Use of the Relative Citation Ratio in Conjunction With H-Index to Promote Equity in Academic Orthopaedics

Quantification of a researcher's productivity relies on objective bibliometric measurements, such as the Hirsch index (h-index). However, h-index is not field and time-normalized and possesses bias against newer researchers. Our study is the first to compare the relative citation ratio (RCR), a new article-level metric developed by the National Institutes of Health, with h-index in academic orthopaedics. METHODS: Academic orthopaedic programs in the United States were identified using the 2022 Fellowship and Residency Electronic Interactive Database. Available demographic and training data for surgeons were collected. RCR was calculated using the National Institutes of Health iCite tool, and h-index was calculated using Scopus. RESULTS: Two thousand eight hundred twelve academic orthopaedic surgeons were identified from 131 residency programs. H-index, weighted RCR (w-RCR), and mean RCR (m-RCR) all significantly differed by faculty rank and career duration. However, while h-index and w-RCR varied between sexes (P < 0.001), m-RCR did not (P = 0.066), despite men having a longer career duration (P < 0.001). DISCUSSION: We propose that m-RCR be used in conjunction with w-RCR or h-index to promote a fairer, comprehensive depiction of an orthopaedic surgeon's academic effect and productivity. Use of m-RCR may reduce the historic bias against women and younger surgeons in orthopaedics, which has implications in employment, promotion, and tenure.