Publication productivity among international medical graduates and U.S. medical graduates in neurosurgery: A comparative assessment using the arms race control score.
Publication/Presentation Date
3-12-2026
Abstract
BACKGROUND AND OBJECTIVES: The Arms Race Control Score (ARCS) was developed to provide a quantitative assessment of publications among residency applicants. International medical graduates (IMGs) often have higher numbers of publications compared to U.S medical graduates (US MDs). However, there is limited knowledge of publication quality and effort among IMGs and US MDs. Our study analyzes publication productivity among IMGs and US MDs using the ARCS.
METHODS: Applicants were selected from ACGME-accredited training programs that enrolled both IMG and US MD residents over the 2018-2024 match cycle. Programs without IMG residents in a given year were excluded from the analysis. The total number of residency applicant publications (TNRAP), cumulative publication value unit (cPVU), cumulative ARCS (cARCS), number of publications with PVU< 1, PVU ≤ 1 and high effort activity index (HEAI) were extracted using PubMed and the ARCS calculator.
RESULTS: Of 272 total applicants, 47.1% (n = 128) were IMGs and 52.9% (n = 144) were US MDs. IMGs had higher TNRAP, cPVU, cARCS, and number of PVU > 1 and PVU ≤ 1 publications than US MDs (P < 0.001). HEAI demonstrated no significant difference between IMGs and US MDs (p = .91). After accounting for match year, IMGs had 2.32-times higher TNRAP (IRR: 2.32, 95% CI: 1.76-3.97, p < .001) and produced articles with PVU> 1 at higher rates than US MDs (IRR: 2.26, 95% CI: 1.68-3.03, p < .001). Among those with cPVU and cARCS scores above zero, IMGs had scores 2.19-times higher than US MDs (95% CI: 1.61-2.98, p < .001) and 2.12-times higher than US MDs (95% CI: 1.59-2.83, p < .001), respectively.
CONCLUSION: Among applicants who match into neurosurgery residency programs in the U.S, IMGs demonstrate higher publication count and higher research effort compared to US MDs. The proportion of high-effort publications relative to total publication output did not differ among groups.
Volume
265
First Page
109383
Last Page
109383
ISSN
1872-6968
Published In/Presented At
Roy, J. M., Mansoor, O. M. M., Sen, S., Segura, A. C., Ganti, R. N., Musmar, B., Garcia, G. P. R., Henshey, B., Patel, S., Ranganathan, S., El-Hajj, V. G., Tjoumakaris, S. I., Gooch, M. R., Rosenwasser, R., Bowers, C., & Jabbour, P. (2026). Publication productivity among international medical graduates and U.S. medical graduates in neurosurgery: A comparative assessment using the arms race control score. Clinical neurology and neurosurgery, 265, 109383. Advance online publication. https://doi.org/10.1016/j.clineuro.2026.109383
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41832795
Department(s)
Administration and Leadership
Document Type
Article