The Arms Race Control Score (ARCS) was developed to provide a quantitative assessment of publications among residency applicants. International medical graduates (IMGs) often have higher numbers of publications compared to U.S medical graduates (US MDs). However, there is limited knowledge of publication quality and effort among IMGs and US MDs. Our study analyzes publication productivity among IMGs and US MDs using the ARCS. Applicants were selected from ACGME-accredited training programs that enrolled both IMG and US MD residents over the 2018–2024 match cycle. Programs without IMG residents in a given year were excluded from the analysis. The total number of residency applicant publications (TNRAP), cumulative publication value unit (cPVU), cumulative ARCS (cARCS), number of publications with PVU 1 and PVU ≤ 1 publications than US MDs (P 1 at higher rates than US MDs (IRR: 2.26, 95% CI: 1.68–3.03, p < .001). Among those with cPVU and cARCS scores above zero, IMGs had scores 2.19-times higher than US MDs (95% CI: 1.61–2.98, p < .001) and 2.12-times higher than US MDs (95% CI: 1.59–2.83, p < .001), respectively. Among applicants who match into neurosurgery residency programs in the U.S, IMGs demonstrate higher publication count and higher research effort compared to US MDs. The proportion of high-effort publications relative to total publication output did not differ among groups. • Previous literature has noted higher overall publication count among IMG applicants compared to their US medical school graduate counterparts. • Our study provides a qualitative assessment of the research productivity of IMG residents in comparison to their US medical school counterparts. • IMGs had more publications and research effort than US MDs but the proportion of high effort publications was the same across both groups.
Roy et al. (2026) studied this question.