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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; 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<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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Journal Information
Vol. 222. Issue 4.
Pages 212-217 (April 2022)
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Vol. 222. Issue 4.
Pages 212-217 (April 2022)
Original article
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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Abstract
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Tables (4)
Table 1. Number and type of publications published by different medical specialties.
Table 2. Quality indices of the publications in the different specialties (n 801).
Table 3. Authorship position of the resident in the publications (n = 801).
Table 4. Journals with a greater number of publications.
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Abstract
Objectives

To compare the quantity and quality of publications during the residency training period in Cardiology, Intensive Care Medicine, Internal Medicine and Medical Oncology in Spain.

Methods

A retrospective cohort study of residents from 4 specialties lasting 5 years (2014–2019). The number and type of publications indexed in PubMed®, the names of the journals and their bibliometric indexes (impact factor and quartiles), and author’s positions were evaluated.

Results

The 649 residents included in the study generated 801 publications (publication/resident ratio 1.23). Cardiology residents published significantly more (ratio 2.57) and Intensive Care Medicine residents less (ratio 0.42) than the remaining specialties (Internal Medicine, ratio 1.06; Medical Oncology, ratio 0.76; p < .001). Overall, only 44.5% of residents participated in a publication, with 27.6% participating in an original article; this latter percentage increased significantly among cardiologists (47.7%; p < .001). The predominant types of publications were original articles (47.9%) and clinical reports (36.8%). The proportion of publications in first quartile journals was higher for Cardiology residents (44.6% of total). The resident was the first or last author in only one-third of the publications. Scientific productivity was related to specialty, but not to gender or the size of the hospital in which the residency training occurred.

Conclusions

Intensive Care Medicine, Internal Medicine and Medical Oncology residents publish insufficiently, while the scientific production from Cardiology residents could be considered acceptable.

Keywords:
Medical education
Internal Medicine
Cardiology
Intensive Care Medicine
Medical Oncology
Residency
Resumen
Objetivos

Comparar la cantidad y calidad de las publicaciones realizadas durante el período de residencia de Cardiología, Medicina Intensiva, Medicina Interna y Oncología Médica en España.

Métodos

Estudio de cohortes retrospectivo de los médicos residentes de cuatro especialidades con cinco años de duración (promoción 2014–2019). Se revisó el número y tipo de publicaciones indexadas en PubMed®, nombre de las revistas y sus índices bibliométricos (factor de impacto y cuartil), y posición de autoría.

Resultados

Los 649 residentes incluidos generaron 801 publicaciones (cociente o índice publicación/residente 1,23). Los residentes de Cardiología publicaron significativamente más (índice 2,57) y los de Medicina Intensiva menos (índice 0,42) que el resto de las especialidades (Medicina Interna, índice 1,06; Oncología Médica, índice 0,76; p < 0,001). Globalmente, solo el 44,5% de los residentes participó en alguna publicación y el 27,6% en un artículo original; este último porcentaje se incrementó significativamente entre los cardiólogos (47,7%; p < 0,001). Los tipos de publicación predominantes fueron los artículos originales (47,9%) y las notas clínicas (36,8%). La proporción de publicaciones en revistas de primer cuartil fue superior para los residentes de Cardiología (44,6% del total). Solo en un tercio de las publicaciones el residente fue primer o último firmante. La producción científica se relacionó con la especialidad, pero no con el sexo ni el tamaño del hospital donde se desarrolló la residencia.

Conclusiones

Los residentes de Medicina Intensiva, Medicina Interna y Oncología Médica publican poco, mientras que la producción científica en Cardiología se puede considerar aceptable.

Palabras clave:
Educación médica
Medicina Interna
Cardiología
Medicina Intensiva
Oncología Médica
Residencia

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