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The Presence of “Ghost” Citations in an Applicant Pool of an Integrated Plastic Surgery Residency Program

Background: In today's morally flexible society, breaches in professionalism abound. Professionalism and integrity are core values required of all physicians. Falsification of application information has been demonstrated in some applicant populations. As one of the most competitive fields among residency training programs, applications to an integrated plastic surgery residency program were analyzed to determine whether nonverifiable or “ghost” publications were being included by applicants. Methods: The study population included 232 applicants to the University of Wisconsin integrated plastic surgery program in 2008 to 2009. In each application, citation information for journal articles, book chapters, and other publications were reviewed for accuracy. The protocol included verifying citation accuracy in the PubMed/MEDLINE database. Citations that could not be verified were submitted to the department of surgery librarian for further review. Other applicant data were also collected to identify potential predictive factors for including ghost publications. Results: Two hundred thirty-two applications listed 876 citations that were reviewed. Two hundred sixty (30 percent) were identified as citations for which publication was pending and were excluded from analysis. A primary search successfully verified 415 citations (47 percent). A secondary search successfully verified 148 citations (17 percent) as well as identified citations that were complicated, incorrectly cited, or ghost publications. There were 14 ghost publications (2 percent). Conclusions: The inclusion of nonverifiable citations among plastic surgery applicants is low. Nonetheless, we should insist on professionalism and integrity as core values in medical students pursuing plastic surgery, as any “ghost” publication raises an index of suspicion for potentially fraudulent activity.