Trends in Academic Misrepresentation in Neurological Surgery Residency Applicants: A 2-Year Analysis

OBJECTIVE: Academic misrepresentation is not an unknown phenomenon, with recent reports in neurosurgery detecting a 45% misrepresentation rate in prospective neurosurgical residents. The purpose of this study was to determine current rates of academic misrepresentation by prospective neurosurgical residents at a single institution across 2 distinct application cycles. METHODS: We retrospectively reviewed all Electronic Residency Application Service applications to 1 institution's neurosurgical residency program in the 2015 (n = 320) and 2020 (n = 355) application cycles. Reported academic works were verified through an extensive Web search of PubMed, Google Scholar, and the individual journal Web sites. Misrepresentation was defined in our study as listing work that does not exist, self-promotion to primary authorship, self-promotion (excluding primary authorship), incorrectly listing online-only publications, and listing non-peerreviewed work as peer-reviewed. RESULTS: In 2015, 253 (79.1%) applicants reported a total of 2097 citations and 305 (85.9%) applicants reported a total of 3018 citations in 2020 (P < 0.05). Median peer-reviewed articles per applicant rose significantly in 2020 (3.0 vs. 4.0, P < 0.001). Misrepresentation rates decreased dramatically in 2020 to 18.4% from a previously reported misrepresentation rate of 459A) in 2012 (P < 0.0001). Increased United States Medical Licensing Exam Step 2 scores were associated with a decreased likelihood of misrepresentation (odds ratio = 0.97, P < 0.001). CONCLUSIONS: Misrepresentation rates within neurosurgical residency candidates have significantly decreased despite an increase in reported citations. A variety of steps including education, modifying reporting methods, and increased screening may help even further decrease misrepresentation.