2046 Does Neurosurgery Residency Program Ranking Impact Scholarly Activity? Quantifying Resident Research Output Across Program Ranking Tiers Using the Publication Value Unit and Arms Race Control Score

INTRODUCTION: Neurosurgery residency training programs (NRTP) prioritize resident scholarly activity and research constitutes a key milestone for resident evaluation. The impact of NRTP resources and reputation, as estimated by national NRTP rankings, on resident scholarly output remains unknown. METHODS: A total of 30 NRTPs were stratified by Doximity rankings, into top (#1-10)(H), middle (#40-47, 49, 50, 52)(M) and low (#80-89)(L) program ranking tiers. Successful graduates from 2021 and 2022 were identified for each program. A retrospective quantitative publication assessment for each resident was conducted for their 7-year residency period, using total indexed residency publications (TIRPs) in PubMed. A 5-point scale was used to calculate a Publication Effort Score (PES) for each publication, ranging from an editorial/historical commentary (PES=1) to a high-effort basic science paper (PES=5). Each PES was subsequently divided by the resident’s authorship position to assign a corresponding PVU for each publication. Each resident’s cumulative PVU (cPVU) was summated. ARCS was also calculated, which eliminates all minimal effort publications (PVU = 1)(MEP) from the cPVU. RESULTS: A total of 145 neurosurgery residency graduates (14.5% female) were identified. On multivariate analysis, top-ranked programs had significantly higher mean TIRPs (H:45.7, M:12.0, L:15.2), mean cPVU (H:73.1, M:20.2, L:25.3) and mean ARCS (H:57.4, M:16.1, L:20.0)(p<0.001). In contrast, across all NRTP ranking tiers, sex, PhD status, medical school affiliation, and fellowship status were not significant predictors of residency publication output. Among top-ranked programs, the proportion of TIRPs that were MEP was more prevalent (H:34.1%, M:30.1%, L:30.3%). CONCLUSIONS: Neurosurgery residents from top-ranked programs published more research, with more MEP, as measured by PVU/ARCS. This finding was irrespective of sex, PhD status, medical school affiliation, or fellowship status.