated with more total (5.1 vs 1.9; P <.001) and first-author publications (3.0 vs 1.0; P <.001) during residency. Promotion to professor or chair/chief was associated with more publications during residency (P <.001). Total publications and first-author publications were independent predictors of holding a current academic position and becoming professor or chair/chief. Although male trainees published more than female trainees (2.6 vs 0.9 publications; P <.004) during training, no significant sex difference was observed regarding current academic position. Program size (≥ 2 graduates a year; P =.02) was predictive of an academic career but not predictive of becoming professor or chair/chief (P >.05). CONCLUSION: Defined in-training factors including number of total publications, number of first-author publications, and program size are predictive of residents choosing and succeeding in an academic career path.