Establishing authorship: a vital first step in manuscript writing

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene. Welcome to today's episode. I'm your host, Toyosi Onwuemene, and I'm super excited to talk to you today about establishing authorship. And I want to talk about this because it came up for me today, actually, and yesterday. So I was editing manuscripts submitted by two people that I'm working with who are first author for manuscripts from which I'm senior author.

1:28 And what I noticed was that they both submitted to me manuscripts that didn't have a title page. So there was no authors listed, there were no authors listed, there was no title page, there was none of that. And they sent me the full manuscript for editing, and it had already passed through some of the authors. And so it was one of those things where I was like, oh, it was really important for me to step back and say it finally. When I got the second manuscript, I was like, is this the pattern where there's no authorship? Let's clarify how important that is to just specify upfront. So I'm about to talk about things that you should consider as far as establishing authorship as maybe the number one thing you do before you ever start writing.

2:14 Okay, so we'll talk a little bit about that. So first of all, you know, collaboration is at the heart of scientific research. Okay. I'm told that once upon a time, there were people who just sat in their labs, and they just did all this work by themselves. And then they would show up and they would publish and it would just be them on the authorship line. And apparently, those days are gone. Because if we're going to do any work that's of significance, it usually involves more than 1%. And in general, it involves many people. And so we talk about team science, right? So research is collaborative in nature. And there are very, very, very few manuscripts that you're going to be able to submit where you are the only author.

2:55 Sometimes it's an editorial, and that may make sense to have one author. But if it's research, typically we'll have several authors. Okay. So authorship is kind of inherent to collaborative research. And it's important to understand that it's an important thing to clarify upfront. Because authorship kind of signifies the work that was done and the contributions of the people who wrote the paper together. So for example, you know, every field is different. But in my field, in general, the first author is the person who's done most of the work. And the senior author, the last person on the list, is the person who's done a lot of the guidance, kind of maybe the person who's conceived the project, who's shepherded things to where they are.

3:41 In both authors, the first and the senior author should participate in writing the manuscripts. And then in the middle is everybody else. Sometimes a second author is a co-author. Sometimes a second to the last author is kind of a co-senior author. But for the most part, everybody in the middle is kind of there. It kind of feels like it can feel like a wash. But it isn't. Everybody's contributed, or at least they should have, kind of officially. There are ethical guidelines regarding who should be an author. So everybody should have contributed to the work. Everybody should contribute to the writing and editing. And everybody should approve the final manuscript for submission. So authors are people who've done the work.

4:23 But what's important is to establish things upfront so that there's no confusion. So in the example of the manuscript that was submitted to me by Mantia that I was working with, she's already sent out the manuscript to many people. And so I don't know how long people have taken to edit. So maybe somebody took like 10 minutes and they were like, oh, I'm done. Maybe somebody else took the manuscript for three days and they worked so hard. And then at the end of the three days, they're like, well, the work I've done, I should be senior. And then there's confusion about how much people put into this thing. And people get really worried and anxious about these things. I worked hard. I worked hard. And so then there's confusion. And people would say, well, if I knew I was going to be senior author, maybe I wouldn't have spent so much time on it.

5:06 And there's a lot of that back and forth. And the back of that is the fact that people need to publish. They need to publish to advance in their careers. They need to publish for promotion or publish to advance to the next level. There are pressures to publish. And so a lot of chaos can ensue when authorship is not decided upfront. So my recommendation, clarify authorship order as the first thing you do. What does that mean as the first thing you do? Work is always ongoing. And by the time you get to a point where you're like, okay, let's go now and publish, you know, there have been different people who've touched the work at different points in time. And so what I'm talking about as far as authorship order is where you go to actually write the manuscript that's going to be published.

5:50 Okay, at the point at which we're like, let's write this up. Number one is who are the authors? So if you're a young person who, you know, has a lot of senior people who are helping as part of this manuscript, and you're pretty sure you want to be first author, but you're not sure that you're going to be able to be, how do you handle this? Well, the easy, easy answer is go talk to your mentor. But I want to ask, I want to give you tools to think about it so that you are able to make decisions for yourself and able to have conversations with your mentor that are mature and that are thoughtful as well. So this is my advice to my trainees. I say the first thing you do before you ever start writing is write up a title page, what's going to be the title of the manuscript, and then write up the author list.

6:36 And clearly it's the line where everybody has, you know, their affiliation and all things related maybe their ORC ID number, but write that out first. Think spend time putting all that information together. And then for the actual manuscript, write an outline. Don't invest time in writing a full length manuscript until you know whether you are the primary author. Do not do it. Do not do it. Because you know what is so painful? To have put in weeks and weeks of writing only for somebody to say, oh, you can't be the first author. And then they take your name off and they put you in the middle somewhere. You've done a lot of work.

7:16 That feels so painful. But many other people who've made those investments without knowing if they were going to be able to actually be the person who would be the primary. And so that shouldn't be happening. It does happen more often than we'd like to admit. It shouldn't be happening, but it does happen. And how do you protect yourself is upfront. Before you start doing major work, make it clear that, you know, make out the author line, write out the outline of the paper. Hey, this is what the title of the paper is going to look like. Write out the outline and pass it around. What does that do for you? Number one, it allows you to clearly specify the title of the article. It allows you to clearly specify the authors and the order, right?

7:59 Because it's written out. And then you are able to think about what the manuscript is going to look like, but you haven't invested all this time and energy into writing pages and pages and pages and pages of things. Before you ever do that, you send out your manuscript, the title page and the outline to all the co-authors. And you say, hey, I'm getting ready to start writing this paper, but I wanted you to weigh in on the outline. And then I can go ahead and start writing once I have your input. And this gives you the opportunity to have everybody see the author order early. And if they want to dispute anything, they can do it soon. Because if you find out that somebody else thought that they would be first author on this paper and they would be the one to write most things, you just want to know upfront.

8:46 You can still fight about it. You can still argue about it. You can still fight for your right to be first author. But what you haven't done is make an investment that you're going to feel like you've lost because you've already put so much into it. You're not going to feel like somebody stole something from you at this point if the authorship order changes. But anyway, it gives everybody a chance to also right size their expectations. And what do I mean by that? Well, you know, if the paper hasn't even been written and you see that your name is number seven of 18, then you don't have to have any illusions about moving to number one. And you can kind of contribute according to your authorship order.

9:29 So if you're person number seven in the list of 18, you really still need to review the manuscript that you need to provide your edits. That's going to be important. But you're not going to be the person who's going to write the full first draft. You're probably not going to be the person who's going to make significant changes to the final draft. And that's important. You know now to measure your contribution accordingly. You're like, okay, I'm number seven of 18. I will review the manuscript when it comes around for edits, but I'm not going to like take three or four or five days off to write the first full length draft of the manuscript if I'm not author number one or the last author or author number two.

10:10 So that's helpful because it helps everybody manage expectations. And then we go back to the example I gave at the beginning where it's like, I may have spent three days editing. That's fine. I chose to spend three days, but I don't get to say at the end of those three days that I should now move to number one because it was already made clear at the beginning. So if you are writing a manuscript, my best advice for my mentees is to first of all just start with the title page, which has the author order and then write out the outline and then pass it around. And so everyone's seen it for the first time. Anyone who wants to argue can argue right then. And then you can make the investment of writing the whole manuscript.

10:52 Okay. Once you've written the whole manuscript, then it's a draft. You can send it to the senior author who can review it. And then when it's time, you can send it around to the co-authors who now are seeing the manuscript for the second time around. It's really the first time around because it's the first time that they're seeing the manuscript in full length draft where they can kind of really make edits because in the outline you can edit the outline, but it's kind of a skeleton of what is to come. But they've seen it now twice. And though this is the first time they're seeing the full length manuscript in draft format, they've already had a chance to see the author order from the beginning and already kind of adjust their expectations to it. So it's important and it helps them to feel like, you know, we've seen this manuscript a couple of times.

11:36 You know, have you ever been part of those manuscript writing opportunities where you see the manuscript in passing as it's on its way to being published? It's almost like they show it to you and they're like, please review. We're submitting tomorrow. You know, that's not actually really kind of the way it should be. Every author should have an opportunity to contribute and it shouldn't be like a drive by. The manuscript is on its way out the door. Quickly speak now or hold your piece. But you know what it does when you do it that way where everyone's had a chance to see the manuscript at least once, actually twice, because first time in outline format and now as a full draft, nobody feels like, you know, people are hiding things from them.

12:18 It's that the co-authors feel like I've seen this manuscript now twice and there's kind of increased confidence in the work, which is important because, you know, every author on that list is responsible for the manuscript. And if there are any major errors in the manuscript, it's important for the co-authors to know because, you know what, they will be on the hook for any major errors. Okay. It's important also to avoid miscommunication. So if somebody's been promised something, you know, especially when the work first started, you know, many of these things evolve over time. And initially you thought the work was going to go this way, but then it went the other way.

12:59 But maybe a mentor promised something to someone who was involved in the work early on. It does help you avoid miscommunication when you just make authorship order just fully clear upfront. Another thing it does is that it just helps to mitigate future disputes, right? So people get really upset over this authorship order thing. They get really mad if they don't get the spot that they're promised. Maybe they're two senior people on the paper and then someone feels like they should be the senior and the other person's like, oh, I should be the senior. And so things like that can really cause a lot of confusion and a lot of stress. And it's just good to just get it out there early before you make too many investments so that if for whatever reason you are not the one to take over and run with the paper, you haven't made too many investments at the end, at the beginning.

13:52 The other thing is that you want to really uphold academic integrity because having all the authorship listed upfront allows each author to make a decision as far as to how best to contribute to match their authorship order. So if you're listed as number one, you know that your work is cut out for you and actually putting together a full manuscript as it's supposed to be. And so that allows you to do it. The other thing is that it also clarifies who is in charge here? Who is the senior person? Who is calling the shots? Who's deciding finally how things look? And so it kind of helps to establish the role of the PI, who usually is in the senior role, but also it also helps you if needed to lean on the PI and say, hey, people are arguing about the authorship order.

14:44 Can we clarify this upfront? So that's important as well. When needed, it's helpful to actually upfront before the paper is written, have everybody sign that, hey, we agree. I hope it doesn't come to that because these should be collaborative things and we shouldn't have to sign contracts over who's first author, who's second author. They can get pretty thorny, especially as sometimes the work we're presenting is so important. It's like whose name comes first? Because the principle we've outlined in this paper will be forever known as the unwemina principle if a woman is first author, right? But if somebody else is first author, then it may not be known as the unwemina principle. And so these are things that people fight for and for different reasons.

15:28 It's neither good nor bad, whether they're fighting for first authorship or not, but it can become a thorny, sticky issue. And you want to know that, you want to be prepared for that upfront. And establishing authorship order from the beginning allows you to save yourself a ton of stress in the end. Okay, so we've talked this whole episode about authorship order. And why do I talk about authorship order? Because it can cause a great deal of stress. And especially if you are the one kind of leading the charge, you want to save yourself the stress at the back end. You just want to move it all up to the front. And sometimes people are anxious or worried.

16:09 They're like, what if I get booted off from the first author? Yeah, you very well might. So you want to bring it up upfront. You want to make sure you clarify that before you start making too many investments into the work. And so it can happen at any time if it's not fully established. So what's my advice at the end of the day before you start writing a full manuscript? Clarify authorship from the very, very beginning. All right, I hope this has been helpful to you. If it has been helpful, please share it with somebody else. Please leave us a review so that other people can find us as well. And they can get insights into how to continue to live life and flourish as a clinician researcher, as a scientist and leader.

16:51 All right, it's been a pleasure. I'll talk to you next time. Thanks for listening to this episode of the Clinician Researcher Podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. If you found the information in this episode to be helpful, don't keep it all to yourself. Someone else needs to hear it. So take a minute right now and share it. As you share this episode, you become part of our mission to help launch a new generation of clinician researchers who make transformative discoveries that change the way we do healthcare.