Dr. Bipasha Mukherjee
Published Online: April 1st, 2021 | Read Time: 26 minutes, 16 seconds

“With great power comes great responsibility”

Stan Lee in Spiderman


Publications represent the three ‘R’s of modern times– recognition, respect, and revenue, for anyone in the field of science and research. Authorship has become the currency of the current generation and a measure of one's status in the international scientific community. The number of papers published, the journals in which they are published, and their ranking on the list of authors is all crucial when it comes to promotions, funding and market value in the employment exchange. The ‘publish or perish’ culture has become our survival mantra.

However, as Rennie, Deputy Editor of theJournal of the American Medical Associationput it: “the coin of publication has two sides: credit and accountability.”1

Authorship is also the fulfillment of great responsibility.It is indeed unfortunate that many authors are not aware of, or choose to disregard this obligation to see their names on print,whatever be the consequences.Irresponsible or unethical behavior in the field of scientific research publications may lead to loss of credibility not only of the individual, but of the institution he/she is attached to, or even the country. It is worthwhile to remember that authorship entailsboth receiving credits and taking the blame when something goes wrong, for example, if dataare found to be imaginary or results are irreproducible.

Who is an author?

In 1978, a small group of editors of general medical journals met informally in Vancouver to establish guidelines for the format of manuscripts, which became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references (so-called “Vancouver Style”) developed by the National Library of Medicine, were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), whichhas developed the following recommendations for authorship of a scientific publication.Authorship is based solely on scientific contributions.

Requirements for authorship:

1. Substantial contributions to conception and design,orto the acquisition of data, analysis and interpretation of data.

2. Drafting the articleorrevising it critically for important intellectual content.

3. Final approval of the manuscript to be published.2

Authors should meet conditions 1, 2, and 3. A person who fulfills the qualifications 1, 2, and 3shouldappear as co-author. Co-authorship should, if possible, be agreed upon when planning the publication. All co-authors should approve the final version of the manuscript and thereby accept their responsibility for the publication. At least one of the authors referred to as 'guarantor' should take responsibility for the integrity of the manuscript.

Increasingly, authorship of multicenter trials is attributed to a group. All members of the group who are named as authors should fully meet the above criteria for authorship/ contributorship.

Who is NOT an author?

Authorship should not be granted for

  • Acquisition of funding
  • Supplying financial support or laboratory space
  • Contributing to routine technical assistance
  • Collection of data or general supervision of the research group.

(It may come as a great surprise or even indignation to many that heading the department /institution doesn’t confer automatic authorship.)


Individuals who may have made some contribution to a publication, but who do not meet the criteria for authorship, such as staff, editorial assistants, medical writers should be mentioned in the ‘acknowledgments’ section of the article. All persons mentioned in the acknowledgments should give written permission for their inclusion in this section.3


(a) Department chairperson who provided general support

(b) Acknowledgments of technical help

(c) Acknowledgments of financial and material support

(d) Financial relationships that may constitute a conflict of interest

(e) Writing assistance.

Order of authors:

In this age of multidisciplinary approach, it is rare to encounter papers authored by a single person. In multi-authored publications, the first author is the person who has carried out the majority of the research workandwho has made the greatest contribution to the conduction of the study/manuscript.4The last author is typically the senior author. However, senior authorship should not be awarded to someone simply because of their seniority, rank, or standing in the field. McKneally defines senior authors as individuals who“generally direct, oversee, and guarantee the authenticity of the work reported”and “implicitly take responsibility for the work's scientific accuracy, valid methodology, analysis, and conclusions”.5The corresponding author is the individual charged with communicating with editors and readers. He/she “ensures that all authors are aware of and approve the submission of the manuscript, its content, authorship, and order of authorship6The corresponding author is also involved with addressing the concerns/questions of editors, reviewers, and readers and to provide information on coauthor contributions. “Middle” or “contributing” authors of a paper are those individuals listed between the first and senior authors. The ordering of middle authors should reflect their relative contribution to the work. Ahmed et al. suggest a scoring method that may be useful for assessing relative contributions in contentious situations.7Table 1 summarizes the requirements and responsibilities of first, senior, corresponding, and middle/contributing authors.

Author Category

Contribution and Responsibility to the Work and Publication

First author

Fulfills ICMJE authorship criteria.
Performs bulk of the experimental work.

Senior author

Fulfills ICMJE authorship criteria.
Typically the last person on an authorship list.
Directs, oversees, and guarantees the authenticity of the work.
Takes responsibility for the scientific accuracy, valid methodology, analysis, and conclusions of all work described in the paper.
Able to explain all of the results described in the paper.

Corresponding author

Fulfills ICMJE authorship criteria.
Typically assumed by the first or senior author.
Communicates with editors and readers.
Provides specific information on the contributions of all coauthors to the paper.
Ensures that all authors are aware of and approve the submission of the manuscript, its content, authorship, and order of authorship.

Middle/contributing author

Fulfills ICMJE authorship criteria.
Contributions do not rise to those of first or senior author.
Order of middle/contributing authors should reflect their relative contributions to the paper.

When a large, multicenter group has conducted the work, the group should identify the individuals who accept direct responsibility for the manuscript. These individuals should fully meet the criteria for authorship/contributorship defined above, and editors will ask these individuals to complete journal-specific author and conflict-of-interest disclosure forms. When submitting a manuscript authored by a group, the corresponding author should clearly indicate the preferred citation and identify all individual authors as well as the group name.8

In some fields, such as management research or economics, alphabetical order of authors is practiced.9

Typesof Authorship:

'Authorship…potentially conveys great benefit, as well as responsibility.'10

Studies show that the authorship criteria laid down by ICMJE is fulfilled only part of the time.11The scientific publishing world has been rocked by revelations and controversies which would make hugely entertaining Bollywood potboilers. (Mr. Bhandarkar, are you listening?) Guest, gift, and ghost authorship are some of the types of non-authors who wrongfully inhabit the publishing arena.12Guest (honorary, courtesy, or prestige) authorship is defined as granting authorship out of appreciation or respect for an individual, or in the belief that expert standing of the guest will increase the likelihood of publication, credibility, or status of the work.Dr. Gerald Schatten, a senior scientist at the University of Pittsburgh, is one such classic example. He was named as the senior author in the publications ofHwang Woo-suk, a South-Korean researcher at Seoul National University.

In February 2004, Hwang and his team announced that they had successfully created an embryonic stem cell, and published their paper in 'Science'.13This was the first reported success in human somatic cell cloning. Until Hwang's claim, it was generally agreed that creating a human stem cell by cloning was next to impossible due to the complexity of primates. Timemagazine named Hwang as one of "People Who Mattered" in 2004. In 2006, Hwang was charged with embezzlementand bioethics law violations after it emerged that much of his stem cell research had been faked. He was sentenced to two years suspended prison sentence.

When the work was revealed to be fraudulent, Schatten made significant efforts to distance himself from it. He claimed that he had helped write the manuscript, but had not participated in or overseen any aspect of the investigation. He therefore could not take responsibility for the integrity of the studies. He was subsequently placed under investigation by the University of Pittsburgh, who criticized his assumption of co-corresponding and senior authorship.A summary of the report stated that “Dr. Schatten's listing as the last author not only conferred considerable credibility to the paper within the international scientific community, but directly benefited Dr. Schatten in numerous ways including enhancement of his scientific reputation, improved opportunities for additional research funding, enhanced positioning for pending patent applications, and considerable personal financial benefit. However, these benefits are accompanied by responsibilities for the manuscript as a whole, approval of the manuscript by all co-authors, and the veracity of the data reported. Dr. Schatten shirked these responsibilities, a serious failure that facilitated the publication of falsified experiments in Science magazine14

Polyauthorosis giftosa'15

Gift authorship is credit, offered from a sense of obligation, tribute, or dependence, within the context of an anticipated benefit, to an individual who has not contributed to the work. This is widely prevalent where many put their names in publications with no knowledge of the subject, by virtue of their position of authority, not because of authorship. The practice of including spouses, colleagues, friends and bosses in the author’s list is still prevalent in publications. Ghost authorship is the failure to identify as an author, someone who made substantial contributions to the research or writing of a manuscript that merited authorship. It may be voluntary, as in the case of authors for hire with the understanding that they will not be credited, or involuntary or “denial of authorship”, where major contributors are removed as an author.1It also happens when papers are shaped for publication not by an impartial research agenda but by the need to sell a product.

Rofecoxib(brand name Vioxx)is a nonsteroidal anti-inflammatory drug (NSAID) that was marketed byMerck & Co. andapproved by the Food and Drug Administration (FDA) in 1999to treatosteoarthritis,dysmenorrhoea, and other acute painful conditions. Worldwide, over 80 million people were prescribed rofecoxib at some time.In2004, Merck withdrew rofecoxib from the market after disclosures that it withheld information about its risks from doctors and patients for over five years, resulting in between 88,000 and 140,000 cases of serious heart disease associated with long-term, high-dosage use. In the year before withdrawal, Merck had sales revenue of 2.5 billion USD from Vioxx.In 2009,Scott S. Reuben, former chief of acute pain at Baystate Medical Center, Massachussets, revealed that data for 21 studies he had authored for the efficacy of the drug had been fabricated in order to augment the analgesic effects of the drugs.Merck had no comment on the disclosure.17

Mutual support” authorships have been defined as an agreement by two or more investigators to place their names on each other's papers to give the appearance of higher productivity.18Duplication authorship” is the publication of the same work in multiple journals.19At institutes where promotions, rewards and grants are based on the number of publications, a non-meritorious person may get ahead by virtue of an over-inflated bibliography. These people are only concerned with the one thing that will speed up any career in modern science, getting published. In "Salami publication" or "salami slicing", data gathered by one research project is separately reported (wholly or in part) in multiple end publications.21To quote Radulescu, 'if you have but one great study, submit it in its best, most complete form to the most appropriate journal. Do not publish in instalments, do not publish it in variants, do not publish it more than once’.22Unfortunately, the lure of easily increasing the numbers of publications continues to prove irresistible to many authors.

Coercive authorship/ The White bull effect:23

The White Bull expects the automatic inclusion of his/her name in any paper written by their subordinates, colleagues, and students. They do so by virtue of their personality (criteria listed below) and they achieve this by virtue of their position, threats (overt and covert), and sheer gall.

The White Bull has a distinct behavior pattern:24

(i) Increasing academic expectations and increased need to publish

(ii) Personal ambition, vanity, and the desire for fame

(iii) Laziness

(iv) Greed linked to direct financial gain

(v) Mental illness

(vi) A messianic complex

(vii) The lack of moral capacity to distinguish right from wrong.

It is an automatic corollary that when his fraud is exposed the White Bull will vehemently deny wrongdoing. It is also seen that white bulls are usually found at the top of an organization.

Copyright = right-click, Copy?Plagiarism

Playwright Wilson Miznersaid, "If you copy from one author, it's plagiarism. If you copy from two, it's research."Even the greatest writer of English literature of all times, William Shakespeare, has been accused of plagiarism. Proposed alternative candidates include Francis Bacon, Christopher Marlowe, and Edward de Vere, 17th Earl of Oxford.25Even five centuries after Shakespeare’s demise, plagiarism continues to plague publications. Deliberate plagiarism is copying the work of others and turning it as one’s own, which is akin tocheating. Accidental plagiarism happens when a writer does not intend to plagiarize, but fails to cite the sources. Content scraping is copying and pasting from websites and blogs. Free online tools are available to help identify plagiarism,26and there is a range of approaches that attempt to limit online copying, such as disabling right clickingand placing warning banners regarding copyrights on web pages. Detecting plagiarism even by detection tools can still be difficult, as plagiarism is not only the mere copying of text but also the presentation of another’s ideas as one’s own, regardless of the specific words used to express that idea. But many so-called plagiarism detection services can only detect word-for-word copies of the text.


‘Peer review doesn’t necessarily say that a paper is right. It says that it is worth publishing.’

-Martin Blume, Past Editor, Journal of American Physics Society.

It is not onlyBollywoodmusicians and directors who are 'inspired' by others work. It is seen in the scientific world also. Unfamiliar language, insufficient content of studies, and sheer laziness lead to blatant copying and pasting. The pressure to prove one's merit in prestigious institutions with a high rate of publications is one such scenario. To restrict publication of such papers the peer review process and editorial processing of the manuscripts need to be stringent.Publishing fraudulent data is not only unethical and immoral, it can have far-reaching consequences in the scientific community. The ripple effect from the “Darsee Affair” in the 1980’s can still be felt even today. Dr. John Darsee was a promising young clinical investigator at Harvard Medical School from 1978 to 1981. He authored or coauthored more than 25 research papers and over 100 abstracts, reviews, and book chapters in the field of cardiology. Later, his work came under investigation by National Institute of Health (NIH) after complaints from co-workers.The NIH review found Darsee had been fabricating data from experiments that he had never conducted.He had to retract his publications from prestigious journals, but even today, they continue to be cited.27

It is a wondrous feeling when one's paper gets accepted in an indexed journal for publication. The sense of achievement one gains on seeing his/her name as an author on print is incomparable. But it is a plea to all authors, past, present, and future, not to sell one's soul to the devil for the gains associated with authorship. Our written words are the footprints we will leave on the sands of time. They are our true legacy to the future generation. To resort to untruths and duplicity would be akin to not only cheating mankind but to deceiving oneself.

Digital image manipulation: Acceptable changes29, 30


Formatting image type, size and resolution as required in the “Instructions for Authors”


Adjusting contrast, brightness, and color correction to the whole of the photograph


Masking or erasing patient/institutional/manufacturer identifiers


Minimally “cleaning” unwanted noise in the background


Aligning a tilted image


Cropping surrounding redundant space


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8. Chung et al. A Guide on Organizing a Multicenter Clinical Trial: the WRIST study group.Plast Reconstr Surg. 2010; 126: 515–523.
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17. Winstein, Keith J."Top Pain Scientist Fabricated Data in Studies, Hospital Says".The Wall Street Journal. 2009.
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30.Mukherjee B, Nair AG.Principles and practice of external digital photography in ophthalmology.Indian J Ophthalmol. 2012;60:119-25.
Dr. Bipasha Mukherjee
Director, Department of Orbit, Oculoplasty, Reconstructive & Aesthetic Surgery, Medical Research Foundation, Sankara Nethralaya, Chennai
Dr. Bipasha Mukherjee completed her fellowship in Orbit & Oculoplasty from Aravind Eye Hospitals, Madurai, under Dr. Usha Kim, and ICO fellowship from University of Limoges, France, under Prof. Jean-Paul Adenis. She has undergone clinical observerships with Jack Rootman, Richard Collins, Mark Duffy, and Robert Goldberg. She currently heads the Orbit, Oculoplasty, Aesthetic & Reconstructive services in Sankara Nethralaya, Chennai. She has had numerous presentations in national and international conferences and publications in peer reviewed journals. She is the principal editor of the book on Emergencies of the orbit and adnexa with Dr. Hunter Yuen. Her areas of interest include diseases of the orbit & adnexa including tumors; lacrimal surgery; socket reconstruction; traumatic orbital & adnexal injuries. She is an enthusiastic teacher of residents and fellows. Her hobbies include traveling and photography.
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