The "Charting Outcomes in the Match" report by the National Resident Matching Program compiles data on abstracts, presentations, and publications (APPs) but does not specify the number of peer-reviewed publications. Prior research indicates discrepancies between the number of APPs and peer-reviewed publications. This study aimed to characterize the drivers of heightened publication rates among applicants who match into competitive surgical residencies.A retrospective cohort comparison study was conducted from October 2023 to January 2024. Data were extracted using publicly available information. An institutional review board waiver was obtained from the University of South Alabama. All applicants in the United States who successfully matched in 2023 into orthopedic surgery, vascular surgery, otolaryngology, plastic surgery, or neurosurgery were investigated. Extracted data included matched specialty, sex, graduating from a top-40 National Institutes of Health (NIH)-funded medical school, attending residency at the same institution where one graduated, additional degree, and matching into a top-40 Doximity-ranked residency program. The primary outcome was the number of peer-reviewed publications by matched applicants in each specialty. Secondary outcomes assessed the impact of demographic factors on publication output, the distribution of top 10th percentile publishers by specialty, the proportion of individuals with zero publications, and the H-index of published applicants. Attending a top-40 NIH-funded school was associated with increased publication output, with odds ratios (ORs) of 3.31 (95% confidence interval (CI) = 2.14-4.47, p <
0.002). ORs represent the strength of association between predictor variables and publication metrics, with values above 1.0 indicating positive associations. This association was higher for neurosurgery (OR = 7.76, 95% CI = 5.55-9.76, p <
0.002) and plastic surgery (OR = 3.87, 95% CI = 1.98-7.77, p <
0.002). Conversely, matching into orthopedic surgery (OR = 1.09, 95% CI = 1.04-1.15, p <
0.002) or vascular surgery (OR = 1.07, 95% CI = 0.94-1.22, p <
0.002) predicted admission without having published a peer-reviewed paper. Neurosurgery applicants had a significantly higher H-index compared to other specialties. Neurosurgery and plastic surgery admitted applicants with more peer-reviewed publications and fewer with zero publications compared to orthopedic, vascular, and otolaryngologic programs. High publication rates were also predicted by holding a non-medical postgraduate degree and graduating from a top-40 NIH-funded medical school, raising equity concerns due to differences in research opportunities and additional degrees.