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Day KM, MD;1,2,3* Henry, SL, MD;1,2,3 Egeland BM, MD;1,2,3 Harshbarger, RJ, MD; 1,2,3 Moore MG, BS;1,3 Vercler CJ, MD3 1Dell Medical School at the University of Texas at Austin; 2Division of Plastic and Reconstructive Surgery 3Department of Surgery and Perioperative Care 2University of Michigan, Department of Plastic and Reconstructive Surgery *Corresponding Author: Address: 4307 Schoalwood Avenue; Austin, TX 78756 Email: Phone: 319-601-9283 Fax: 512-324-0786

Background: Scientific publishing is conventionally an intellectual meritocracy but is not immune to economic pressures. Internet-based communication has revolutionized web-based "ePrinting," enabling the advent of fee-based, open access, online-only journals. The financial aspects of open access publishing and its implications for academic plastic surgery are under-appreciated. We describe theoretical means by which academic rank could be influenced monetarily in the open access publication model.

Methods: We devised a computational model for generating an authorís Hirsh index (H-index) through publication in three fictitious publication strategems, defined by the average journal impact factor (IF) and corresponding average article processing fee (APC) in "High (IF 4.0, APC $4000)," "Medium (IF 2.0, APC $1000)," and "Low (IF 1.0, APC $200)." We then referenced published average H-indexes for academic professional ranks in plastic surgery and calculated the theoretical number of publications (N) necessary to achieve each professorial position referencing published means of 4.6 for Assistant Professor, 9.1 for Associate Professor, 15.3 for Professor. The Cost of Academic Rank (CAR) was then computed by multiplying the number of publications by their cost.

Results: The mean N necessary to achieve the average academic rank H-index was 9.0 for Assistant Professor, 15.0 for Associate Professor, and 29.0 for Professor. Table 1 summarizes the average High, Medium, and Low CAR amounts. The CAR ranged from $1,800 for Low Class Assistant Professorship to $29,000 for High Class Professorship. These results assume acceptance of all articles for which APCís are paid.

Conclusion: Scientific publications have been described as the "currency" of academia assumed to be based on intellectual merit rather than monetary impact. However, the fee-based, open access model produces a system by which traditional H-index academic credibility is associated with economic transactions. This makes online scientific publications prone to financial manipulation that could corrupt the meritocracy of scientific publishing and deserves further investigation and awareness in the plastic surgery community.

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