In Response

We thank Drs. Benumof and Manecke for their insightful comments¹ about our article². We agree that evidence of scholarly activity is not limited to articles found in the PubMed database nor does a PubMed citation provide any insight into an individual article’s relative merit. For example, in 2017 for the fields of neuroscience, rehabilitation, and neurology, 16.1%, 23.7%, and 24.7% of predatory journals were indexed PubMed.³ The Accreditation Council for Graduate Medical Education (ACGME) Program Requirements for Graduate Medical Education in Anesthesiology require residents to complete an academic assignment in the form of “grand rounds presentations; preparation and publication of review articles, book chapters, manuals for teaching or clinical practice; or development, performance, or participation in one or more clinical or laboratory investigations”.⁴ Our results certainly do not encompass the entire scope of this residency requirement, as we quantified scholarship solely on the basis of PubMed citations. Furthermore, separate evaluation of each of these possible resident academic assignments would be necessary to gauge quality. Such an analysis lies well beyond the scope of our investigation. There is no question that the morbidity and mortality-based book produced by the residents and faculty at the University of California-San Diego (UCSD) is a superb example of resident scholarship, as Benumof and Manecke correctly argue. Our methods connected the names of anesthesiology graduates to publicly accessible evidence of scholarship through a widely-accepted existing author database; we chose PubMed for this purpose. Collecting a central repository of all US-based residents’ academic assignments may help achieve the goal of assessing resident scholarly activity more comprehensively and may also encourage others to emulate successful initiatives such as the one led by Benumof and Manecke at UCSD.