Pre-residency research productivity and its impact on admission to top-tier U.S. residency programs: a meta-analysis across specialties in surgical education.

BACKGROUND: Pre-residency research productivity is widely regarded as a critical factor for medical students aspiring to competitive residency programs. However, its specific impact on admission to top-tier programs remains uncertain. METHODS: A meta-analysis was conducted to evaluate the association between pre-residency research productivity-including total publications, first-author publications, H-index, and specialty-specific output-and admission into high-reputation or high-research ranking residency programs. A comprehensive literature search of PubMed, Embase, and CENTRAL databases (up to May 2025) identified eight studies involving 3,477 U.S. medical students across seven specialties. RESULTS: Total publication volume (OR = 1.82, 95% CI: 1.21-2.74, p < 0.01) and H-index (OR = 1.93, 95% CI: 1.57-2.37, p < 0.001) were significantly associated with admission into high-reputation programs. Similar trends were observed for high research ranking programs, with total publications (OR = 1.83, 95% CI: 1.42-2.36, p < 0.001) and H-index (OR = 1.92, 95% CI: 1.15-3.20, p = 0.01) showing robust correlations. In contrast, first-author publications demonstrated non-significant associations with both reputation (OR = 4.83, 95% CI: 0.37-63.26, p = 0.23) and research rankings (OR = 4.27, 95% CI: 0.74-24.51, p = 0.10). CONCLUSION: Pre-residency research productivity may confer a measurable advantage for admission into top-tier U.S. residency programs. These findings underscore the strategic value of sustained and impactful scholarly contributions, while challenging the traditional emphasis on first-author publications.