Follow-up on misrepresentation of research activity by orthopaedic residency applicants: Has anything changed?

Background: In our previous study, published in 1999, we showed that 18% of research citations listed as published by orthopaedic residency applicants were misrepresented. Since our last report, we sought to determine whether there had been any change in the behavior of applicants wishing to pursue the field of orthopaedic surgery. Methods: We evaluated the research citations that were identified after a review of the Publications section of the Common Application Form from the Electronic Residency Application Service for all applicants to our orthopaedic residency program for 2005 and 2006. Inclusion and exclusion criteria were established for citations listed on candidate applications. Citations were required to be from journals listed in Ulrich's Periodicals Directory. The PubMed-MEDLINE database engine was used to search for citations. If searching failed to yield the cited publication, a review of the journal of alleged publication was undertaken and an interlibrary search was conducted with the use of several research databases. When no match was found, the citation was labeled as misrepresented. Misrepresentation was defined as either (1) nonauthorship of an existing article or (2) claimed authorship of a nonexistent article. Results: One hundred and forty-two (35.9%) of 396 applicants during the 2005 and 2006 application periods listed publications. A total of 304 citations were claimed from these 142 applicants. Listings included articles that were in press or in print (thirty-four citations), articles in journals not found in Ulrich's Periodicals Directory (twenty-eight citations), book chapters (twenty-three citations), and articles recorded as having been submitted (eighty-eight citations). These 173 works were excluded from our analysis. One hundred and thirty-one citations were referenced as appearing in journals per our search criteria, and all were verified. Twenty-seven or 20.6% (95% confidence interval, 14.2% to 28.7%) of 131 citations were misrepresented. Conclusions: The prevalence of misrepresented research publications from orthopaedic surgery residency applicants increased modestly to 20.6% compared with that found in our original report (18%). As we recommended in our last report, we strongly urge residency programs to require applicants to submit reprints of their publications with their residency applications. Perhaps standardized guidelines should be developed to help to prevent misrepresentation through the Electronic Residency Application Service.