Publication productivity and experience: Factors associated with academic rank among orthopaedic surgery faculty in the United States

Background: Many factors play a role in academic promotion among orthopaedic surgeons. This study specifically examined the importance of publication productivity metrics, career duration, and sex on academic rank in orthopaedic surgery programs in the United States. Methods: Faculty at 142 civilian academic orthopaedic surgery departments in 2014 were identified. Geographic region, department size, and 3 specific faculty characteristics (sex, career duration, and academic position) were recorded. The Hirsch index (h-index), defined as the number (h) of an investigator's publications that have been cited at least h times, was recorded for each surgeon. The m-index was also calculated by dividing the h-index by career duration in years. Thresholds for the h-index and the m-index were identified between junior and senior academic ranks. Multivariate analysis was used to determine whether the 3 physician factors correlated independently with academic rank. Results: The analysis included 4,663 orthopaedic surgeons at 142 academic institutions (24.7% clinical faculty and 75.3% academic faculty). Among academic faculty, the median h-index was 5, the median career duration was 15 years, and the median m-index was 0.37. Thresholds between junior and senior faculty status were 12 for the h-index and 0.51 for the m-index. Female academic faculty had a lower median h-index (3 compared with 5; p < 0.001) and career duration (10 years compared with 16 years; p < 0.001) than male academic faculty, but had a similar median m-index (0.33 compared with 0.38; p = 0.103). A higher h-index and longer career duration correlated independently with an increased probability of senior academic rank (p < 0.001), but sex did not (p = 0.217). Conclusions: This analysis demonstrates that a higher h-index and m-index correlate with a higher academic orthopaedic faculty rank. Although female surgeons had a lower median h-index and a shorter median career duration than male continued surgeons, theirm-index was not significantly different, and thus sex was not an independent predictor for senior academic rank. The identified thresholds (h-index of 12 and m-index of 0.51) between junior and senior academic ranks may be considered as factors in promotion considerations.