The Credit Crunch

Posted January 24, 2012

By Sachin Jain, MD

Trainees face special challenges in negotiating research authorship. Here’s a way forward.

As a first-year medical student at HMS, I worked as a research assistant for a senior faculty member writing a book chapter on health care reform. While I collected and summarized articles and drafted some prose on the topic we were studying, the faculty member did the bulk of writing. I had sought experience in a new field and the respect of a potential career mentor, but much to my surprise I was also listed as a co-author. If only all research collaborations could be managed so easily and effortlessly.

Since that time, through my own experiences and those of others, I’ve learned that research collaborations can be fraught with unnecessary tension over perceived contributions and attribution. While credit disputes may arise at any career stage, they pose special challenges for students and trainees. The conflicts lead to breakdowns in otherwise productive relationships between mentors and students and can dampen interest in research careers.

The literature on negotiations offers an approach to conflict resolution that may lead to greater satisfaction for students and trainees and their collaborating investigators. These concepts include:

Establish expectations early. Conflict over authorship often manifests at the preparation of the title page of a manuscript, abstract or presentation. Research collaborators have expectations and a role hierarchy regarding credit and attribution that often go unstated until a draft publication or presentation is produced. Often, too much suspense hangs over the question. Establishing roles and authorship at the outset of a project creates needed transparency about expectations. Medical students and trainees may avoid explicit discussions of authorship because of power asymmetries. Raising the issue of authorship with a mentor who offers guidance, funding or data to facilitate one’s work might be perceived as thankless. But clarity about authorship, attribution, roles and responsibilities can facilitate productivity — a shared goal for everyone.

Build in flexibility. While the best-case scenario in a collaborative effort is that a plan of work is established and executed, relative contributions often change. Unexpected efforts or insights can alter expectations about attribution and credit. In the absence of clearly defined roles or responsibilities, changes in contribution levels are often a source of added tension. If terms and the flexibility of those terms are established upfront, deviations can be discussed and resolved. Scheduled re-negotiations about attribution, role and responsibility can strengthen collaboration by ensuring that changes in contributions are matched with changes in attribution. The best collaborative efforts in which I have been involved have included a steady and transparent dialog around authorship.

Broaden the negotiation. Discussions about attribution often get stuck on a single research product — usually a single manuscript — without consideration of the larger set of products that may emerge from a collaborative effort.

In situations where consensus is difficult to achieve, broadening the negotiation to include research products that extend or continue the research can help resolve conflicts. When the question turns on a single research product, the negotiation is “zero-sum,” i.e. when one party wins, the other loses. With more research products — manuscripts, abstracts, and presentations — at play, it is more likely that all parties emerge satisfied from the negotiation.

One HMS classmate resolved an authorship dispute by accepting a secondary authorship position along with the opportunity to present the work at a national meeting. No one was fully happy, but everyone was satisfied with the outcome.

Use mediation when necessary. In many collaborations, the student or trainee feels left at the mercy of a collaborator of higher institutional rank or position. The student or trainee may fear retribution for raising concerns about attribution. While the number of “deadlock” situations will be minimal if collaborators routinely revisit the terms of their work, agreement is not always immediately possible.

Institutions can support research collaborations by designating mediators to help settle disagreements. Mediators can play a variety of roles, ranging from acting as a formal arbiter to simply providing impartial perspective. Mediation is less desirable than if collaborators achieved consensus on their own, but even the availability of such a process can empower trainees to raise concerns with more senior collaborators. At HMS, the Ombuds Office serves this role — and is frequently called upon to help resolve difficult situations.

It is not part of our academic medicine culture to so explicitly and frequently discuss attribution. In the high-minded world of research and scientific inquiry, it can seem petty, picayune and self-serving. Yet, anyone who has spent time in academic research has heard stories of immense frustration or disappointment over the assignment of credit at all levels — student, resident, fellow, junior faculty or senior faculty.

This is particularly problematic, however, at the early stages of a career, where continued interest in pursuing research may be affected by perceptions of fairness.

Without a major cultural change, implementing negotiations as I have described may be uncomfortable for students, trainees and senior investigators alike. It is, nonetheless, a change worth pursuing. Nothing short of the integrity of our collective research enterprise is at stake.

Sachin H. Jain, MD, MBA, is a senior medical resident at the Brigham and Women’s Hospital and clinical fellow in medicine at Harvard Medical School. He is a member of Wing of Zock’s external advisory board and can be reached at shjain@gmail.com.

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