Whose Name Goes First?

Linda Helton for The Chronicle

January 11, 2017

We are three colleagues — a humanities scholar, a social scientist, and a physician — who recently made it through a quagmire of disagreement over authorship order and lived to tell about it.

We teach in an interdisciplinary medical-humanities department. Our story centers on our collaboration on an article describing how a "hidden curriculum" is revealed in comics created by fourth-year medical students for a course that one of us (Michael) developed. Like many writing projects among colleagues who care passionately about their work, ours was a success. However, as we readied the article for submission, the reality that we had failed to agree on authorship order came crashing down. We worked hard to talk things through, but it soon became clear that there were distinct disciplinary worldviews that precluded an easy solution.

This is a story about when things fall apart, told through our three perspectives. Having navigated the choppy waters of interdisciplinary disagreement, we feel we have some hard-earned guidance to impart to colleagues in similar situations.

Danny: As an anthropologist, I’d found the comics created by Michael’s students to be a scholarly treasure trove. The unsettling imagery, narratives, and metaphors — while deeply disturbing — have provided insights into the experience of being acculturated into medicine, and Michael and I have published several articles about our findings.

If someone who is not first author offers to improve and transform a paper, don't begin major revisions unless and until there is agreement about the implications for authorship.
When Kimberly joined us to write a new article on the hidden curriculum, it seemed clear that Michael was, ineluctably, the first author. He was the progenitor of the course, had put in countless hours to create the scholarly infrastructure that enabled our collaboration, and had developed a PowerPoint to organize his thinking around the subject. That content ultimately became the first draft of our article.

However, as we met about the project, I could see a creative spark ignited in Kimberly. When we agreed with her suggestion to develop the article for a mainstream publication, she volunteered to take the lead. In reworking the draft, she infused it with a new voice and style. It was during this period that something shifted in my perception of authorship order. When we had arrived at a near-final draft, I dashed off a now laughably naïve email to the group: "I don’t know that we ever decided about authorship. Obviously, Kimberly is first author. ..."

Michael did not share that view. Both he and Kimberly offered well-reasoned, spirited arguments for why they felt they should be first author. When it became clear that we could not reach a consensus, we decided to write up an anonymous account of the project and consult three of my colleagues. If nothing else, I hope my email mistake serves as a monument for anyone wishing to use the word "obviously" in academe.

Michael: During seven years of teaching the comics course, I have collaborated with Danny and Kimberly on numerous shared presentations and publications. When our conversations stimulated interest in the hidden curriculum within medical education, I drafted several abstracts (with Danny) that were accepted for presentations at national conferences. I then prepared PowerPoints and delivered talks on comics and the hidden curriculum, refining the ideas along the way. My various presentations resulted in a first draft of our manuscript.

Danny and I invited Kimberly to join the writing team, as she had a long-standing interest in both comics and medical education, and we thought she would make a substantive contribution. At this point, my assumption (which I thought was shared by all three of us) was that I would be first author and Danny and Kimberly would be co-authors.

When we met, Kimberly suggested writing for an educated lay audience rather than a medical journal, and volunteered to render the original ideas in a new literary voice. We all agreed (unfortunately, without specifically discussing how our names would be listed) and she got to work. By the time her draft was complete, it was stylistically different, with her voice evident throughout. At this point, Danny sent around an email presuming Kimberly as first author, and I bristled.

Quite simply, I didn’t see that coming. While Kimberly unquestionably transformed the manuscript and put more words on the page than did I, the raw material, the idea, the framing, and the first draft were mine. And I felt unprepared to relinquish the primary role.

That said, I also felt uncertain, and sought input from two trusted colleagues who were more detached than I. Both said that they believed I should remain first author. So when Danny, Kimberly and I spoke, we realized that we had reached an impasse.

Kimberly: When we initially met to discuss the project, I suggested that we target a new readership. Danny and Michael had just published a related piece in JAMA and, given that journal’s high visibility, I believed we had already reached the widest audience we could in academic medicine. The three of us were excited about expanding into new territory.

Michael sent me his original PowerPoint and the document he had subsequently created — an outline, as it seemed to me, in the format and style of an academic paper, with the comic panels and itemized themes from his presentation.

Because the new audience would be quite different from what Michael had originally intended, the format and the nature of the information had to change entirely. I removed the Methods, Results, and Discussion sections and created a narrative — and a conversational style and tone — to draw readers into the topic. Because Michael’s discussion of each theme seemed largely a summary of what appears in the comics panels, the majority of my work was analysis: fleshing out the nuances depicted in the panels to illuminate themes Michael had identified. Subsequent edits to my draft by the three of us were minor.

In claiming first-authorship, Michael was, I felt, appropriating my unique style, analysis, and vision for a new kind of manuscript. Whereas humanities scholars typically write alone, on this collaborative paper, author order would be germane to my potential promotion in academic medicine.

Furthermore, when Michael reported that two of his colleagues thought he should be first author, I immediately wondered about their objectivity. His reporting their views made me feel that he was pushing the issue. For these reasons, I was not willing to concede that this was a fair "arbitration" and suggested that we get input from trusted colleagues in different disciplines.

Resolution: Danny agreed to contact a colleague in academic medicine and another in the humanities. The three of us then wrote — and edited until we all agreed upon — a description of the problem, casting both parties as female to remove gender bias. The referendum came back split, along disciplinary lines.

We then decided to send it to a third colleague in our hybrid discipline of medical humanities. Kimberly readily agreed to abide by the decision; Michael was willing, but hesitant.

Here is how the medical-humanities colleague responded: "My gut sense is that both authors have, in their own ways, contributed equally to this project, which simply supports how difficult this negotiation must be. In recognition that a decision must be reached, however, I would argue that credit goes to the first professor — as the originator of the idea and the generator of the initial draft, as she maintained active work in the project through collaborative editing. The tacit understanding of the first professor’s ‘ownership’ of the project also supports this.

"At the same time, were I in the first professor’s shoes, I would cede first author to the second professor — partly to credit the reconceptualization of the project for a lay audience, and much of the writing work — but largely because she is in a position where it matters more professionally."

Satisfied that this had been a fair process, we talked it over and ultimately agreed that Michael and Kimberly would share primary authorship, with Michael’s name appearing first. Our article has not yet appeared in print but we plan to indicate in a note, depending on the magazine’s protocol, that two of us share primary authorship on the piece. Even so, as those of us in higher education know, tensions can linger after disagreements are resolved. This essay is one attempt at reconciliation.

So, what have we learned? Although our own experience has not been fully satisfying, we do have some advice for other scholars contemplating cross-disciplinary collaboration:

  • Discuss the meaning of authorship order before beginning. How do respective academic fields prioritize order? What is implied by first and last position? Is order typically determined by contribution, seniority, alphabet, or something else?
  • Craft a common understanding of expectations for first author. What are that scholar’s responsibilities? Determine contingency plans if the first author can’t or doesn’t meet expectations.
  • If someone who is not first author offers to improve and transform a paper, don’t begin major revisions unless and until there is agreement about the implications for authorship.
  • Revisit authorship discussions as the project evolves. If anyone feels the order is not commensurate with the work, take the time to discuss, renegotiate, and proceed with revised duties or revised author order.
  • Communicate openly and frequently, and be transparent. Consider using a worksheet, contract, or other document that sets criteria and expectations for authorship.
  • State who did what and agree on authorship order before submitting for publication. When authors contribute equally, consider a statement such as "joint first authors" or "contributed equally."

Kimberly R. Myers, Daniel R. George, and Michael J. Green are members of the humanities department in the Penn State College of Medicine.