Relative Citation Ratios of Global Surgery, Obstetrics, Trauma, and Anesthesia: Implications and Lessons for Global Neurosurgery

Background: The National Institutes of Health has developed a new metric, the Relative Citation Ratio (RCR), to assess the impact of research articles and compare academic productivity across different fields. Global surgery, obstetrics, trauma, and anesthesia (SOTA) are young and increasingly popular fields attracting researchers and funding. This study analyzed the RCR of global neurosurgery; compared it with other global SOTA specialties; and discussed the implications for researchers, academic institutions, and aspiring global neurosurgeons. Methods: Metadata were downloaded from the National Institutes of Health RCR website for 12 established global surgery specialties, including global neurosurgery. The authors performed descriptive and bivariable inferential analyses to evaluate differences in the number of total publications, median number of citations per year, and median RCR for each specialty for which data were available. Results: Global pediatric surgery had the highest median citations per year (2.00, interquartile range: 0.63–3.50; P = 0.048) and median relative citation ratio (1.36, interquartile range: 0.33–1.95; P = 0.693). In comparison, global neurosurgery articles had 0.20 median citations per year (IQR: 0–1.5) and 0.54 (IQR: 0.12–1.30) median relative citations. The median expected citations per year for all SOTA articles was 1.77. Conclusions: We observed strong development of global neurosurgery and SOTA research. Overall, the use of the RCR will facilitate standardized interfield and intrafield academic productivity comparisons. Based on the results presented in this study, global neurosurgery is a promising career route for young and aspiring academic neurosurgeons.