Impact of Academic Pedigree on Surgery Faculty for Top-Ranked Medical Schools.

OBJECTIVE: The relationship between academic pedigree (AP) and working at high-ranked institutions remains unknown. Herein, we characterize the impact of AP on surgery faculty at these top-ranked institutions. DESIGN: A cross-sectional study was performed of surgical faculty (n = 2364) at the top 20 medical schools according to the 2023 U.S. News & World Report Best Medical School rankings. Faculty were identified from institutional websites in October 2024. Demographic and training institution information of surgeons was abstracted. Surgeons in non-professorial positions and those trained entirely outside of the United States were excluded. Educational pedigrees were ranked using composite medical school, hospital, and specialty rankings. SETTING: Top 20 Ranked U.S Medical Schools (2023 U.S. News & World Report rankings). PARTICIPANTS: Professorial Surgical Faculty. RESULTS: Among the 2364 surgeons identified, 460 (19%) trained at the #1 ranked medical school or an affiliated residency or fellowship. An AP including a top-5 program was seen in 1416 (60%) surgeons, and a top-50 pedigree in 2259 (96%). More than half (1268; 54%) were employed at institutions where they had trained. The median AP ranks improved across training stages: medical school 23 (IQR 5-53), residency 10 (IQR 4-25), and fellowship 5 (IQR 3-18) (p < 0.001). The median medical school rank differed significantly across academic ranks: assistant professor 30 (IQR 10-58), associate professor 25 (IQR 5-53), and professor 18 (IQR 5-50) (p < 0.001). CONCLUSIONS: AP is strongly associated with faculty placement at top institutions with significant self-retention and increasing pedigree selectivity across training stages. These patterns raise important questions about whether pedigree-driven selection may narrow the range of training backgrounds represented in academic surgery.