Redefining Research Productivity in Neurosurgery Residency Applications Through the Predictive Value of Authorship Order and Research Year Engagement

Objective With the recent change to pass/fail USMLE Step 1 assessment and increasing reliance on other metrics of applicant ability, neurosurgery residency programs face challenges in evaluating the academic potential of applicants. This study examines the relative contributions of first-author publications, research year completion, and total publication volume to match success. Methods Data were drawn from the Texas STAR (Seeking Transparency in Applications to Residency) survey between 2022 and 2025, including 2,674 U.S. MD applicants and a detailed 2025 sub-cohort (n = 58) with authorship data. Logistic regression models, Chi-squared tests, and t-tests were used to examine associations between publication patterns and match outcomes. Covariates included Step 2 CK score (categorized), geographic connection, and away rotation participation. Results When mutually adjusted, first-author publication count was strongly predictive of match success (OR = 2.76 per additional first-authored paper, 95% CI: 1.82–4.67, p < 0.001), while total publication count was negatively associated with matching when controlling for authorship (OR = 0.64, 95% CI: 0.46–0.84, p < 0.001). Completion of a research year was associated with a significantly higher number of first-author publications (mean = 3.96 vs. 2.53, p = 0.0023), but not with greater total publication volume (mean = 8.04 vs. 6.41, p = 0.07). A greater number of research experiences was inversely associated with match success (OR = 0.53 per experience, 95% CI: 0.38–0.68, p < 0.001). Conclusion First-authored papers better predict match success than total publication count in neurosurgery residency applications. Dedicated research years appear to support meaningful productivity rather than sheer volume. These findings delineate how research experience is weighted in neurosurgery residency selection and may be helpful for medical students applying into neurosurgery.