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Paul Klimo Jr., L. Madison Michael II, Garrett T. Venable and Douglas R. Taylor

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Kyle A. Smith and Morgan B. Glusman

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Douglas R. Taylor, Garrett T. Venable, G. Morgan Jones, Jacob R. Lepard, Mallory L. Roberts, Nabil Saleh, Said K. Sidiqi, Andrew Moore, Nickalus Khan, Nathan R. Selden, L. Madison Michael II and Paul Klimo Jr.

OBJECT

Various bibliometric indices based on the citations accumulated by scholarly articles, including the h-index, g-index, e-index, and Google’s i10-index, may be used to evaluate academic productivity in neurological surgery. The present article provides a comprehensive assessment of recent academic publishing output from 103 US neurosurgical residency programs and investigates intradepartmental publishing equality among faculty members.

METHODS

Each institution was considered a single entity, with the 5-year academic yield of every neurosurgical faculty member compiled to compute the following indices: ih(5), cumulative h, ig(5), ie(5), and i10(5) (based on publications and citations from 2009 through 2013). Intradepartmental comparison of productivity among faculty members yielded Gini coefficients for publications and citations. National and regional comparisons, institutional rankings, and intradepartmental publishing equality measures are presented.

RESULTS

The median numbers of departmental faculty, total publications and citations, ih(5), summed h, ig(5), ie(5), i10(5), and Gini coefficients for publications and citations were 13, 82, 716, 12, 144, 23, 16, 17, 0.57, and 0.71, respectively. The top 5 most academically productive neurosurgical programs based on ih(5)-index were University of California, San Francisco, University of California, Los Angeles, University of Pittsburgh, Brigham & Women’s Hospital, and Johns Hopkins University. The Western US region was most academically productive and displayed greater intradepartmental publishing equality (median ih[5]-index = 18, median Ginipub = 0.56). In all regions, large departments with relative intradepartmental publishing equality tend to be the most academically productive. Multivariable logistic regression analysis identified the ih(5)-index as the only independent predictor of intradepartmental publishing equality (Ginipub ≤ 0.5 [OR 1.20, 95% CI 1.20–1.40, p = 0.03]).

CONCLUSIONS

The ih(5)-index is a novel, simple, and intuitive metric capable of accurately comparing the recent scholarly efforts of neurosurgical programs and accurately predicting intradepartmental publication equality. The ih(5)-index is relatively insensitive to factors such as isolated highly productive and/or no longer academically active senior faculty, which tend to distort other bibliometric indices and mask the accurate identification of currently productive academic environments. Institutional ranking by ih(5)-index may provide information of use to faculty and trainee applicants, research funding institutions, program leaders, and other stakeholders.

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Joseph H. McAbee, Brian T. Ragel, Shirley McCartney, G. Morgan Jones, L. Madison Michael II, Michael DeCuypere, Joseph S. Cheng, Frederick A. Boop and Paul Klimo Jr.

OBJECT

The object of this study was to identify and quantify predictors of burnout and career satisfaction among US neurosurgeons.

METHODS

All US members (3247) of the American Association of Neurological Surgeons (AANS) were invited to participate in a survey between September and December 2012. Responses were evaluated through univariate analysis. Factors independently associated with burnout and career satisfaction were determined using multivariable logistic regression. Subgroup analysis of academic and nonacademic neurosurgeons was performed as well.

RESULTS

The survey response rate was 24% (783 members). The majority of respondents were male, 40–60 years old, in a stable relationship, with children, working in a group or university practice, and trained in a subspecialty. More than 80% of respondents reported being at least somewhat satisfied with their career, and 70% would choose a career in neurosurgery again; however, only 26% of neurosurgeons believed their professional lives would improve in the future, and 52% believed it would worsen. The overall burnout rate was 56.7%. Factors independently associated with both burnout and career satisfaction included achieving a balance between work and life outside the hospital (burnout OR 0.45, satisfaction OR 10.0) and anxiety over future earnings and/or health care reform (burnout OR 1.96, satisfaction OR 0.32). While the burnout rate for nonacademic neurosurgeons (62.9%) was higher than that for academic neurosurgeons (47.7%), academicians who had practiced for over 20 years were less likely to be satisfied with their careers.

CONCLUSIONS

The rates of burnout and career satisfaction were both high in this survey study of US neurosurgeons. The negative effects of burnout on the lives of surgeons, patients, and their families require further study and probably necessitate the development of interventional programs at local, regional, and even national levels.

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Nickalus R. Khan, Clinton J. Thompson, Douglas R. Taylor, Garrett T. Venable, R. Matthew Wham, L. Madison Michael II and Paul Klimo Jr.

Object

Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery is in its infancy. The authors calculate a number of publication productivity measures for almost all academic neurosurgeons and departments within the US.

Methods

The h-index, g-index, m-quotient, and contemporary h-index (hc-index) were calculated for 1225 academic neurosurgeons in 99 (of 101) programs listed by the Accreditation Council for Graduate Medical Education in January 2013. Three currently available citation databases were used: Google Scholar, Scopus, and Web of Science. Bibliometric profiles were created for each surgeon. Comparisons based on academic rank (that is, chairperson, professor, associate, assistant, and instructor), sex, and subspecialties were performed. Departments were ranked based on the summation of individual faculty h-indices. Calculations were carried out from January to February 2013.

Results

The median h-index, g-index, hc-index, and m-quotient were 11, 20, 8, and 0.62, respectively. All indices demonstrated a positive relationship with increasing academic rank (p < 0.001). The median h-index was 11 for males (n = 1144) and 8 for females (n = 81). The h-index, g-index and hc-index significantly varied by sex (p < 0.001). However, when corrected for academic rank, this difference was no longer significant. There was no difference in the m-quotient by sex. Neurosurgeons with subspecialties in functional/epilepsy, peripheral nerve, radiosurgery, neuro-oncology/skull base, and vascular have the highest median h-indices; general, pediatric, and spine neurosurgeons have the lowest median h-indices. By summing the manually calculated Scopus h-indices of all individuals within a department, the top 5 programs for publication productivity are University of California, San Francisco; Barrow Neurological Institute; Johns Hopkins University; University of Pittsburgh; and University of California, Los Angeles.

Conclusions

This study represents the most detailed publication analysis of academic neurosurgeons and their programs to date. The results for the metrics presented should be viewed as benchmarks for comparison purposes. It is our hope that organized neurosurgery will adopt and continue to refine bibliometric profiling of individuals and departments.