How do some doctors have >500 publications.

[agiraffe999]

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I saw this online (my parent needed a doctor) and this was in their bio:

He has over 820 peer-reviewed and 200 non-peer reviewed publications. He is the editor-in-chief of Clinical Spine Surgery. He has published over 372 book chapters and is the editor of over 63 textbooks and co-editor of OKU-Spine I and editor of OKU-8.

This seems absurd to have 800 publications, and be a full time surgeon as well. What could be a cause for this?

 

[M&L]

I saw this online (my parent needed a doctor) and this was in their bio:


This seems absurd to have 800 publications, and be a full time surgeon as well. What could be a cause for this?

just my speculation, - the surgeon doesnt actually write them all personally, he/she probably coordinates and manages residents and students who do the ground work. For example, the students and residents could be the first authors and he is the last one.

 

[GoSpursGo]

There's a difference between being *an* author and being first/last author of a paper. First author is generally the junior person who did the most work, last person is usually the senior mentor who was responsible for the original project concept and oversaw the project. Then in the middle you have everyone who did *something* that contributed significantly to the work, and there is a wide range of contributions that would qualify that are too numerous to mention here.

For any project that involves the treatment of patients, the physicians who treat the patients and in particular the surgeons who perform the surgeries often get thrown somewhere in the middle of the author list. Same for any project which relies on human samples, you need a surgeon to get you that tissue and they get middle authorship.

So surgeons are kind of notorious for being able to run up the publication count, because they can "contribute" to these publications just by doing their regular job (ie doing surgeries). But if you look closer, I suspect a fraction of those publications are either first/last author. No doubt this doctor is an incredible force within academia, but I don't think he's doing much of the actual writing.

 

[efle]

I've seen residents who already list 100+ pubs. If you're doing work like database analysis, there's essentially no bottleneck, any question you can come up with and answer with appropriate statistical methods can become another pub. Alternatively (or in combination) you could have affiliation with a large lab/department that tends to always include everyone on every paper, no matter how minor their contribution was, and you can absolutely crank out the CV entries at an absurd rate. I've even seen medical students who publish more than 1/month during a research year.

Now, the quality and clinical relevance isn't always there. You can find a journal to take almost anything, no matter how useless. But just in terms of volume, it's totally possible to rack up dozens and dozens to hundreds over the decades.

 

[GoSpursGo]

Alternatively (or in combination) you could have affiliation with a large lab/department that tends to always include everyone on every paper, no matter how minor their contribution was, and you can absolutely crank out the CV entries at an absurd rate.

To be clear, this is fraud. Most reputable journals (and some schools) have very clear authorship guidelines that delineate what does and what does not qualify for authorship, and "sitting in lab meeting while someone else talks about the project" doesn't count.

Doesn't mean it doesn't happen all the time, but it shouldn't, and you certainly shouldn't go into a research year expecting your lab to do this.

 

[Miles Gloriosus]

I saw this online (my parent needed a doctor) and this was in their bio:


This seems absurd to have 800 publications, and be a full time surgeon as well. What could be a cause for this?

They do it on the blood, sweat and tears of their resident/med student minions.

 

[deleted1064759]

They do it on the blood, sweat and tears of their resident/med student minions.

Aren't basic science PIs essentially the same by relying on their grad students?

 

[Goro]

Aren't basic science PIs essentially the same by relying on their grad students?

Said students aren't as productive, nor do they originate most of the ideas.

There used to be a time where a department chair would get a publication simply by being the chair of a department where a lab published a paper. These were people who had over a thousand papers.

As you can imagine, this lack of oversight led to an interesting amount of Fraud, and I can remember really big names in my own field having to resign their positions when it was found that somebody working under them, completely unsupervised, faked their data

 

[Dave1980]

To be clear, this is fraud.

It isn't fraud if everyone is doing it though.

 

[efle]

To be clear, this is fraud. Most reputable journals (and some schools) have very clear authorship guidelines that delineate what does and what does not qualify for authorship, and "sitting in lab meeting while someone else talks about the project" doesn't count.

Doesn't mean it doesn't happen all the time, but it shouldn't, and you certainly shouldn't go into a research year expecting your lab to do this.

Haha true I havent seen anything that extreme. I mean more like when the Neurosurg residents crowdsource a chart review and have 10 med students each pull data from charts for a few weekends, and then puts them all on the paper as middle authors. That's like putting a lab tech onto a basic science paper in my mind - not a role in the actual design or analysis that should get an authorship. But, I'd guess that is the most common type of med student authorship by far.

 

[Miles Gloriosus]

Aren't basic science PIs essentially the same by relying on their grad students?

Grad students get paid albeit not much. But still, that is what they are getting paid for. Medical students PAY for being used. Although residents do get paid, they are getting paid to do clinical work. Research is done on their own time. ACGME requires residents to do one project which is fair, but by no means does it require them to get abused. Face it, attendings have a huge amount of control over your career. They know it and exploit it.

 

[efle]

Grad students get paid albeit not much. But still, that is what they are getting paid for. Medical students PAY for being used. Although residents do get paid, they are getting paid to do clinical work. Research is done on their own time. ACGME requires residents to do one project which is fair, but by no means does it require them to get abused. Face it, attendings have a huge amount of control over your career. They know it and exploit it.

Average number of research entries for Neurosurg matches this year was 24.

TWENTY FOUR.

Give it another ten years and surgically oriented med students will be paying tuition for the privilege to work as a research coordinator, while trying to learn a little bit of medicine on the side.

 

[slowthai]

Average number of research entries for Neurosurg matches this year was 24.

TWENTY FOUR.

Give it another ten years and surgically oriented med students will be paying tuition for the privilege to work as a research coordinator, while trying to learn a little bit of medicine on the side.

And it's all your fault, efle. Should've never pushed for p/f step

 

[efle]

And it's all your fault, efle. Should've never pushed for p/f step

All part of the plan - now that you only need a 195, you can study medicine for 5 hours/week and review charts for 50 hours/week.

 

[GoSpursGo]

It isn't fraud if everyone is doing it though.

Yes it is, it just means it's hard to get caught. This is way above the paygrade above current med students, but it's a major problem.

Haha true I havent seen anything that extreme. I mean more like when the Neurosurg residents crowdsource a chart review and have 10 med students each pull data from charts for a few weekends, and then puts them all on the paper as middle authors. That's like putting a lab tech onto a basic science paper in my mind - not a role in the actual design or analysis that should get an authorship. But, I'd guess that is the most common type of med student authorship by far.

I don't really have a problem with that--it's on the low-end of authorship and you could easily argue against them meriting authorship, but it's not downright fraudulent. I will say that's an excellent example of how these papers can be of questionable quality though--if you have 10 different people all collecting data and they do it in slightly different ways, your conclusions are sitting on tenuous methods. Garbage in, garbage out.

 

[Dave1980]

Yes it is, it just means it's hard to get caught. This is way above the paygrade above current med students, but it's a major problem.

But if everyone is doing it then it is OK.

 

[slowthai]

All part of the plan - now that you only need a 195, you can study medicine for 5 hours/week and review charts for 50 hours/week.

Sounds like my personal nightmare. Thank God I'm an M2

Condolences to my M2s taking it after Jan 2021 and my M1s

 

[agiraffe999]

There's a difference between being *an* author and being first/last author of a paper. First author is generally the junior person who did the most work, last person is usually the senior mentor who was responsible for the original project concept and oversaw the project. Then in the middle you have everyone who did *something* that contributed significantly to the work, and there is a wide range of contributions that would qualify that are too numerous to mention here.

For any project that involves the treatment of patients, the physicians who treat the patients and in particular the surgeons who perform the surgeries often get thrown somewhere in the middle of the author list. Same for any project which relies on human samples, you need a surgeon to get you that tissue and they get middle authorship.

So surgeons are kind of notorious for being able to run up the publication count, because they can "contribute" to these publications just by doing their regular job (ie doing surgeries). But if you look closer, I suspect a fraction of those publications are either first/last author. No doubt this doctor is an incredible force within academia, but I don't think he's doing much of the actual writing.

So, basically becoming a program director and then have every resident/fellow publish with your name on it. Sounds like a (fraudulent) plan! /s

 

[Miles Gloriosus]

All part of the plan - now that you only need a 195, you can study medicine for 5 hours/week and review charts for 50 hours/week.

I would caution med students and residents to avoid being roped into writing book chapters. They are a huge huge time dump/time commitment and in a few years your work will be obsolete when the next edition comes around. Medical text books are very expensive and I imagine publishers would not publish them if the books didn't make money. Where is the money going? Certainly not the fellows/resident/med student who do the majority of the work.

 

[crossroad]

Average number of research entries for Neurosurg matches this year was 24.

curious, where did you find these data? Could you share it for other specialities as well?

 

[GoSpursGo]

I would caution med students and residents to avoid being roped into writing book chapters. They are a huge huge time dump/time commitment and in a few years your work will be obsolete when the next edition comes around. Medical text books are very expensive and I imagine publishers would not publish them if the books didn't make money. Where is the money going? Certainly not the fellows/resident/med student who do the majority of the work.

Just to piggy back on this, it's also basically worthless on your CV after residency applications, as are review articles (which are also a huge time dump/commitment). There is a reason your PI is farming these out to unsuspecting trainees.

Case reports/series are also more or less worthless, but at least they're quick turnaround and fulfill the objective of checking boxes relatively quickly.

 

[agiraffe999]

curious, where did you find these data? Could you share it for other specialities as well?

Match Data

Core to the NRMP’s mission is the development and distribution of data reports and publications that inform national conversations about the transition to residency and advance understanding of the…

www.nrmp.org

There is the data for this year, as well as a few before

 

[agiraffe999]

Just to piggy back on this, it's also basically worthless on your CV after residency applications, as are review articles (which are also a huge time dump/commitment). There is a reason your PI is farming these out to unsuspecting trainees.

Case reports/series are also more or less worthless, but at least they're quick turnaround and fulfill the objective of checking boxes relatively quickly.

After residency, publications are only important to brag, become a medical professor/research, or for personal joy from it right?

 

[GoSpursGo]

After residency, publications are only important to brag, become a medical professor/research, or for personal joy from it right?

Not sure where you are in your training, but the profs that you meet in your first 2 years of med school are a tiny fraction of the faculty in academic medicine. Some people like staying in academia because they like doing research, or because they like being at tertiary care centers taking care of complex patients, or they like teaching residents, or any number of other reasons. Whatever one's reason for staying at an academic medical center, you generally need pubs to get promoted (and the salary bump that comes with it).

Chances are, that won't be you 🙂 But if someone DOES know they are interested in academia, it's something to keep in mind when deciding how to allocate their time.

 

[Miles Gloriosus]

After residency, publications are only important to brag, become a medical professor/research, or for personal joy from it right?

There are people who get personal/professional joy from doing research. We need those people to advance medicine. Research is very important, but the process is highly ripe for exploitation and produces a lot of garbage research (research to only increase your pub count, not quality or field advancement). For most departments, there is a reason they don’t hire a stats person or research assistants....they know that trainees will do it for free. They know that it’s part of the game (a game they set up) where trainees have no choice but to be exploited otherwise they won’t get residency X or fellowship Y etc....

When I was a med student on an away, the PGY5 who I worked with that month asked me at the end of the rotation to help him do a retrospective chart review. I presume he asked
Me b/c I was stupid and told him earlier that had a couple weeks off between before the next away. He knew I might be available to help him (I did med school in the same city). He told me he had already talked to the attending that I was planning to get a letter from and told him that I was gonna help with the project.
I ultimately declined, but understood that chances at matching at that place was over. I had worked 8 straight weeks on aways and had like 3 days off during that time. I needed the time off to recharge, but prime example of trainee exploitation.

 

[agiraffe999]

Not sure where you are in your training, but the profs that you meet in your first 2 years of med school are a tiny fraction of the faculty in academic medicine. Some people like staying in academia because they like doing research, or because they like being at tertiary care centers taking care of complex patients, or they like teaching residents, or any number of other reasons. Whatever one's reason for staying at an academic medical center, you generally need pubs to get promoted (and the salary bump that comes with it).

Chances are, that won't be you 🙂 But if someone DOES know they are interested in academia, it's something to keep in mind when deciding how to allocate their time.

For me, I’m very early in my medical career. Frankly I’ve only been exposed to private, not academic life. I’ve got plenty of time to decide 🙂

thank you for all the comments!

 

[libertyyne]

I feel like there is a multiplier effect as well. When a doctor has a few publications under their belt other people think he is proliferative and end up working with him. Or he gets tagged on as lead because the reviewers know his name and will give more credence to the paper and publish it.

 

[asdf123g]

Its called ghost writing I believe. Its an unethical pratice but it is very very common. Theres lots of pubmed articles pointing out how prevalent this is.

Basically the other authors do all of the work ('ghost authors aside) and they get their name on the paper with or without doing work. Some places require you to have PI from the institution you work at and as a resident you cannot just solo publish or publish without a faculty who may or may not do zilch to contribute

 

[TAVR4life]

It’s not technically fraud, but it’s unethical. It’s very rampant at academic institutions including top places.

 

[Tangerine123]

Just to piggy back on this, it's also basically worthless on your CV after residency applications, as are review articles (which are also a huge time dump/commitment). There is a reason your PI is farming these out to unsuspecting trainees.

Case reports/series are also more or less worthless, but at least they're quick turnaround and fulfill the objective of checking boxes relatively quickly.

Regarding review articles.
If you're doing a PhD, PhD/MD, PhD/Residency or PhD/Fellowship then it's a good idea to write a review article of your field.

Sure, it might be worthless down the line. But doing a systematic review (Prisma or Cochrane guidelines) near the start of your program is the best un-biased way to actually get to know what's happening in the field.

I'm in the middle of writing one. From 4,000 elegible articles we (3 people) narrowed it down to around 100. These 100 articles are the base of my (very narrow) field of study.

After a systematic review you gain past, current and future perspectives of your field. You know what worked and what didn't. You know what arguments are in favor and what evidence exists against. Then you build up your research from there.

Book chapters are a different story. I just finished helping writing one (together with another PhD student and a Masters student) and the topic was so specific that it got to a point were we had no idea what we were talking about. Book chapters "should" be written by actual experts in the field and not newcomers.It was also biased. Since it's not systematic (Prisma or Cochrane guidelines) you almost only use references that suport your narrative

 

[GoSpursGo]

Regarding review articles.
If you're doing a PhD, PhD/MD, PhD/Residency or PhD/Fellowship then it's a good idea to write a review article of your field.

Sure, it might be worthless down the line. But doing a systematic review (Prisma or Cochrane guidelines) near the start of your program is the best un-biased way to actually get to know what's happening in the field.

I'm in the middle of writing one. From 4,000 elegible articles we (3 people) narrowed it down to around 100. These 100 articles are the base of my (very narrow) field of study.

After a systematic review you gain past, current and future perspectives of your field. You know what worked and what didn't. You know what arguments are in favor and what evidence exists against. Then you build up your research from there.

Book chapters are a different story. I just finished helping writing one (together with another PhD student and a Masters student) and the topic was so specific that it got to a point were we had no idea what we were talking about. Book chapters "should" be written by actual experts in the field and not newcomers.It was also biased. Since it's not systematic (Prisma or Cochrane guidelines) you almost only use references that suport your narrative

I mean... if you got something out of the experience, then good for you. I don't think it's necessary to do a review article to gain an understanding of the field.