Predictors of Full-Time Spine Surgeon Faculty Position at a University Hospital.

Abstract

Although spine surgery careers are influenced by a multitude of professional and personal factors, predictors of career trajectories and future research effect may be identifiable at the spine fellow applicant stage. As such, this study aimed to (1) determine factors predictive of University Hospital [UH] employment and research contributions and (2) compare the application metrics identified as most important to an academic career by spine surgery program directors (PD) to those predictive of career environments from prior spine fellows applications. All applications of individuals applying for spine fellowship training between 2017 and 2021 at an academic institution were reviewed. Application metrics pertaining to research achievement, academic achievement, prior and current education, extracurricular involvement, leadership, examination scores, applicant interests, and letter of recommendation (LOR) reputation were extracted. The careers of all prior spine fellow applicants were grouped by the presence or absence of full-time university appointment and research effect (current H-index). A survey sent to spine PDs asked them to rank the importance of application factors to academic careers using analogous metrics to the application review. A total of 310 applications were reviewed. Residency publications (odds ratio [OR]: 1.09, P = 0.0116), preclinical publications (OR: 1.24, P = 0.0447), and expressed academic interest (OR: 2.25, P = 0.0229) predicted UH appointment. Applicant physician scientist interest (β: 2.41, P < 0.001), LOR writers' reputation (β: 0.05, P < 0.001), and journal reviewer positions (β: 0.80, P < 0.001) predicted current H-index. In the PDs survey, metrics predicting academic trajectory were ranked (descending): research achievements, physician scientist interest, academic interest, leadership positions, LOR writers' reputation, prestige of training, and United States Medical Licensing Examination scores. Research year(s), advanced degrees, and society leadership and membership positions, although theoretically deemed important by PDs, were in actuality minor contributors to the career environments of spine fellow applicants. Spine fellow academic interest, residency publications, and preclinical publications predicted full-time UH-based careers. 3. Retrospective Cohort Analysis.