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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Publish or perish</span> is an aphorism that expresses the pressure to publish scientific works in order to be successful in an academic career&#46; The knowledge necessary for conducting a research study that results in a publication in a biomedical journal &#40;or&#44; alternatively&#44; that materializes in a doctoral thesis&#41; must be progressively acquired over years of specialization or residency&#46; It is stipulated as such in the training programs for different resident physician &#40;RP&#41; specialties&#44; including cardiology &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#44; intensive care medicine &#40;1996&#41;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#44; internal medicine &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#44; and medical oncology &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#44; which will be the subject of this investigation&#46; Likewise&#44; on the list of basic competences of internal medicine established by the Spanish Society of Internal Medicine &#40;SEMI&#44; for its initials in Spanish&#41;&#44; knowing how to write a scientific article for publication is included among the academic activities<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">There are few studies on the research work of Spanish resident physicians&#46; Those that do exist focus on specific specialties and are based on surveys with the recognized limitations of low participation&#44; a lack of verification of the veracity of data on publications&#44; and a lack of validation<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#8211;12</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">This research work quantitatively and qualitatively compares research productivity in terms of publications indexed in PubMed which were produced by four medical specialties &#40;cardiology&#44; intensive care medicine&#44; internal medicine&#44; and medical oncology&#41; of the 2014&#8211;2019 RP cohort during their five-year training program&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A list was obtained of the 2014 RP cohort&#8217;s choice of placements&#44; which was published by the Spanish Ministry of Health and Consumption&#46; Candidates who obtained a placement in the specialties of cardiology&#44; intensive care medicine&#44; internal medicine&#44; and medical oncology were selected&#46; The first initial of the candidate&#8217;s given name as well as the first and second surname were entered into the PubMed literature search engine in order to extract publications from May 2014 to May 2020&#44; verifying that the author affiliation indicated the hospital where the physician had his or her placement&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The search was extended to up to one year after they finished residency in order to include publications from the end of the period of specialization&#46; Due to the study&#8217;s design and characteristics&#44; approval from a local ethics committee was not necessary&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The variables analyzed were the participants&#8217; sex&#44; size of the hospital where they completed their RP training &#40;&#60;500 beds&#44; between 500 and 1&#44;000 beds&#44; and more than 1&#44;000 beds&#41; and&#44; regarding the publications&#44; the name&#44; language &#40;Spanish&#44; English&#44; or other&#41;&#44; impact factor&#44; and quartile &#40;Q&#41; of the journal according to <span class="elsevierStyleItalic">Journal Citation Reports</span>&#59; article type &#40;original&#44; review&#44; clinical case report&#44; letter to the editor&#41;&#59; and authorship position &#40;first or last author or other position&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">Quantitative variables were expressed as medians &#40;25&#37; and 75&#37; Q&#41; and qualitative variables as absolute values and percentages&#46; Comparisons between groups for quantitative variables &#40;for example&#44; journal impact factor&#41; were conducted using the Kruskal&#8211;Wallis test and&#44; if it was statistically significant&#44; with a later analysis using the Mann&#8211;Whitney U test&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In the case of qualitative variables&#44; comparisons between groups were made using Fisher&#8217;s test with a <span class="elsevierStyleItalic">post hoc</span> analysis using the adjusted residuals of the contingency table method&#46; The mean number of publications among the various specialties was compared using the ANOVA test and a <span class="elsevierStyleItalic">post hoc</span> Bonferroni correction&#46; A logistic regression model was created to search for factors associated with research productivity&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Age&#44; the hospital size as measured by number of beds&#44; and the medical specialty were included on the multivariate analysis&#46; Statistical significance was established as <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;05&#46; Calculations were done using the SPSS statistical package version 24&#46;0 &#40;Chicago&#44; IL&#44; USA&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">The study population included 649 residents &#40;257 men and 392 women&#41; in the specialties of cardiology &#40;149&#41;&#44; intensive care medicine &#40;132&#41;&#44; internal medicine &#40;275&#41;&#44; and medical oncology &#40;93&#41;&#46; They were trained in hospitals with a capacity of less than 500 beds &#40;148&#44; 22&#46;8&#37;&#41;&#44; between 500 and 1&#44;000 beds &#40;282&#44; 43&#46;4&#37;&#41;&#44; or more than 1&#44;000 beds &#40;219&#44; 33&#46;7&#37;&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">This cohort of residents generated a total of 801 publications &#40;publication&#47;resident quotient or index&#58; 1&#46;23&#41;&#46; In total&#44; 289 &#40;44&#46;5&#37;&#41; residents produced at least one publication during their training period&#46; This percentage was significantly higher among cardiology residents &#40;70&#46;5&#37;&#41; and lower among intensive care medicine residents &#40;25&#37;&#41; with respect to the remaining specialties &#40;internal medicine 41&#46;1&#37;&#44; medical oncology 40&#46;9&#37;&#44; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46; The publication&#47;resident indices for said specialties were 2&#46;57 &#40;cardiology&#41;&#44; 0&#46;42 &#40;intensive care medicine&#41;&#44; 1&#46;06 &#40;internal medicine&#41;&#44; and 0&#46;76 &#40;medical oncology&#41;&#46; A total of 158 &#40;24&#46;3&#37;&#41; residents published on more than one occasion and only 97 &#40;15&#37;&#41; completed their specialty with three or more indexed publications&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The 801 publications were written in English &#40;453&#44; 56&#46;5&#37;&#41;&#44; Spanish &#40;333&#44; 41&#46;5&#37;&#41;&#44; or other languages &#40;15&#44; 2&#37;&#41;&#46; Medical oncology residents published proportionally more in English &#40;59 of 71 publications&#44; 83&#37;&#41; and intensive care medicine residents published less in English &#40;19&#47;55&#44; 35&#37;&#41; than the rest of specialties &#40;cardiology 233&#47;383&#44; 61&#37;&#59; internal medicine 142&#47;292&#44; 48&#46;5&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The manuscript types published were original articles &#40;384&#44; 47&#46;9&#37;&#41;&#44; clinical case reports &#40;295&#44; 36&#46;8&#37;&#41;&#44; letters to the editor &#40;80&#44; 10&#37;&#41;&#44; and reviews &#40;42&#44; 5&#46;2&#37;&#59; of which 32 were narrative reviews and ten were systematic reviews&#41;&#46; The proportion of original publications was significantly higher among medical oncology residents &#40;64&#46;8&#37;&#44; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Of the 649 residents in the study&#44; just 179 &#40;27&#46;6&#37;&#41; published an original article&#44; broken down by medical specialty as follows&#58; 47&#46;7&#37; of cardiologists&#44; 15&#46;9&#37; of intensive care physicians&#44; 22&#46;9&#37; of internists&#44; and 25&#46;8&#37; of medical oncologists&#46; The percentage was significantly higher among cardiology residents and lower among intensive care medicine residents &#40;<span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">In regard to quality indices&#44; the mean impact factor of publications by residents in cardiology &#40;3&#46;27&#41; and medical oncology &#40;2&#46;78&#41; was significantly higher than in the rest of specialties &#40;intensive care medicine 1&#46;98&#44; internal medicine 1&#46;74&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46; Likewise&#44; the proportion of publications in first quartile &#40;Q1&#41; journals was higher among cardiology residents &#40;44&#46;6&#37; of all their publications&#41; whereas Q3 journals were predominant among internists and Q4 journals among intensive care medicine residents &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The resident was the first or last author &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; in 277 &#40;34&#46;6&#37;&#41; publications&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Altogether&#44; just 75 &#40;11&#46;6&#37;&#41; residents published an original article in Q1 journals&#44; 51 &#40;7&#46;9&#37;&#41; published an original article &#40;regardless of the journal&#8217;s rank&#41; as first or last author&#44; and 15 &#40;2&#46;3&#37;&#41; published an original article in Q1 journals as first or last author&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Articles were published in 303 different journals&#46; Those that published more than 15 articles were&#58; <span class="elsevierStyleItalic">Revista Espa&#241;ola de Cardiolog&#237;a</span> &#40;73&#41;&#44; <span class="elsevierStyleItalic">Medicina Cl&#237;nica</span> &#40;53&#41;&#44; <span class="elsevierStyleSmallCaps">Revista Cl&#237;nica Espa&#241;ola</span> &#40;32&#41;&#44; <span class="elsevierStyleItalic">Archivos de Cardiolog&#237;a de M&#233;xico</span> &#40;21&#41;&#44; and <span class="elsevierStyleItalic">Medicina Intensiva</span> &#40;17&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Among cardiologists&#44; the three most commonly chosen journals were <span class="elsevierStyleItalic">Revista Espa&#241;ola de Cardiolog&#237;a</span> &#40;71&#41;&#44; <span class="elsevierStyleItalic">Archivos de Cardiolog&#237;a de M&#233;xico</span> &#40;20&#41;&#44; and <span class="elsevierStyleItalic">Medicina Cl&#237;nica</span> &#40;12&#41;&#46; Among intensive care physicians&#44; they were <span class="elsevierStyleItalic">Medicina Intensiva</span> &#40;13&#41;&#44; <span class="elsevierStyleItalic">Medicina Cl&#237;nica</span> &#40;7&#41;&#44; and <span class="elsevierStyleItalic">Transplantation Proceedings</span> &#40;6&#41;&#46; Among internists&#44; they were <span class="elsevierStyleItalic">Medicina Cl&#237;nica</span> &#40;32&#41;&#44; <span class="elsevierStyleSmallCaps">Revista Cl&#237;nica Espa&#241;ola</span> &#40;27&#41;&#44; and <span class="elsevierStyleItalic">Revista Espa&#241;ola de Quimioterapia</span> &#40;13&#41;&#46; Lastly&#44; among oncologists&#44; three articles were published in <span class="elsevierStyleItalic">Case Reports in Oncology</span> and two each were published in the following journals&#58; <span class="elsevierStyleItalic">Medicina Cl&#237;nica</span>&#44; <span class="elsevierStyleItalic">Journal of Clinical Medicine</span>&#44; <span class="elsevierStyleItalic">Journal of Thoracic Oncology</span>&#44; <span class="elsevierStyleItalic">Cancer Research</span>&#44; <span class="elsevierStyleItalic">Cancers &#40;Basel&#41;</span>&#44; <span class="elsevierStyleItalic">Clinical and Translational Oncology</span>&#44; <span class="elsevierStyleItalic">Frontiers in Oncology</span>&#44; and <span class="elsevierStyleItalic">Melanoma Research</span>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">On the multivariate analysis&#44; research productivity was not related to sex &#40;49&#37; of men had at least one publication vs&#46; 41&#46;6&#37; of women&#44; <span class="elsevierStyleItalic">p</span>&#8239;&#61;&#8239;&#46;062&#41; or hospital type &#40;41&#46;9&#37; of residents in hospitals with &#60;500 beds published at least one article versus 43&#46;3&#37; of those in hospitals with 500&#8722;1&#44;000 beds and 47&#46;9&#37; of those in hospitals with more than 1&#44;000 beds&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#61;&#8239;&#46;442&#41;&#46; Only the type of medical specialty was associated with a greater probability of publishing &#40;<span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46; In this regard&#44; cardiology &#40;odds ratio &#91;OR&#93; 7&#46;16&#44; 95&#37;CI&#44; 4&#46;22&#8211;12&#46;14&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#44; internal medicine &#40;OR 2&#46;09&#44; 95&#37;CI&#44; 1&#46;32&#8211;3&#46;32&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#61;&#8239;&#46;002&#41;&#44; and medical oncology residents &#40;OR 2&#46;07&#44; 95&#37;CI&#44; 1&#46;17&#8211;3&#46;67&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#61;&#8239;&#46;012&#41; showed greater scientific research productivity than intensive care medicine residents&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">This is the first study to objectively evaluate publications included in the PubMed database produced by RP from four medical specialties during their training period&#46; An initial finding was that&#44; overall&#44; more than half of residents did not participate in any publication&#46; The only exception to this low level of research&#44; which was particularly prevalent among intensive care medicine residents &#40;publication&#47;resident index of 0&#46;42&#41;&#44; were cardiology residents &#40;index of 2&#46;57&#41;&#46; If we consider the original article to be the paradigm of a research study&#44; the panorama is even more disheartening&#44; given that nearly three-fourths of residents &#40;little more than half in the case of cardiology&#41; completed their training without any original articles on their curriculum vitae&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Additionally&#44; 43&#46;4&#37; of publications were written in a language other than English&#44; which <span class="elsevierStyleItalic">a priori</span> could limit their dissemination&#46; Nevertheless&#44; this aspect would be mitigated to a large extent due to the existence of English-language versions of the main journals which published the works&#44; such as the <span class="elsevierStyleItalic">Revista Espa&#241;ola de Cardiolog&#237;a</span>&#44; <span class="elsevierStyleItalic">Medicina Cl&#237;nica</span>&#44; and <span class="elsevierStyleSmallCaps">Revista Cl&#237;nica Espa&#241;ola</span>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Around one-third of manuscripts were published in Q1 journals&#59; among cardiology residents&#44; the figure was nearly 45&#37; given that the <span class="elsevierStyleItalic">Revista Espa&#241;ola de Cardiolog&#237;a</span>&#44; the official publication of the Spanish Society of Cardiology and main recipient of manuscripts from this group&#44; currently holds 30th place &#40;Q1&#41; on a ranking of 138 journals in the cardiovascular area&#44; according to <span class="elsevierStyleItalic">Journal Citation Reports</span>&#46; This is not true for the official journals of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units &#40;SEMICYUC&#44; for its initials in Spanish&#41;&#44; the SEMI&#44; and the Federation of Spanish Oncology Societies &#40;FESEO&#44; for its initials in Spanish&#41;&#46; Indeed&#44; <span class="elsevierStyleItalic">Medicina Intensiva</span> &#40;23&#47;36 in critical care medicine&#41;&#44; <span class="elsevierStyleSmallCaps">Revista Cl&#237;nica Espa&#241;ola</span> &#40;100&#47;165 in general and internal medicine&#41;&#44; and <span class="elsevierStyleItalic">Clinical &#38; Translational Oncology</span> &#40;157&#47;244 in oncology&#41; are in Q3 in their area of knowledge&#46; The same is true for <span class="elsevierStyleItalic">Medicina Cl&#237;nica</span> &#40;87&#47;165 in general and internal medicine&#59; Q3&#41;&#59; and publishing in this journal is a long-standing tradition among Spanish clinical physicians&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Regarding the residents&#8217; contributions to the publications&#44; they only held a relevant position among the authors in one-third of publications&#44; either as first author &#40;author who carries out the majority of the work&#41; or as the final author &#40;generally the instigator or coordinator of a project and commonly reserved for senior coauthors&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The results of this study refute those of a recent survey conducted on 194 fifth-year internal medicine residents which reported that 67&#37; &#40;versus the 41&#46;1&#37; found in our study&#41; had published at least one work in a journal<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#46; This discrepancy could be due to the fact that a large part of the journals were not indexed in PubMed&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">At any rate&#44; there is a contrast between residents&#8217; motivation for research work and their dissatisfaction due to the little amount of research carried out&#46; Indeed&#44; in a 2014 survey of 146 internal medicine residents in Andalusia&#44; 62&#37; considered that it was difficult to investigate in their department and 67&#37; considered that more time should be devoted to research compared to time spent on healthcare tasks<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">In another survey from 2018 on 765 residents from Castile and Le&#243;n&#44; the mean score awarded for the support they perceived for conducting research work or publications was just 5&#46;7 &#40;on a scale from one to ten with a minimum passing score of five&#41;&#44; with no differences between primary care or hospital residents<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Compared to the limited scientific research productivity of Spanish residents&#44; a study showed that 308 internal medicine residents from the Mayo Clinic &#40;Rochester&#44; MN&#44; USA&#41; in their third year of training had already published a mean of two articles&#44; of which 69&#37; were original articles&#44; and they were first authors on 59&#46;2&#37; of all publications<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46; More significant was the fact that this research activity did not impact their clinical care skills&#46; On the contrary&#44; the residents who published more obtained better scores on later formal evaluations which involved both theoretical knowledge and an objective&#44; structured clinical examination &#40;OSCE&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Conducting and being competent in research was associated with higher quality of care and overall satisfaction<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#44; probably because some of the traits associated with researchers &#40;for example open-mindedness&#44; logical thinking&#44; careful analysis&#44; self-discipline&#41; also favor excellence in clinical medicine&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Recently&#44; it was reported that just 5&#37; of the works presented as posters or oral communications at a national internal medicine conference &#40;tasks mostly carried out by residents&#41; ended up being published<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46; Both the aforementioned study and this study lead one to reflect on the insufficient research during the period of residency&#46; Various reasons can be put forth to justify this finding&#58; lack of formal training&#44; lack of time due to the constant pressure of healthcare tasks&#59; difficulty finding financial resources to support research projects&#59; little or no support from the institution or bosses&#47;tutors&#59; perception of the effort of publishing as something useless for securing a future job in a context of a deficit in professionals&#44; or a mere lack of personal interest&#46; Nevertheless&#44; these arguments have been repeated regarding generations of Spanish physicians and they have not been a hindrance to the rise and recognition of many of them&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">This study has limitations&#46; The results obtained do not necessarily reflect what has happened or may happen in the future in other resident cohorts&#44; nor does it presuppose the same reality for other medical or surgical specialties&#46; On the other hand&#44; other forms of research productivity expression &#40;such as article in journals registered in databases other than PubMed&#44; book chapters&#44; doctoral theses&#44; communications at conferences&#41; were not considered nor were other bibliometric indices &#40;for example&#44; immediacy index&#44; h-index&#41; other than the journals&#8217; impact factor and Q&#46; Even so&#44; we believe that this study faithfully reflects a palpable reality in our healthcare education system&#44; which was excellent in its conception but which lacks ongoing review to improve some shortcomings&#44; such as those regarding clinical research&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="par0150" class="elsevierStylePara elsevierViewall">Despite the fact that research and&#44; consequently&#44; publication during the period of residency are considered mandatory&#44; the majority of residents in the medical specialties evaluated&#44; with the exception of cardiology&#44; do not fulfill this assumed requirement&#46; It is important to dig deeper into the barriers that lead to this suboptimal scientific productivity&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">RP education programs must actively stimulate research so that in the end&#44; residents may publish and not perish&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0160" class="elsevierStylePara elsevierViewall">No funding was received for this study&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that they do not have any conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To compare the quantity and quality of publications during the residency training period in Cardiology&#44; Intensive Care Medicine&#44; Internal Medicine and Medical Oncology in Spain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A retrospective cohort study of residents from 4 specialties lasting 5 years &#40;2014&#8211;2019&#41;&#46; The number and type of publications indexed in PubMed&#174;&#44; the names of the journals and their bibliometric indexes &#40;impact factor and quartiles&#41;&#44; and author&#8217;s positions were evaluated&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The 649 residents included in the study generated 801 publications &#40;publication&#47;resident ratio 1&#46;23&#41;&#46; Cardiology residents published significantly more &#40;ratio 2&#46;57&#41; and Intensive Care Medicine residents less &#40;ratio 0&#46;42&#41; than the remaining specialties &#40;Internal Medicine&#44; ratio 1&#46;06&#59; Medical Oncology&#44; ratio 0&#46;76&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46; Overall&#44; only 44&#46;5&#37; of residents participated in a publication&#44; with 27&#46;6&#37; participating in an original article&#59; this latter percentage increased significantly among cardiologists &#40;47&#46;7&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46; The predominant types of publications were original articles &#40;47&#46;9&#37;&#41; and clinical reports &#40;36&#46;8&#37;&#41;&#46; The proportion of publications in first quartile journals was higher for Cardiology residents &#40;44&#46;6&#37; of total&#41;&#46; The resident was the first or last author in only one-third of the publications&#46; Scientific productivity was related to specialty&#44; but not to gender or the size of the hospital in which the residency training occurred&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Intensive Care Medicine&#44; Internal Medicine and Medical Oncology residents publish insufficiently&#44; while the scientific production from Cardiology residents could be considered acceptable&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Comparar la cantidad y calidad de las publicaciones realizadas durante el per&#237;odo de residencia de Cardiolog&#237;a&#44; Medicina Intensiva&#44; Medicina Interna y Oncolog&#237;a M&#233;dica en Espa&#241;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes retrospectivo de los m&#233;dicos residentes de cuatro especialidades con cinco a&#241;os de duraci&#243;n &#40;promoci&#243;n 2014&#8211;2019&#41;&#46; Se revis&#243; el n&#250;mero y tipo de publicaciones indexadas en PubMed&#174;&#44; nombre de las revistas y sus &#237;ndices bibliom&#233;tricos &#40;factor de impacto y cuartil&#41;&#44; y posici&#243;n de autor&#237;a&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Los 649 residentes incluidos generaron 801 publicaciones &#40;cociente o &#237;ndice publicaci&#243;n&#47;residente 1&#44;23&#41;&#46; Los residentes de Cardiolog&#237;a publicaron significativamente m&#225;s &#40;&#237;ndice 2&#44;57&#41; y los de Medicina Intensiva menos &#40;&#237;ndice 0&#44;42&#41; que el resto de las especialidades &#40;Medicina Interna&#44; &#237;ndice 1&#44;06&#59; Oncolog&#237;a M&#233;dica&#44; &#237;ndice 0&#44;76&#59; p&#8239;&#60;&#8239;0&#44;001&#41;&#46; Globalmente&#44; solo el 44&#44;5&#37; de los residentes particip&#243; en alguna publicaci&#243;n y el 27&#44;6&#37; en un art&#237;culo original&#59; este &#250;ltimo porcentaje se increment&#243; significativamente entre los cardi&#243;logos &#40;47&#44;7&#37;&#59; p&#8239;&#60;&#8239;0&#44;001&#41;&#46; Los tipos de publicaci&#243;n predominantes fueron los art&#237;culos originales &#40;47&#44;9&#37;&#41; y las notas cl&#237;nicas &#40;36&#44;8&#37;&#41;&#46; La proporci&#243;n de publicaciones en revistas de primer cuartil fue superior para los residentes de Cardiolog&#237;a &#40;44&#44;6&#37; del total&#41;&#46; Solo en un tercio de las publicaciones el residente fue primer o &#250;ltimo firmante&#46; La producci&#243;n cient&#237;fica se relacion&#243; con la especialidad&#44; pero no con el sexo ni el tama&#241;o del hospital donde se desarroll&#243; la residencia&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Los residentes de Medicina Intensiva&#44; Medicina Interna y Oncolog&#237;a M&#233;dica publican poco&#44; mientras que la producci&#243;n cient&#237;fica en Cardiolog&#237;a se puede considerar aceptable&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Please cite this article as&#58; Porcel JM&#44; Bag&#252;este G&#44; Liesa L&#44; Bielsa S&#46; Producci&#243;n cient&#237;fica durante el per&#237;odo de residencia en Espa&#241;a&#58; comparaci&#243;n entre especialidades m&#233;dicas con programas de 5 a&#241;os&#46; Rev Clin Esp&#46; 2022&#59;222&#58;212&#8211;217&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:8 [
        "identificador" => "tbl0005"
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        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
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        "tabla" => array:2 [
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                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cardiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intensive Care Medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Internal Medicine&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Medical Oncology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total number of publication types&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Originals&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">189 &#40;49&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;54&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119 &#40;40&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">46 &#40;64&#46;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">384&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clinical Case Reports&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">139 &#40;36&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;41&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;37&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;33&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">295&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reviews&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13 &#40;3&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;3&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;9&#46;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Letters to the Editor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;12&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total number of publications per specialty&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">383&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">292&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">801&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Number &#40;&#37;&#41; of residents with at least one publication&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#47;149 &#40;70&#46;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">33&#47;132 &#40;25&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#47;275 &#40;41&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#47;93 &#40;40&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Significantly higher than in the rest of specialties &#40;<span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46;</p>"
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              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Significantly lower than in the rest of specialties &#40;<span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46;</p>"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Number and type of publications published by different medical specialties&#46;</p>"
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        "tabla" => array:3 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intensive Care Medicine&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Internal Medicine&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Medical Oncology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Journals without IF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;9&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;9&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;8&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81 &#40;10&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">First-quartile journals &#40;Q1&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">171 &#40;44&#46;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;14&#46;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;23&#46;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;33&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">271 &#40;33&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Second-quartile journals &#40;Q2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;12&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;18&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;22&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">142 &#40;17&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Third-quartile journals &#40;Q3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;12&#46;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;25&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94 &#40;32&#46;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;23&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">174 &#40;21&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fourth-quartile journals &#40;Q4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56 &#40;14&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;38&#46;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;16&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;11&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133 &#40;16&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IF of the indexed journals&#44; median &#40;quartiles&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;27 &#40;1&#46;28&#8722;5&#46;08&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;98 &#40;0&#46;96&#8722;2&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;74 &#40;1&#46;04&#8722;3&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;78 &#40;1&#46;75&#8722;5&#46;01&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;42 &#40;1&#46;17&#8722;5&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2878300.png"
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          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Regarding original articles &#40;n&#8239;&#61;&#8239;384&#41;&#44; the percentages published in Q1 journals are 40&#46;2&#37; &#40;cardiology&#41;&#44; 10&#37; &#40;intensive care medicine&#41;&#44; 30&#46;3&#37; &#40;internal medicine&#41;&#44; 41&#46;3&#37; &#40;oncology&#41;&#44; and 34&#46;9&#37; &#40;total&#41;&#46; The percentage corresponding to internal medicine was significantly lower than the rest &#40;<span class="elsevierStyleItalic">p</span>&#8239;&#61;&#8239;&#46;007&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Significantly higher than in the rest of specialties &#40;<span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Significantly lower than in the rest of specialties &#40;<span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;&#46;001&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Quality indices of the publications in the different specialties &#40;n 801&#41;&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cardiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intensive Care Medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Internal Medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Medical Oncology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">First author&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">118 &#40;30&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;21&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;26&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;29&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">228 &#40;28&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Second author&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;13&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;21&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;23&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;26&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">149 &#40;18&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Last author&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;3&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;12&#46;7&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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Original article
DOI: 10.1016/j.rceng.2021.02.001
Research productivity during residency training in Spain: Comparison among medical specialties lasting 5 years
Producción científica durante el período de residencia en España: comparación entre especialidades médicas con programas de 5 años
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J.M. Porcel
Corresponding author
jporcelp@yahoo.es

Corresponding author.
, G. Bagüeste, L. Liesa, S. Bielsa
Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, IRBLleida, Universidad de Lleida, Lleida, Spain

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