Academic productivity and career trajectory of international medical graduates in US neurosurgery residency programs

OBJECTIVE The objective of this study was to review and compare the research experiences and career outcomes of international medical graduates (IMGs) with those of US medical graduates (USMGs). METHODS Neurosurgery graduates from 2018 to 2020 were evaluated on the basis of medical school, degree, residency program, publications before and during residency, postresidency fellowships, and career progression. Publications were further categorized by author order and type (laboratory, comprehensive clinical, or short communication). RESULTS Of 550 neurosurgery graduates, 39 (7%) were IMGs, with the largest percentages from India (8/39, 21%) and in a residency position in Pennsylvania (5/39, 13%). Prior to residency, IMGs had a higher median number of all publications (4 vs 1, p < 0.001), first-author articles (2 vs 0, p < 0.001), comprehensive clinical articles (1 vs 0, p = 0.002), and short communication articles (1 vs 0, p < 0.001) than USMGs. Similarly, the median number of papers published by IMGs during residency was also higher compared with that of USMGs for all publications (20 vs 9, p = 0.004), laboratory articles (1 vs 0, p < 0.001), and short communication articles (4 vs 3, p = 0.04). The percentage of early academic appointments was higher for IMGs (25/39, 64%) than for USMGs (232/511, 45%) (p = 0.03). No significant difference was observed between the percentages of postresidency clinical fellowships completed by IMGs (28/39, 72%) and USMGs (302/511, 59%) (p = 0.15). No statistical significance was found between the ranking of neurosurgery residency programs attended by IMGs and USMGs (p = 0.65). CONCLUSIONS The results indicate that IMGs often exhibit higher academic productivity than USMGs. Although there was no discernible difference in residency program rankings or postresidency fellowships completed, early academic appointments were more prevalent among IMGs.