Dermatology: Practical and Conceptual Research Letter | Dermatol Pract Concept. 2024;14(4):e2024216 1 A Survey-Based Study of Dermatologist Research Productivity: Consideration of Restructuring the Current Academic Model Michelle J. Chang1, Amar D. Desai2, Shari R. Lipner3 1 Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York 2 Rutgers New Jersey Medical School, Newark, New Jersey 3 Department of Dermatology, Weill Cornell Medicine, New York Key words: research, survey, research practices, dermatology, academics Citation: Chang MJ, Desai AD, Lipner SR. A Survey-Based Study of Dermatologist Research Productivity: Consideration of Restructuring the Current Academic Model. Dermatol Pract Concept. 2024;14(4):e2024216. DOI: https://doi.org/10.5826/dpc.1404a216 Accepted: May 11, 2024; Published: October 2024 Copyright: ©2024 Chang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Shari R. Lipner, MD, PhD, 1305 York Avenue, New York, NY 10021. E-mail: Shl9032@med.cornell.edu Introduction Lack of protected time for pursuing academic interests was the second highest burnout reason in a survey-based study of academic dermatologists [1]. In another study, dermatol- ogists in academia vs. private practice spent 16-19x more hours doing research, teaching, and administration, but saw 59%-68% of the number of patients seen by private practice dermatologists [2]. Therefore, we hypothesized that dedicated time for research would be minimal and aimed to characterize dermatologist research practices. Case Presentation An anonymous voluntary survey was emailed to dermatol- ogists using APD and WDS LISTSERVS (12/2022-4/2022). Responses were collected using REDCap. Univariable and multivariable analyses were performed using Microsoft Excel (Microsoft, Seattle, WA) and SAS (SAS Studio Release 3.8, Cary, North Carolina). Linear regression models assessed correlations between annual publications and respondent demographics, employment, and training, with P<0.05. Of 158 respondents, 75% were female, with mean age 49 years, average residency graduation in 2005 (range: 1979-2021), and 73% practiced in academia (Table 1). On average, participants saw 81 patients/week during 3.2  days/week of direct patient care. Academic vs. private practice dermatologists had higher annual publications (2.64 vs 0.78 publications/year, P=0.0004), saw fewer patients/week (73 vs. 112 patients, P=0.002), and practiced fewer clinical days/week (3.0 vs 3.8 days, P=0.003). The top 5% of publishers saw 70 patients/week, prac- ticed clinical care 2.8 days/week, and published 14.5  articles/ year. Annual publications increased by 0.52  articles/year per each additional hour of non-clinical time (P=.01), in- creased by 0.74 articles/year per each additional day/ week dedicated to research (P=0.005), and decreased by 0.42 articles/year for each additional day/week seeing 2 Research Letter | Dermatol Pract Concept. 2024;14(4):e2024216 Table 1. Demographics and Factors Related to Publications. Demographics and characteristics of respondents Annual Publicationa (Mean or change from mean) P-value Overall 2.14 Residency +0.11 0.0146 Medical School +0.06 <.0001 Satisfaction Satisfied 2.1 0.1975 Neutral 3.2 Dissatisfied 0.9 Current research mentor 2.82 0.0589 Number of faculty mentors +0.05 0.846 Sex Male 3.34 0.0103 Female 1.74 Fellowship Dermatopathology 2.6 0.04 Mohs 1.3 Pediatric Dermatology 2.4 None 1.8 Academic Affiliation Yes 2.64 0.0004 No 0.78 Academic Job Title Professor 14.5 0.0155 Job Responsibilities Dedicated research hours +0.11 0.0004 Non-clinical protected time +0.52 0.0005 Dedicated days per week research +0.73 0.0155 Days per week seeing patients -0.42 0.0155 Administrative hours +0.04 0.2303 Dermatopathology +0.01 0.53 Consults +0.09 0.32 Lecturing 0.00 0.946 Grand Rounds +0.25 0.367 Factors related to publication rates of respondents since graduating residency. Annual Publicationa (Mean or change from mean) P-value Overall 2.14 Residency +0.11 0.0146 Medical School +0.06 <.0001 Satisfaction Satisfied 2.1 0.1975 Neutral 3.2 Dissatisfied 0.9 Current research mentor 2.82 0.0589 Number of faculty mentors +0.05 0.846 Sex Male 3.34 0.0103 Female 1.74 Fellowship Dermatopathology 2.6 0.04 Mohs 1.3 Pediatric Dermatology 2.4 None 1.8 Academic Affiliation Yes 2.64 0.0004 No 0.78 Research Letter | Dermatol Pract Concept. 2024;14(4):e2024216 3 patients (P=0.0155). Number of residency publications was associated with attending publication rate (R2=0.038, P=0.015). Discussion We found that protected research time was associated with higher annual publication numbers, which should not be sur- prising, but has not been previously quantitated. Our findings complement results of a survey-based study of 197 derma- tology attendings reporting improved work-life balance with less patient care time and more dedicated research time [3]. Therefore, our findings, taken together with studies show- ing increased burnout rates with lack of protected research time and improved satisfaction with dedicated research time, might encourage rethinking of the current academic model. Other medical specialties are confronted with similar problems. In a survey-based study of academic physicians, dedicated time for research/teaching decreased from 58% to 28%, while clinical service time increased from 23% to 59%, 2001-2016 [4]. In a 2016 survey of 1,671 physicians, burn- out was associated with more clinical time (P=0.043), and greater job autonomy associated with lower burnout risk (P<0.001) [5]. Increased salary support, research funding, and financially crediting education/research efforts might reduce burnout rates. Basing salaries of academic physicians solely on clinical revenue discourages research pursuits [4]. Limitations include small sample size, and most partici- pants were White and non-Hispanic. Conclusion We found that amongst respondents, the current academic dermatology model promotes high patient volume and lim- ited protected time for research. Research productivity was associated with more dedicated research time and less clin- ical time. Therefore, we suggest restructuring the academic model to encourage diagnostic and therapeutic innovations and improved career satisfaction. References 1. Dorrell DN, Feldman SR, Huang WW. The most common causes of burnout among US academic dermatologists based on a survey study.  J Am Acad Dermatol. 2019;81(1):269-270. DOI:10.1016/j.jaad.2019.01.021. 2. Resneck JS, Tierney EP, Kimball AB. Challenges facing aca- demic dermatology: survey data on the faculty workforce. J Am Acad Dermatol. 2006;54(2):211-216. DOI:10.1016/j.jaad .2005.10.013. 3. Waqas B, Matushansky JT, Thomas C, Lipner SR. Dermatolo- gist work practices and work-life balance during COVID-19: a cross-sectional survey.  Int J Dermatol. 2022;61(5):e158-e162. DOI:10.1111/ijd.15955. 4. Meador KJ. The Shrinking Roles of Clinical Research and Education for Academic Neurologists. JAMA Neurol. 2022;79(9): 837–838. doi:10.1001/jamaneurol.2022.1892. 5. Busis NA, Shanafelt TD, Keran CM, et al. Burnout, career satisfaction, and well-being among US neurologists in 2016. Neurology. 2017;88(8):797-808. DOI:10.1212/WNL.0000000 000003640. Factors related to publication rates of respondents since graduating residency. Annual Publicationa (Mean or change from mean) P-value Academic Job Title Professor 14.5 0.0155 Job Responsibilities Dedicated research hours +0.11 0.0004 Non-clinical protected time +0.52 0.0005 Dedicated days per week research +0.73 0.0155 Days per week seeing patients -0.42 0.0155 Administrative hours +0.04 0.2303 Dermatopathology +0.01 0.53 Consults +0.09 0.32 Lecturing 0.00 0.946 Grand Rounds +0.25 0.367 aAnnual publication was calculated by dividing the number of publications by years. Table 1. Demographics and Factors Related to Publications. (continued)