The Power of Cooperation: A Quantitative Analysis of the Benefit of Civilian Partnerships on the Academic Output of Military Surgeons

Elise E H Fannon; Peter A Learn; John D Horton; Kerry P Latham; Ian L Valerio

doi:10.1093/milmed/usad033

The Power of Cooperation: A Quantitative Analysis of the Benefit of Civilian Partnerships on the Academic Output of Military Surgeons

Mil Med. 2023 Feb 20:usad033. doi: 10.1093/milmed/usad033. Online ahead of print.

Authors

Elise E H Fannon^{1

2}, Peter A Learn³, John D Horton^{3

4}, Kerry P Latham^{3

5

6}, Ian L Valerio^{3

7}

Affiliations

¹ Department of Surgery, UC Davis, Sacramento, CA 95817, USA.
² Department of Surgery, David Grant Medical Center, Travis Air Force Base, CA 94535, USA.
³ Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
⁴ Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, DC 98431, USA.
⁵ Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.
⁶ Department of Surgery, University of Maryland, College Park, MD 21201, USA.
⁷ Department of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.

PMID: 36807454
DOI: 10.1093/milmed/usad033

Abstract

Introduction: Military-civilian partnerships are crucial to maintaining the skills of active duty surgeons and sustaining readiness. There have been no publications to date that report the quantitative effect of these partnerships on academic research. To address this question, the Hirsch indices (H-indices) of active duty surgeons with a civilian affiliation (CA) were compared to those without. As a secondary outcome, H-indices of military surgeons with and without an appointment to the Uniformed Services University (USU) were similarly compared. We hypothesized that military surgeons with a CA would have a higher H-index as compared to those without.

Materials and methods: Rosters of active duty military surgeons were obtained confidentially through each branch consultant. H-indices were found on Scopus. Graduation dates and hospital affiliations were identified via public Doximity, LinkedIn profiles, and hospital biographies. Rosters were cross-referenced with USU appointments. Stata software was used for final analysis.

Results: Military surgeons without a civilian association have a median H-index of 2 versus 3 in those with such an affiliation (P = .0002). This pattern is also seen in average number of publications, at 3 and 5 articles (P < .0001). When further stratified by branch, Air Force surgeons have median H-indices of 2.5 and 1 with and without a CA, respectively (P = .0007). The Army surgeons follow a similar pattern, with median H-indices of 5 and 3 for those with and without affiliations, respectively (P = .0021). This significance does not hold in the Naval subgroup. Similar results are found for the secondary outcome of USU appointment, with median H-indices of 3 and 2 in those with and without CAs, respectively (P < .0001). In the multivariable negative binomial regression model, both CA and USU appointment significantly increased H-index in the overall cohort, with incidence rate ratios of 1.32 (95% CI = 1.08, 1.61) and 1.56 (95% CI = 1.28, 1.91), respectively.

Conclusion: This article provides objective evidence that there is a benefit to military-civilian partnerships on the academic output of military surgeons. These relationships should continue to be fostered and expanded.