Cross-Sectional Study of Osteopathic General Surgeons in University-Based General Surgery Departments

Thursday, September 15, 2022

3:40 PM – 3:50 PM East Coast USA Time

Location: JW Grand Ballroom 5-6

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Reference 2: 0
Reference 3: 0

Primary Presenter(s)

Cassidy Wheeler, OMS-IV

Medical Student
Texas College of Osteopathic Medicine/University of North Texas HSC

Disclosure(s): No financial relationships to disclose

Author(s)

HW

Haley Wolf, OMS-II

Texas College of Osteopathic Medicine/University of North Texas HSC

Disclosure information not submitted.

Disclosure(s):

Cassidy Wheeler, OMS-IV: No financial relationships to disclose

Introduction/Purpose: Discrepancy between osteopathic (DO) and allopathic (MD) graduates in general surgery spans across all levels of training. While the barriers for DO students to enter surgical residency have previously been studied, there is a lack of literature describing osteopathic surgeons who eventually pursue careers in academic general surgery as attending physicians. To fill this gap in knowledge and to serve as a guide for future academic osteopathic surgeons, we performed a cross-sectional analysis of osteopathic faculty at university-based academic surgery departments and characterized their academic credentials.

Methods or Case Description: Overall, 106 university-based surgery departments were reviewed. DO and MD surgeons from the same institutions were identified, and demographic data were tabulated. MD surgeons were the control group. Univariate analysis and multivariate regression models were used to compare total publications, h-index, and citations.

Outcomes: A total of 70 DO surgeons from 34 institutions were identified: 53 assistant professors, 16 associate professors, and one full professor. Of the DO surgeons, 35.7% completed residency at a university-based program, and 92.9% completed a fellowship, with surgical critical care and trauma being the most common. They were compared to 1,307 MD surgeons from the same institutions. Univariate analysis showed that MD faculty graduated medical school earlier (mean years (standard deviation (SD)): 14.8 (6.0) versus 23.3 (10.6); p < 0.0001), had more total publications (median (interquartile range (IQR)): 5 (2.0-18.3) versus 35 (15.0-79.0); p< 0.0001), had higher number of citations (median (IQR): 61.0 (14.0-265.0) versus 655.0 (155.0-2267.0); p< 0.001), and had a higher h-index (median (IQR): 3 (1.0-8.0) versus 12 (6.0-24.0); p< 0.001). Negative binomial regression models accounting for years since graduation, gender, and degree were performed. At the assistant professor rank, MD surgeons had more total publications (exponential coefficient (CI): 2.24 (1.67-3.02); p< 0.001), more citations (3.10 (2.20-4.11); p< 0.001), and a higher h-index (1.93 (1.36-2.73); p< 0.001). Similar trends were noted at the associate professor level with MD surgeons having more total publication (1.67 (1.00-2.79); p=0.049), more citations (3.63 (2.13-6.18); p< 0.001), and higher h-index (1.93 (1.10-3.39); p=0.022).

Conclusion: The discrepancy between DO and MD surgeons spans all levels of medical training, from medical students to academic faculty. Many osteopathic programs do not have direct partnerships with academic general surgery programs; thus, opportunities to find mentors and research opportunities are limited. Many osteopathic students have to go beyond their own institution to other residency programs and academic institutions to seek mentorship and research. This may have impacted both research opportunities and opportunities to network. To address this discrepancy, action must be taken by osteopathic medical schools and leaders of the field to ensure that DO students receive better access to mentorship and research support to foster an academic career.

Learning Objectives:

Upon completion, participants will be able to recognize current osteopathic representation in general surgery compared to their allopathic counterparts.
Upon completion, participants will be able to identify the demographics of DO and MD surgeons, including academic qualifications (residency and fellowship training) and research involvement (total number of publications and citations; H-index).
Upon completion, participants will be able to list barriers encountered by osteopathic students pursuing careers in general surgery academia.
Upon completion, participants will be able to recognize ways to better support students interested in surgical specialties.