UK paediatric surgical academic output (2005–2020): A cause for concern?

Abstract

Background

The publication record can be regarded as a key metric of the academic output of a craft surgical speciality with an almost exponential increase in the number of such publications worldwide over the past 20 years (Ashfaq et al. J Surg Res 2018;229:10–11). We aimed to examine and explore if this was the experience within UK paediatric surgery centres.

Methods

The academic search engine Scopus™ (Elsevier) was used to track every paediatric surgeon's (NHS or University) publication history between Jan. 2005 – Dec. 2020. This was validated by an algorithmic search of PubMed™. The h-index (citations/publication), considered a validated metric of career academic output, was also calculated for each individual surgeon. A Field-Weighted Citation Index (Scopus™) (FWCI) was used to assess impact of individual publications. Textbooks, book chapters, abstracts, duplications (“double dipping“) and output attributed to UK BAPS-CASS national studies were excluded. Some output(s), not considered as relevant to “paediatric surgery”, was edited. Data are quoted as median(range).

Results

During this 16-year period, there were 3838 publications identified from 26 centres with a “top ten” listing of those paediatric surgical units contributing over half the output (n = 2189, 57%). To look for evidence of trend(s) we analysed the output from these surgical centres in two 5-year periods (2005–9 and 2015–19) and showed an overall fall in output(s) - [730 (53.4%) to 645 (46.4%)] with 6/10 (60%) ‘ top ten ‘ centres here recording a reduction in publications. The median h-index of the 232 contributing paediatric surgical consultants was 12 (range 1–56). The best performing publication from the “top ten” centres had 96.5(51–442) citations with the FWCI being 4.5 (2.2 – 30.2).

Conclusions

This study highlights current paediatric surgery publication output metrics in UK centres. There is evidence of a relative reduction in outputs overall which is a cause for concern for the future, although individual publications from the 10 most active units in the UK remain highly cited. These findings may serve purpose in several ways: (i) UK paediatric surgical centre rankings may be helpful for guiding residency / trainee application; (ii) surgical research funding for the top performing units may be better facilitated and finally (iii) UK centres showing a ‘ fertile ground ‘ for nurturing and training paediatric surgeons with academic aspirations could be useful for future workforce planning.

Introduction

Paediatric surgery is a relatively small craft speciality that emerged out of the field of general surgery in Europe and North America, largely during the 1950s and 1960s with the establishment of professional organisations in the 1950s (e.g. British Association of Paediatric Surgery), and a speciality-dedicated journal (Journal of paediatric Surgery) in 1966. Its surgical remit has always been wide, encompassing for example both fetal surgery and adolescent bariatric surgery at its extremes. Although most academic output in paediatric surgery may be regarded as clinical themed research there has always been a basic science foundation niche to the speciality with a small cadre of university surgeons working in some of the major UK centres.

Academic or research output, whether in an individual surgeon or from a department, can be a difficult concept to define particularly for those outside of a university-setting. Publications can be regarded as one of the key metrics of academic output and "performance". [1,2, 3]. In order to try and define the impact or influence of a publication further metrics have also been devised. The Hirsch h-index - a composite of the number of citations and number of publications - is a validated metric of an individual's academic output which alters during one's professional career [4, 5]. These tools of measurement can also be applied to learned institutions [5] including examining national output(s) within specific subject areas [6].

The current study seeks to provide a contemporary overview of the academic profile of paediatric surgery in the UK .