Quality versus Quantity of Research Output among Applicants to Ophthalmology Residency

Purpose: Research output remains one of the few quantitative factors by which applicants to ophthalmology residency can be compared. In the highly competitive application process, understanding how to assess the quality of research with the information provided is important to ensuring a fair selection process. The goal of this study was to determine whether the number of published articles reflects the quality of research output among ophthalmology residency applicants. Methods: Cross-sectional analysis of ophthalmology applications received by a single Northeast residency program in the 2022-2023 San Francisco Match. Average impact factor of the journals listed in the applications under published articles or abstracts was calculated for each applicant. Percentage of first authorship was calculated based on self-reported order of authorship. The association between number of publications and impact factor or percentage first authorship in multivariable linear regressions including and excluding applicants with no publications. Secondary outcomes included comparisons in quality of research output between subgroups of applicants. Results: 631 applications were received and included; 42% (264/631) of the applicants were women and 16% (102/631) were underrepresented in medicine (URiM). The average number of published articles and abstracts in the cohort was 5.77 ± 8.72 with an average journal impact factor per applicant of 3.70 ± 4.15 and an average percentage of first-author publications of 31.0% ± 31.2. The number of publications was significantly associated with average impact factor (coefficient=0.062; 95% confidence interval (CI) 0.024 – 0.099; p=0.001) and percentage of first-author publications (coefficient=0.004; 95% CI 0.001 – 0.007; p=0.018). However, when applicants with no publications were excluded, there was no longer a significant association between quantity and average impact factor (coefficient=0.022; 95% CI: -0.019 – 0.064; p=0.286) or percentage of first authorship (coefficient Conclusions and Relevance: Although there is a significant relationship between quantity and quality overall, there is no significant association among applicants with at least one publication. When ophthalmology residency programs review the research output of applicants who have published, the number of publications should not be a surrogate for the quality of the work.