Early Career First and Senior Authorship and Its Relation to Future Neurosurgical Leadership.

Abstract

Assessing the future academic potential of neurosurgery residency applicants is challenging. Metrics such as total publications and H-index fail to capture differences in authorship roles. First and senior authors typically contribute the most, reflecting initiative and ownership. We hypothesized that individuals with more first-author or senior-author publications in their first 10 academic years are more likely to later hold departmental leadership roles. We randomly selected a sample of 50 US academic neurosurgery programs and identified department chairs and program directors. Each leader was matched with a control subject based on academic rank and degree. Using PubMed, we quantified the numbers of total, first-author, senior-author, and combined first-/senior-author publications published in the 10 years after each individual's first publication and the H-index based on that 10-year span and compared these metrics between leaders and controls. Among 200 neurosurgeons (100 leaders, 100 controls), there were no significant differences in academic rank (P = .902) or degree (P = .700). Leaders and nonleaders had a similar overall publication output in their first 10 years (P = .077); however, leaders had significantly more first-author-only publications (9.23 vs 6.55, P = .033) and combined first-author and senior-author publications (15.73 vs 9.85, P = .005) and a higher H-index based on early work (13.04 vs 10.20, P = .028). On multivariable analysis controlling for degree, the number of first/senior-author publications was independently associated with higher odds of holding a leadership position (odds ratio 1.054; 95% CI, 1.008-1.108; P = .022). Total publication count and H-index were not significant predictors. The number of first-author or senior-author publications within the first 10 years of publishing is a stronger predictor of future neurosurgical leadership than overall publication count or early-career H-index. Tracking first/senior authorships-which demand greater initiative, ownership, and dedication-may provide a simple and fast way to identify future academic leaders among neurosurgery applicants.