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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to today's episode.

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I'm your host, Toyosi Onwuemene, and I'm super excited to talk to you today about establishing

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authorship.

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And I want to talk about this because it came up for me today, actually, and yesterday.

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So I was editing manuscripts submitted by two people that I'm working with who are first

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author for manuscripts from which I'm senior author.

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And what I noticed was that they both submitted to me manuscripts that didn't have a title

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page.

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So there was no authors listed, there were no authors listed, there was no title page,

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there was none of that.

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And they sent me the full manuscript for editing, and it had already passed through some of

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the authors.

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And so it was one of those things where I was like, oh, it was really important for

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me to step back and say it finally.

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When I got the second manuscript, I was like, is this the pattern where there's no authorship?

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Let's clarify how important that is to just specify upfront.

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So I'm about to talk about things that you should consider as far as establishing authorship

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as maybe the number one thing you do before you ever start writing.

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Okay, so we'll talk a little bit about that.

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So first of all, you know, collaboration is at the heart of scientific research.

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Okay.

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I'm told that once upon a time, there were people who just sat in their labs, and they

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just did all this work by themselves.

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And then they would show up and they would publish and it would just be them on the authorship

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line.

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And apparently, those days are gone.

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Because if we're going to do any work that's of significance, it usually involves more

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than 1%.

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And in general, it involves many people.

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And so we talk about team science, right?

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So research is collaborative in nature.

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And there are very, very, very few manuscripts that you're going to be able to submit where

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you are the only author.

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Sometimes it's an editorial, and that may make sense to have one author.

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But if it's research, typically we'll have several authors.

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Okay.

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So authorship is kind of inherent to collaborative research.

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And it's important to understand that it's an important thing to clarify upfront.

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Because authorship kind of signifies the work that was done and the contributions of the

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people who wrote the paper together.

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So for example, you know, every field is different.

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But in my field, in general, the first author is the person who's done most of the work.

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And the senior author, the last person on the list, is the person who's done a lot of

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the guidance, kind of maybe the person who's conceived the project, who's shepherded things

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to where they are.

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In both authors, the first and the senior author should participate in writing the manuscripts.

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And then in the middle is everybody else.

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Sometimes a second author is a co-author.

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Sometimes a second to the last author is kind of a co-senior author.

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But for the most part, everybody in the middle is kind of there.

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It kind of feels like it can feel like a wash.

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But it isn't.

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Everybody's contributed, or at least they should have, kind of officially.

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There are ethical guidelines regarding who should be an author.

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So everybody should have contributed to the work.

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Everybody should contribute to the writing and editing.

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And everybody should approve the final manuscript for submission.

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So authors are people who've done the work.

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But what's important is to establish things upfront so that there's no confusion.

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So in the example of the manuscript that was submitted to me by Mantia that I was working

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with, she's already sent out the manuscript to many people.

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And so I don't know how long people have taken to edit.

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So maybe somebody took like 10 minutes and they were like, oh, I'm done.

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Maybe somebody else took the manuscript for three days and they worked so hard.

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And then at the end of the three days, they're like, well, the work I've done, I should be

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senior.

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And then there's confusion about how much people put into this thing.

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And people get really worried and anxious about these things.

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I worked hard.

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I worked hard.

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And so then there's confusion.

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And people would say, well, if I knew I was going to be senior author, maybe I wouldn't

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have spent so much time on it.

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And there's a lot of that back and forth.

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And the back of that is the fact that people need to publish.

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They need to publish to advance in their careers.

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They need to publish for promotion or publish to advance to the next level.

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There are pressures to publish.

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And so a lot of chaos can ensue when authorship is not decided upfront.

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So my recommendation, clarify authorship order as the first thing you do.

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What does that mean as the first thing you do?

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Work is always ongoing.

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And by the time you get to a point where you're like, okay, let's go now and publish, you

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know, there have been different people who've touched the work at different points in time.

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And so what I'm talking about as far as authorship order is where you go to actually write the

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manuscript that's going to be published.

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Okay, at the point at which we're like, let's write this up.

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Number one is who are the authors?

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So if you're a young person who, you know, has a lot of senior people who are helping

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as part of this manuscript, and you're pretty sure you want to be first author, but you're

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not sure that you're going to be able to be, how do you handle this?

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Well, the easy, easy answer is go talk to your mentor.

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But I want to ask, I want to give you tools to think about it so that you are able to

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make decisions for yourself and able to have conversations with your mentor that are mature

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and that are thoughtful as well.

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So this is my advice to my trainees.

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I say the first thing you do before you ever start writing is write up a title page, what's

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going to be the title of the manuscript, and then write up the author list.

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And clearly it's the line where everybody has, you know, their affiliation and all things

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related maybe their ORC ID number, but write that out first.

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Think spend time putting all that information together.

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And then for the actual manuscript, write an outline.

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Don't invest time in writing a full length manuscript until you know whether you are

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the primary author.

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Do not do it.

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Do not do it.

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Because you know what is so painful?

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To have put in weeks and weeks of writing only for somebody to say, oh, you can't be

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the first author.

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And then they take your name off and they put you in the middle somewhere.

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You've done a lot of work.

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That feels so painful.

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But many other people who've made those investments without knowing if they were going to be able

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to actually be the person who would be the primary.

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And so that shouldn't be happening.

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It does happen more often than we'd like to admit.

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It shouldn't be happening, but it does happen.

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And how do you protect yourself is upfront.

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Before you start doing major work, make it clear that, you know, make out the author

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line, write out the outline of the paper.

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Hey, this is what the title of the paper is going to look like.

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Write out the outline and pass it around.

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What does that do for you?

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Number one, it allows you to clearly specify the title of the article.

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It allows you to clearly specify the authors and the order, right?

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Because it's written out.

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And then you are able to think about what the manuscript is going to look like, but

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you haven't invested all this time and energy into writing pages and pages and pages and

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pages of things.

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Before you ever do that, you send out your manuscript, the title page and the outline

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to all the co-authors.

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And you say, hey, I'm getting ready to start writing this paper, but I wanted you to weigh

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in on the outline.

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And then I can go ahead and start writing once I have your input.

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And this gives you the opportunity to have everybody see the author order early.

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And if they want to dispute anything, they can do it soon.

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Because if you find out that somebody else thought that they would be first author on

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this paper and they would be the one to write most things, you just want to know upfront.

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You can still fight about it.

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You can still argue about it.

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You can still fight for your right to be first author.

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But what you haven't done is make an investment that you're going to feel like you've lost

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because you've already put so much into it.

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You're not going to feel like somebody stole something from you at this point if the authorship

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order changes.

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But anyway, it gives everybody a chance to also right size their expectations.

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And what do I mean by that?

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Well, you know, if the paper hasn't even been written and you see that your name is number

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seven of 18, then you don't have to have any illusions about moving to number one.

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And you can kind of contribute according to your authorship order.

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So if you're person number seven in the list of 18, you really still need to review the

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manuscript that you need to provide your edits.

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That's going to be important.

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But you're not going to be the person who's going to write the full first draft.

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You're probably not going to be the person who's going to make significant changes to

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the final draft.

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And that's important.

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You know now to measure your contribution accordingly.

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You're like, okay, I'm number seven of 18.

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I will review the manuscript when it comes around for edits, but I'm not going to like

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take three or four or five days off to write the first full length draft of the manuscript

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if I'm not author number one or the last author or author number two.

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So that's helpful because it helps everybody manage expectations.

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And then we go back to the example I gave at the beginning where it's like, I may have

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spent three days editing.

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That's fine.

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I chose to spend three days, but I don't get to say at the end of those three days that

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I should now move to number one because it was already made clear at the beginning.

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So if you are writing a manuscript, my best advice for my mentees is to first of all just

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start with the title page, which has the author order and then write out the outline and then

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pass it around.

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And so everyone's seen it for the first time.

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Anyone who wants to argue can argue right then.

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And then you can make the investment of writing the whole manuscript.

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Okay.

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Once you've written the whole manuscript, then it's a draft.

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You can send it to the senior author who can review it.

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And then when it's time, you can send it around to the co-authors who now are seeing the manuscript

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for the second time around.

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It's really the first time around because it's the first time that they're seeing the

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manuscript in full length draft where they can kind of really make edits because in the

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outline you can edit the outline, but it's kind of a skeleton of what is to come.

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But they've seen it now twice.

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And though this is the first time they're seeing the full length manuscript in draft

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format, they've already had a chance to see the author order from the beginning and already

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kind of adjust their expectations to it.

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So it's important and it helps them to feel like, you know, we've seen this manuscript

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a couple of times.

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You know, have you ever been part of those manuscript writing opportunities where you

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see the manuscript in passing as it's on its way to being published?

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It's almost like they show it to you and they're like, please review.

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We're submitting tomorrow.

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You know, that's not actually really kind of the way it should be.

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Every author should have an opportunity to contribute and it shouldn't be like a drive

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by.

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The manuscript is on its way out the door.

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Quickly speak now or hold your piece.

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But you know what it does when you do it that way where everyone's had a chance to see the

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manuscript at least once, actually twice, because first time in outline format and now

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as a full draft, nobody feels like, you know, people are hiding things from them.

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It's that the co-authors feel like I've seen this manuscript now twice and there's kind

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of increased confidence in the work, which is important because, you know, every author

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on that list is responsible for the manuscript.

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And if there are any major errors in the manuscript, it's important for the co-authors to know because,

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you know what, they will be on the hook for any major errors.

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Okay.

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It's important also to avoid miscommunication.

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So if somebody's been promised something, you know, especially when the work first started,

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you know, many of these things evolve over time.

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And initially you thought the work was going to go this way, but then it went the other

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way.

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But maybe a mentor promised something to someone who was involved in the work early on.

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It does help you avoid miscommunication when you just make authorship order just fully

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clear upfront.

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Another thing it does is that it just helps to mitigate future disputes, right?

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So people get really upset over this authorship order thing.

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They get really mad if they don't get the spot that they're promised.

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Maybe they're two senior people on the paper and then someone feels like they should be

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the senior and the other person's like, oh, I should be the senior.

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And so things like that can really cause a lot of confusion and a lot of stress.

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And it's just good to just get it out there early before you make too many investments

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so that if for whatever reason you are not the one to take over and run with the paper,

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you haven't made too many investments at the end, at the beginning.

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The other thing is that you want to really uphold academic integrity because having all

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the authorship listed upfront allows each author to make a decision as far as to how

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best to contribute to match their authorship order.

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So if you're listed as number one, you know that your work is cut out for you and actually

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putting together a full manuscript as it's supposed to be.

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And so that allows you to do it.

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The other thing is that it also clarifies who is in charge here?

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Who is the senior person?

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Who is calling the shots?

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Who's deciding finally how things look?

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And so it kind of helps to establish the role of the PI, who usually is in the senior role,

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but also it also helps you if needed to lean on the PI and say, hey, people are arguing

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about the authorship order.

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Can we clarify this upfront?

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So that's important as well.

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When needed, it's helpful to actually upfront before the paper is written, have everybody

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sign that, hey, we agree.

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I hope it doesn't come to that because these should be collaborative things and we shouldn't

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have to sign contracts over who's first author, who's second author.

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They can get pretty thorny, especially as sometimes the work we're presenting is so

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important.

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It's like whose name comes first?

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Because the principle we've outlined in this paper will be forever known as the unwemina

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principle if a woman is first author, right?

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But if somebody else is first author, then it may not be known as the unwemina principle.

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And so these are things that people fight for and for different reasons.

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It's neither good nor bad, whether they're fighting for first authorship or not, but

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it can become a thorny, sticky issue.

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And you want to know that, you want to be prepared for that upfront.

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And establishing authorship order from the beginning allows you to save yourself a ton

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of stress in the end.

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Okay, so we've talked this whole episode about authorship order.

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And why do I talk about authorship order?

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Because it can cause a great deal of stress.

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And especially if you are the one kind of leading the charge, you want to save yourself

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the stress at the back end.

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You just want to move it all up to the front.

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And sometimes people are anxious or worried.

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They're like, what if I get booted off from the first author?

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Yeah, you very well might.

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So you want to bring it up upfront.

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You want to make sure you clarify that before you start making too many investments into

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the work.

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And so it can happen at any time if it's not fully established.

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So what's my advice at the end of the day before you start writing a full manuscript?

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Clarify authorship from the very, very beginning.

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All right, I hope this has been helpful to you.

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If it has been helpful, please share it with somebody else.

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Please leave us a review so that other people can find us as well.

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And they can get insights into how to continue to live life and flourish as a clinician researcher,

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as a scientist and leader.

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All right, it's been a pleasure.

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I'll talk to you next time.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.