Joanna M. Roy, Omar M.M. Mansoor, Samit Sen, Aaron Segura, Rithvik Naga Ganti, Basel Musmar, Gilberto Perez Rodriguez Garcia, Brett Henshey, Saarang Patel, Sruthi Ranganathan, Victor Gabriel El-Hajj, Stavropoula Tjoumakaris, M. Reid Gooch, Robert H. Rosenwasser, Christian Bowers, Pascal Jabbour
BACKGROUND AND OBJECTIVES: The Arms Race Control Score (ARCS) was developed to provide a quantitative assessment of publications among residency applicants. International medical graduates (IMGs) often have higher numbers of publications compared to U.S medical graduates (US MDs). However, there is limited knowledge of publication quality and effort among IMGs and US MDs. Our study analyzes publication productivity among IMGs and US MDs using the ARCS. METHODS: Applicants were selected from ACGME-accredited training programs that enrolled both IMG and US MD residents over the 2018-2024 match cycle. Programs without IMG residents in a given year were excluded from the analysis. The total number of residency applicant publications (TNRAP), cumulative publication value unit (cPVU), cumulative ARCS (cARCS), number of publications with PVU< 1, PVU ≤ 1 and high effort activity index (HEAI) were extracted using PubMed and the ARCS calculator. RESULTS: Of 272 total applicants, 47.1% (n = 128) were IMGs and 52.9% (n = 144) were US MDs. IMGs had higher TNRAP, cPVU, cARCS, and number of PVU > 1 and PVU ≤ 1 publications than US MDs (P < 0.001). HEAI demonstrated no significant difference between IMGs and US MDs (p = .91). After accounting for match year, IMGs had 2.32-times higher TNRAP (IRR: 2.32, 95% CI: 1.76-3.97, p < .001) and produced articles with PVU> 1 at higher rates than US MDs (IRR: 2.26, 95% CI: 1.68-3.03, p < .001). Among those with cPVU and cARCS scores above zero, IMGs had scores 2.19-times higher than US MDs (95% CI: 1.61-2.98, p < .001) and 2.12-times higher than US MDs (95% CI: 1.59-2.83, p < .001), respectively. CONCLUSION: Among applicants who match into neurosurgery residency programs in the U.S, IMGs demonstrate higher publication count and higher research effort compared to US MDs. The proportion of high-effort publications relative to total publication output did not differ among groups.