medic documentWelcome to season 3, episode 9 of the ALiEM Medical Education in Cases (MEdIC) series! Our team (Brent Thoma, Sarah Luckett-Gatopoulos, Tamara McColl, Eve Purdy, John Eicken, and Teresa Chan) is pleased to welcome you to our online community of practice where we discuss the practice of academic medicine! In this month’s case a junior staff person is unsure of whether or not to include a senior staff on a paper.

[su_spoiler title=”MEdIC Series: The Concept” style=”fancy” icon=”caret”] Inspired by the Harvard Business Review Cases and initially led by Dr. Teresa Chan (@TChanMD) and Dr. Brent Thoma (@Brent_Thoma), the Medical Education In Cases (MEdIC) series puts difficult medical education cases under a microscope. On the one Friday of the month, we pose a challenging hypothetical dilemma, moderate a discussion on potential approaches, and recruit medical education experts to provide “Gold Standard” responses. Cases and responses are be made available for download in PDF format – feel free to use them! If you’re a medical educator with a pedagogical problem, we want to get you a MEdIC. Send us your most difficult dilemmas (guidelines) and help the rest of us bring our teaching to the next level.[/su_spoiler]

MEdIC: The Case of the Honorary Authorship

by Dr. Brent Thoma

Dr. Keurin was excited for her meeting with her research mentee, Andrei, today. He was a junior emergency medicine resident with a strong interest in research that had just completed his first project! They were just meeting to review the final draft before submission. As she walked into the coffee shop she saw him slumped in his chair, looking a bit dejected. That wasn’t like him at all.

“Hey Andrei, is everything okay?”

He sighed. “I dunno. I just met with Dr. Lee to talk about this whole submission process. You know, which journal we should submit my manuscript to and such.” Dr. Lee was the program’s Research Director and one of the most renowned emergency medicine researchers in the country. She knew that one of the reason’s that Andrei had ranked the program so highly was so that he could work with the illustrious Dr. Lee and he had confided to her in previous meetings that he had been disappointed about their lack of interaction so far in residency.

“Oh, and that didn’t go well?” she asked.

“Well, I dunno. It was the first time that we had discussed the project since I ran into him in the hall at the beginning of the year. You’ll remember that he hadn’t been too impressed with the idea at that time.”

Dr. Keurin remembered. That was actually how she, a much more junior researcher in the Faculty, had come to be Andrei’s mentor. She thought he had a great idea for a research project and had supported it to fruition.

“Anyways, I had met with him to ask for some advice on where we should submit the manuscript and we had a good chat about that. But then he mentioned that I should send it to him to give it a final once over and add him as the senior author. He said that if we added his name it would strengthen the chance of our paper getting published. I was so shocked that I didn’t know what to say. You’ve really mentored me through this project, that should be your spot! But I’m also worried about my future job and research projects if I were to piss him off. What do you think?”

Dr. Keurin pursed her lips. This was putting her in an awkward position. She recalled a similar conversation from when she was a resident. She had just gone along with it because she figured that was how research worked, but it didn’t feel right then and it still doesn’t feel right now. At the same time, it would be horrible for her prospects at her institution to be on Dr. Lee’s bad side. What should she say?

Discussion Questions

  1. What are the requirements for being listed as an author on a manuscript? Does Dr. Lee meet these authorship criteria? How should the authorship order be determined?
  2. How should Dr. Keurin deal with this situation? What advice should she give to Andrei? Should she confront Dr. Lee?
  3. What are some policies that you have seen that are used to protect junior residents and faculty from encountering this problem?

Weekly Wrap Up

As always, we will post the expert responses and a curated commentary derived from the community responses 2 weeks after the case is published.

This time the experts (3 jointly writing a piece from the University of Toronto)

  • Farah Friesen, Lindsay Baker, and Dr. Stella Ng from the University of Toronto’s Centre for Faculty Development
  • Dr. Kerstin De Wit from McMaster University

On July 25, 2016 we will post the expert responses to this case! After that date, you may continue to comment below, but your commentary will no longer be integrated into the curated commentary. That said, we’d love to hear from you, so please comment below!

All characters in this case are fictitious. Any resemblance to real persons, living or dead, is purely coincidental. Also, as always, we will generate a curated community commentary based on your participation below and on Twitter. We will try to attribute names, but if you choose to comment anonymously, you will be referred to as your pseudonym in our writing.

Teresa Chan, MD, MHPE
ALiEM Associate Editor
Emergency Physician, Hamilton
Associate Professor, McMaster University
Assistant Dean, Program for Faculty Development, McMaster University Ontario, Canada
Teresa Chan, MD, MHPE


ERDoc. #meded #FOAMed Own views expressed. Contributor to @ALiEMteam, @WeAreCanadiEM, ICE Blog, #FeminEM. @MedEdLIFE founder. Works @McMasterU & @HamHealthSci