Medical Student Authorship Trends: A 10-Year Analysis of Four Major Orthopaedic Journals

Obana, Kyle K.
Mau, Makoa K.
Morikawa, Landon H.
Maka, Piueti T.
DeJesus IV, James C.
Lee, Lorrin S.K.
Mitsunaga, Kyle A.
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Introduction: Orthopaedic surgery continues to be an increasingly competitive specialty for medical students to match into. Recent studies have identified the United States Medical Licensing Exam (USMLE) Step 1 and Step 2 CK scores, Alpha Omega Alpha Medical Honor Society induction, and mean number of research products as independent factors contributing to a successful match into orthopaedic surgery. Of these metrics, orthopaedic research is the only one that can be continuously improved over the course of medical school. Orthopaedic-specific research demonstrates scholarly activity, as well as interest in and commitment to the specialty. Given the rising competitiveness of matching into orthopaedic surgery residency and emphasis placed on research, the purpose of this study was to analyze medical student publication trends in four major orthopaedic journals over a 10-year period. Objectives: Identify the proportion of medical student publications in major orthopaedic journals and how these trends have changed over time. Methods: Websites of four major orthopaedic journals (American Journal of Sports Medicine, Clinical Orthopaedics and Related Research, Journal of Arthroplasty, and Journal of Bone and Joint Surgery) were accessed to identify articles published between 2011 and 2020. Articles were reviewed for the year, number of authors, degree(s) of each author, sex of each author, country, and state (if USA). Non-clinical studies were defined as basic science, biomechanical, technique, and educational studies. Country and state were determined based on affiliation of the senior author. Medical students were defined as authors who held a bachelor’s only degree. Editorials and letters to the editor were not included. Results: 15740 articles were included in this review (13510 clinical, 2230 non-clinical). The total number of authors was 82837. MDs constituted the majority of first authors in this study (64.5%). A total of 5242 medical students were listed as authors on 3769 publications (21.49% of overall publications). Out of the 3769 publications, 919 (24.38%) were first author publications. Linear regression demonstrated an increasing annual trend of first author (p=0.001) and any author (p<0.001) medical student publications over the study period, with increases of 291% and 206%, respectively, from 2011 to 2020. Linear regression demonstrated an increasing annual trend of female first author medical student publications (p=0.01), with an increase of 346% from 2011 to 2020. Overall number of publications did not significantly change over the study period. States with the most first author medical students were New York (111/919, 12.1%), Pennsylvania (96/919, 10.5%), and California (82/919, 8.9%). States with the most any author medical student studies were New York (514/3769, 13.6%), Pennsylvania (347/3769, 9.2%), and California (298/3769, 7.9%). Discussion: First author and any author medical student publications increased over the last 10 years, despite a constant number in overall orthopaedic publications. Additionally, the growing female medical student involvement in the literature highlights the importance and efficacy of advocacy, mentorship, and opportunities in improving diversity in orthopaedics and medicine. Lastly, states with the most first-author and any author medical student publications contain institutions with ample research funding, providing access and opportunities for students at the institution and others within geographic range. Target Audience: Medical students, orthopaedic chairs, and program directors
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