Top Sources on the Plastic Surgery in-Service Examination: Lag Time from Publication and Trends over the Last Ten Years

Purpose:

Every year the American Council of Academic Plastic Surgeons (ACAPS) publishes the answers to the plastic surgery in-service exam. In this publication, multiple journal articles, textbooks, and recently websites, are cited for each question. To the best of our knowledge, there are no studies analyzing the top sources in this examination.  This study identifies the top sources and citations, and lag time from publication.

Methods:

We analyzed all ACAPS In-Service Exam references from 2004 to 2013 (http://acaplasticsurgeons.org/InService-Exams/) and identified the most referenced journals, text-books, and the lag time from article publication to citation on the in-service examination. We repeated the analysis considering the most recent reference for each question.

Results:

The most referenced journals over the last ten years were Plastic & Reconstructive Surgery, Clinics of Plastic Surgery, and the Journal of Hand Surgery, accounting respectively for ten year averages of 38%, 7.5%, and 5.5% of all journal references. When looking at the last five years, Annals of Plastic Surgery comes third after the Journal of Hand Surgery, each contributing 4.3% and 4.7%.

The top three referenced textbooks were Mathes’ Plastic Surgery, Green’s Operative Hand Surgery, and Grabb & Smith’s Plastic Surgery, each accounting respectively for 16%, 12% and 11% of all textbook references.  We noticed a consistent decline in textbook references from 2004 (45%) to 2013 with only 17% of all references.   

The mean time from publication to citation on the exam was 10 years (median: 9.2 years). Considering each year individually, the lag time remained stable; i.e. 2013 was 9 years versus 2004 which was 8.6 years. When only the most recent reference for each question was considered, the average lag time was reduced to 5 years (median: 6 years) with a further reduction since 2008 (median: 3 years, mode: 2 years).

Conclusion:

Today’s technology has made it easier for residents and their educators to have access to a much broader range of educational resources, such as online books and subscriptions to several journals. Knowledge of the top sources used for the in-service examination may help residents in organizing journal clubs and educators in designing a high yield didactic curriculum.