Abstract
Introduction: Research is still not required for graduation from residency programs in the United States (U.S.). In order to provide a glimpse into the research productivity of OBGYN residency programs we conducted the following study.
Methods: The biomedical indexing engine “PubMed” was used to search for publications that originated from OBGYN residency programs in the U.S. in the last decade.
Results: The average number of publications per decade was 46. The highest number of publications was 342, achieved by Washington University/B-JH/SLCH Consortium Program in Missouri. In the second and third place were Wayne State University/Detroit Medical Center Program, Michigan, with 325 papers and University of Michigan Program, Michigan, with 317 papers. The majority (153 programs) has less than 30 publications per decade.
Conclusion: More attention to research is needed in OBGYN residency programs.
Background
Obstetrics and Gynecology (OBGYN) is a quickly evolving discipline with new discoveries, inventions, and achievements that come to see the light every day. All this occurs thanks to the diligent work of researchers, both in the medical and technological fields. In spite of this, research is still not required for graduation from residency programs in the United States (U.S.). Many of these programs, however, has paced their peers and now require a completed research project from every resident before graduation. So, in order to provide a glimpse into the research productivity of OBGYN residency programs we conducted the following study.
Methods
The biomedical indexing engine “PubMed” was used to search for publications that originated from OBGYN residency programs in the U.S. in the last decade.
The names and addresses of 244 OBGYN residency program were extracted from FREIDA Online [1], the database of graduate medical education programs accredited by the Accreditation Council for Graduate Medical Education.
We used the following keywords in PubMed:
- Department_of_obstetrics_and_gynecology
- The name of the residency program sponsor or hospital
- Town and state.
The search was conducted between 11th and 16th July 2010 and publications were counted back to 2000. We called the number of publications per decade the Research Productivity Index (RPI). Distribution curves were tested for normality using the Kolmogorov-Smirnov-Lilliefors and the Shapiro-Wilk tests.
Results
The average number of publications per decade was 46. The highest number of publications was 342, achieved by Washington University/B-JH/SLCH Consortium Program in Missouri. In the second and third place were Wayne State University/Detroit Medical Center Program, Michigan, with 325 papers and University of Michigan Program, Michigan, with 317 papers. Overall, the distribution of published papers was not Gaussian.
We suggest a grading system where programs with < 30 publications per decade are seen as not research oriented, 30-99 as average in research activity, 100-199 as good, 200-299 as excellent and ≥ 300 as super.
Using this classification we find that 153 programs rank poor by research productivity (63%), 53 programs rank average, 23 programs rank good, 10 programs rank excellent and 5 programs rank super (Graph).
Study Limitations
- Some publications may have not been indexed by PubMed.
- PubMed search results may come by the affiliation of the first or corresponding author only.
Commentary
Residency is a stage of graduate medical training that is necessary to practice medicine in the United States even if the resident has completed postgraduate education in another country. The numbers above, to the best of our knowledge, show that little attention is being directed to research in OBGYN residency programs. Unfortunately, research remains a nonmandatory part of the curriculum and many residency programs evidently do not enforce the research commitment of their faculty leading to the above shown unnormal (non-Gaussian) distribution of the Research Productivity Scale.
The Accreditation Council for Graduate Medical Education clearly states the following in the Common Program Requirements for Graduate Medical Education in Obstetrics and Gynecology [2]:
1. The curriculum must advance residents’ knowledge of the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care.
2. Residents should participate in scholarly activity.
3. The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities.
One may argue that large university-based programs produce more publications because they have more workforce, more financial resources and provide protected time for their faculty to do research and publish. In smaller programs, however, the emphasis is on clinical productivity in order to generate revenue and provide clinical experience for the residents. We think that the first motive to research should be the desire for knowledge. If the will to achieve better levels of knowledge is present, then even meager resources can produce excellent research.
We would like to see the Accreditation Council for Graduate Medical Education takes a firm stance regarding the research obligations of residency programs, both in university and community-based healthcare institutions, and makes clinical research an indispensable requirement for graduation from OBGYN residency programs.
Appendix
Excel file of OBGYN residency programs and number of papers in the period 2000-2010.
References
- FREIDA Online.
- ACGME Scholarly Activity Requirements
Source(s) of Funding
none
Competing Interests
None
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