• Adham M Khalafallah, Adrian E Jimenez, Marcus Daniels, Ali Bydon, Alan R Cohen, Rafael J Tamargo, Timothy Witham, Judy Huang, Henry Brem, and Debraj Mukherjee.
• Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: akhalaf2@jhmi.edu.
• J Surg Educ. 2020 Sep 1; 77 (5): 1312-1320.

ObjectiveMany studies have sought to determine predictors of academic career placement in surgical subspecialities. However, previous research has yet to establish whether the ranking of a surgeon's undergraduate institution or medical school is significantly associated with pursuit of an academic career. The purpose of this study was to investigate these novel factors' predictive impact on an academic career in the surgical subspeciality of neurosurgery. Factors investigated included undergraduate university rankings, medical school rankings, and residency program rankings.DesignData were retrospectively collected for 884 alumni of Accreditation Council for Graduate Medical Education neurological surgery residency programs. Bivariate analyses were conducted to determine covariates for a logistic regression model, and multivariate analysis was performed with 13 covariates to determine which factors were independently associated with academic career trajectory.ResultsIn multivariate analysis, factors that were independently associated with an academic career in neurological surgery included having 1 year or more of protected research time during residency (odds ratio [OR] =1.96, p = 0.020), attending a "top" undergraduate university (OR =1.88, p = 0.00033), attending a "top" research medical school (OR = 1.53, p = 0.031) attending a residency program affiliated with a "top" research medical school (OR = 1.78, p = 0.012), possessing a Master of Science (OR = 3.46, p = 0.00097), or Doctor of Philosophy (OR = 2.05, p = 0.0019) degree, and completing a clinical fellowship (OR = 2.56, p = 1.90 × 10-8).ConclusionsOur study establishes 3 novel factors for predicting residents' choice of pursuing an academic career in neurological surgery, namely undergraduate university rank, medical school rank, and completing residency at a program affiliated with a "top" research medical school. Such findings reinforce the notion that educational and training environments are key in shaping the career trajectory of future academic surgical subspecialists.Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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