Writing manuscripts is an essential component of any academic surgery career – “publish or perish” is a rule we all live by. While most of us physician-scientists spent years in science lectures and labs, very few of us have formal training in writing, and probably even less of us, formal training in negotiating the complex relationships that often arise during the process of generating new knowledge. In humanities fields like anthropology and sociology, authors spend months or even years writing lengthy manuscripts where the writing itself is often essential to the interpretation and understanding of the work. In medical literature, on the other hand, we tend to use writing as a tool to get our work “out there.” The writing is simply the medium in which we convey the science, or the actual work, so the definition of authorship can be more open to interpretation.
The work we do is done through teamwork – the idea for a manuscript may be generated at a departmental meeting while discussing a clinical problems. The data often is generated over years by many different individuals, in the case of institutional clinical databases. Usually, for clinical database manuscripts, there is additional data that needs to be collected, and it is often the most junior member of the team who gets assigned to pulling specific data from medical records. A less tedious task today because of electronic medical records, but still a mundane and necessary part of many projects. Data analysis is often given to a few individuals in a department who have that specific expertise, even if he or she was not involved in the project up to that point, but are able to crunch the numbers. The actual task of writing it all up in a cohesive manuscript often is led by one person, but then many members of the team critically revise and edit the manuscript, as we rely much less on professional copy editors than academics in the humanities fields.
Because of our reliance on team science, it is rare in the medical literature to see fewer than 4 authors on a single manuscript, and often the number of authors can be so high that it requires a separate page to list them all. Because of our obsession with quantity of papers published and tying that directly to promotion, issues of authorship can sometimes be contentious.
Most journals give guidelines of who is an author, and the definition usually goes something like this: An author should have made a substantial, direct intellectual contribution. This means that each author should be directly involved in three parts of the writing process:
- designing the project, collecting the data or analyzing the results,
- drafting or revising the manuscript, and
- approving the final manuscript.
However, this is sometimes difficult to sort out. A funder is not an author – that much is easy. Every author should review the manuscript and approve the final version. The first author is usually the one who put in the most work, the last author is the senior author, the mentor, or the principal investigator. The authors in the middle may have contributed much or very little, and this is often a place of difficulty.
The best way to reduce authorship conflicts is to be as clear as possible at the beginning of a project. This can be difficult if you are the most junior person on the team, but it is important to ask questions of your mentor from the very start. Don’t demand upfront to be the first author, but stress your interest in doing most of the data gathering, help with the analysis, and take charge of the writing. You should then be rewarded for your hard work by being named first author. Ask your mentor in a very early meeting who he or she thinks could be some co-authors on your project. Make sure you know all of those people, and, if you do not, it is a great time to introduce yourself and talk about your hypotheses and plan. Sometimes, co-authors are brought in late in the process, and you, as the person who has done most of the work, are left wondering about their level of contribution. Don’t wait until the end for that to happen to you, approach your co-authors for advice and help early on, many of these more junior people are often more available than your senior mentor, and most want to be able to help determine the direction of a project from the beginning. If the tables are ever turned and you are offered authorship for a project you do not feel you contributed substantially to, even if that person’s intentions are good or they are trying to reciprocate some good deed you did in the past, it is best to be consistent. Stick to your definition of authorship, no matter if you would stand to benefit from loosening that interpretation, and you will feel more confident about doing the same to someone else if the situation ever arises. Issues of authorship do not have to be ethical dilemmas, and the more proactive and clear about your expectations that you are upfront can make the process go smoothly.
For more information, check out http://publicationethics.org/resources/guidelines for helpful tips and ways to avoid conflict and resolve disputes if they do arise. Another great resource to check out before you begin the research and writing process is: http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html