Impact of Subspecialty Fellowship Training on Research Productivity Among Academic Plastic Surgery Faculty in the United States

Aditya Sood, MD, MBA; Paul J. Therattil, MD; Stella Chung, BA; Edward S. Lee, MD


ePlasty. 2015;15 

In This Article

Abstract and Introduction


Purpose: The impact of subspecialty fellowship training on research productivity among academic plastic surgeons is unknown. The authors' aim of this study was to (1) describe the current fellowship representation in academic plastic surgery and (2) evaluate the relationship between h-index and subspecialty fellowship training by experience and type.

Methods: Academic plastic surgery faculty (N = 590) were identified through an Internet-based search of all ACGME-accredited integrated and combined residency programs. Research output was measured by h-index from the Scopus database as well as a number of peer-reviewed publications. The Kruskal-Wallis test, with a subsequent Mann-Whitney U test, was used for statistical analysis to determine correlations.

Results: In the United States, 72% (n = 426) of academic plastic surgeons had trained in 1 or more subspecialty fellowship program. Within this cohort, the largest group had completed multiple fellowships (28%), followed by hand (23%), craniofacial (22%), microsurgery (15%), research (8%), cosmetic (3%), burn (2%), and wound healing (0.5%). Higher h-indices correlated with a research fellowship (12.5; P < .01) and multiple fellowships (10.4; P < .01). Craniofacial-trained plastic surgeons demonstrated the next highest h-index (9.8), followed by no fellowship (8.4), microsurgery (8.3), hand (7.7), cosmetic (5.2), and burn (5.1).

Conclusion: Plastic surgeons with a research fellowship or at least 2 subspecialty fellowships had increased academic productivity compared with their colleagues. Craniofacial-trained physicians also demonstrated a higher marker for academic productivity than multiple other specialties. In this study, we show that the type and number of fellowships influence the h-index and further identification of such variables may help improve academic mentorship and productivity within academic plastic surgery.


Plastic surgeons in academic practice are crucial in preparing the future surgeons in our field. Identifying the processes that correlate with the pursuit of higher academic achievement may help improve academic mentorship.

Advancement within academic plastic surgery is multifactorial, with research output being one of the most heavily examined aspects in determining productivity.[1–5] There are several frequently used metrics to assess research productivity, including total number of publications, "significant" number of publications, and number of citations by other authors in peer-reviewed literature.[6,7] Although easily quantifiable, these metrics do little to measure the overall impact of research productivity.

The h-index is a powerful tool that can help evaluate both the quantity and quality of an individual author's contributions in academia. This tool was first proposed in 2005 by physicist Hirsch[7] at the University of California, San Diego, in which he defined an h-index as the number of h articles that have been cited at least h times. For example, if an academic plastic surgeon has an h-index of 10, it means that he or she has 10 publications, with at least 10 citations each. This metric is not skewed by the total number of publications as the number of citations is accounted for. This allows for the h-index to be a potentially more accurate measure of research productivity than pure quantitative metrics.

There are several online medical literature databases available for calculating this score, including Scopus and Google Scholar.[8] Although results of h-indices between the 2 aforementioned sources may vary, previous analysis evaluating the h-indices between academic neurosurgeons found a high degree of correlation in the calculated scores between Scopus and Google Scholar.[2]

There have been previous works published in plastic surgery analyzing the influence of training institution on h-index, as well as gender disparities and academic productivity.[1,9] There has been no previous analysis in plastic surgery evaluating whether this objective quantification of research impact is affected by fellowship training. It is the authors' hypothesis that training in multiple subspecialty plastic surgery fellowships will have a positive impact on academic productivity. To study this, we examined the training attributes of academic plastic surgery faculty at accredited combined and integrated plastic surgery training institutions. Our aims were to (1) evaluate the relationship between h-index and fellowship training by experience and type and (2) to describe the current fellowship representation in academic plastic surgery to assess whether there are any correlations to be drawn.