As a medical postgraduate, one is introduced into their field and has to get themselves up to terms with various aspects of clinical practice, apart from the theoretical aspects of the specialty. One such aspect that postgraduates have to familiarize themselves with during their course is research and publications. Research is an integral part of medicine, no matter which specialty one is practicing ^[1,2]. As the world has moved clearly in the direction of evidence-based medicine, the medical literature is at the centerpiece of clinical decision-making. Literature, however, is an evolving entity. Research keeps advancing the field and helping medical professionals deliver better outcomes for their patients. This is why research has been identified as an essential part of postgraduate training. With research, comes the publication of that research work so that it reaches the clinicians and enables the entire medical fraternity and society to benefit from the research. The National Medical Council (NMC), identifying the importance of research and publications, has made it a compulsory requirement for all medical postgraduates to undertake a research study during their course, which needs to be written in the form of a thesis ^[3,4]. This research work is to be carried out under the guidance of a postgraduate teacher termed the guide. This is an almost universal practice and is widely considered an important facet of postgraduate training. The problem, however, occurs when it comes to assigning credit for that research work during publication.

When a postgraduate is submitting a research project for publication, be it their thesis or any other article, a crucial decision arises regarding authorship. Who should be included as authors, and what the order of authorship must be. On the face of it, it may seem a rather simple exercise of assigning credit proportional to the work put in, but there are nuances to this, and unfortunately, more factors are in play than there should be. With the NMC making publications a requirement for academic promotions, there is pressure on all teaching faculty to publish. This pressure means that faculty needs publications even more than postgraduates. The move aimed at promoting research and publication has inadvertently led to the culture of “publish or perish” ^[5]. With the regulations of NMC only recognizing the first three authors of a paper as significant contributors, this has also created a situation where the order of authorship has become a bone of contention ^[6]. This has led to an atmosphere and culture where everyone wants their name ahead in publications, irrespective of the actual work put into the research project or publication. The postgraduate, often the junior most member of the team, has to unfortunately settle for a spot lower down in the pecking order for the credit. Another difficulty when it comes to assigning credit is the different roles of the contributors and determining the significance of each of those roles ^[7,8]. The head of the unit, under whom the patients (research subjects) may be admitted, feels they have authority over the patient data and hence must be given credit for allowing the use of that data. The faculty performing an intervention or surgical procedure may claim credit as it was their skill that was required to perform the required surgical or interventional procedure. The thesis guide may believe they have the most significant role in guiding the entire research project. Faculty members who give input at various points may do so, hoping to be included in the authorship. Other faculty members who review the manuscript and suggest modifications may also claim credit for their input and suggested modifications were crucial for the manuscript to be up to the required standard for publication. Hence, it is not an uncommon situation for a single publication to have more claimed authors than is even allowed by most journals. In this tug-of-war for authorship, postgraduates often find themselves helpless.

This dispute might even take a more ugly turn. Often, the determination of authorship might not even be based on contributions to the study but rather on hierarchy within the department. The principal investigator may not even get to have a say in determining the order of the authorship, with that decision being taken by their superior or head of the unit/head of the department. Any attempts at correcting this practice may be dismissed, citing seniority, and worse yet, might lead to straining of professional relationships and might have repercussions on their work unrelated to the publication as well. When it comes to the thesis, the postgraduate is at the mercy of the guide because if the guide refuses to sign the thesis, they would be unable to appear for their final examinations and obtain their degree. This disparity in power is often exploited to dictate terms regarding the authorship for publications ^[9].

Determining authorship should not be an arbitrary procedure based on the whims and fancies of one individual. There are laid down guidelines for authorship criteria that most reputed journals follow. The International Committee of Medical Journal Editors (ICMJE) guidelines or Committee on Publication Ethics (COPE) guidelines for authorship criteria are adopted by most journals worldwide. For example, the ICMJE guidelines clearly state that for an individual to be considered an author, they must meet all of the following four criteria: substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of data for the work; AND drafting the work or reviewing it critically for important intellectual content; AND final approval of the version to be published; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Any contributors not meeting any of the above criteria should not be considered for the authorship. Contributions such as acquisition of funding, general supervision of a research group, general administrative support, writing assistance, technical editing, language editing, and proofreading do not qualify as warranting authorship. Such contributions should instead be acknowledged in the acknowledgment section of the article. These guidelines must be the basis for determining the authorship. The order of authorship must correspond to the quantum of work done by each author in each of the above criteria.

When there is teamwork and collaboration, wonderful things can be achieved. However, for a team to function well, the individuals’ roles must be well defined, and importantly, everyone must be aware of their role and the contributions expected of them. These roles and expectations must be laid down at the beginning of the project. The individual must be aware of what they are signing up for and must do so only if they are willing to accept the expected reward. Ambiguity about the role or the reward will be a recipe for dissatisfaction and disagreements at a later stage. In the context of postgraduates and faculty, it must not be assumed that the roles will correspond to a hierarchy or that the credit given will be determined by seniors. The role of a mentor or guide is to guide the postgraduate through the research and publication process. This need not necessarily mean that the guide can dictate all terms when it comes to the publication of the paper. For a postgraduate, their thesis may be the first research project they are undertaking and is to be guided through the process by someone aware of the process and willing to take the time to help the postgraduate during that process. The aim of the thesis is not for the guide to further their academic profile or gain recognition, with the postgraduate to do the brunt of the work for them. Faculty must understand that mentorship does not mean authorship ^[10,11]. There must be a clear distinction between clinical work in the department and the publication of research. If a surgeon performs a surgical procedure that is used in a research project, the surgeon must remember that the compensation for performing the surgical procedure is the monetary compensation or requirements of their post and not authorship for a publication. Faculty must remember that guiding postgraduates in research and publication is a part of teaching and mentoring of postgraduates, encompassed within their roles as postgraduate teachers, that is expected of them even without authorship in publications. The heads of units and heads of departments must not view their position of seniority as a privilege to be included in any work done by their junior colleagues but rather as a responsibility to guide them to achieve their goals and strive for excellence in academics and clinically.

One must also be aware of some questionable practices that are regarded as unethical. Postgraduates must be aware of these to not fall prey to them, and faculty must be aware of these to ensure that they do not consciously or unknowingly commit such unethical acts. Mentors and guides must review their actions during mentorship and whether their actions are meant to benefit the mentee or themselves. They must respect the postgraduate and not overstep the line from guiding to bullying ^[12]. While the roles of faculty in the functioning of the department may be according to hierarchy, that must not spill over directly to authorship. Coercive authorship, where a senior researcher forces a junior researcher to include someone as an author who did not contribute to the work, must not be practiced ^[13]. Even practices such as courtesy authorship, where an individual is listed as an author as a gesture of goodwill or to reciprocate other favors, must not be practiced as it is unethical and promotes further unethical practices in research and publication. Not including a senior colleague as an author in a paper must not be viewed as disrespectful if the senior colleague does not meet the authorship criteria. Authors must differentiate professional relationships and positions from authorship criteria.

When there is a dispute regarding authorship, all too often, the decision of the senior faculty is considered binding. This may be unfair at times, leave the junior colleagues dissatisfied and unmotivated, and strain professional relationships. Hence, there must be better mechanisms for resolution when authorship cannot be agreed upon by the contributors. The ICMJE criteria must form the basis for determining authorship in discussions on authorship. However, if the contributors cannot agree on it, there should be a conflict resolution committee that can help solve the disagreement. It is a prerogative of the institution to establish such a mechanism for resolution, ideally with the establishment of a committee, to provide an unbiased opinion. The contributors, irrespective of seniority, must be allowed to express/prove their contributions made to the research project/publication, and the committee must thereafter make the decision, keeping in mind the ICMJE criteria for authorship.

We must take certain steps to preserve intellectual property, prevent authorship disputes, and reward genuine research work. Before research is conducted, the roles of individual researchers must be laid out. A transparent and laid out authorship agreement, which is a written agreement outlining authorship roles, must be made and signed by the contributors before starting the research project. Institutions must actively ensure that all ethical guidelines are followed for research conducted in their institution. This includes having a dispute resolution committee for disputed authorship claims. Institutions and medical organizations must promote awareness regarding authorship criteria guidelines and unethical authorship practices. Research must ideally be voluntary, which would decrease the problem of individuals disinterested in research trying to include their names in publications for ulterior purposes. Mentorship programs for postgraduates need minor reforms to ensure that the mentor is entrusted with the responsibility of guiding the postgraduate but is not given undue powers or authority, thereby making the relationship one of a master and slave. A culture of inquisitiveness, honesty, and fairness must be promoted in the department to encourage genuine research and publications rather than one of toxicity, hierarchy, and opportunism.

To prevent and resolve disputes, it advocates for clear agreements on roles and authorship at the start of projects, institutional conflict resolution mechanisms, and a culture of fairness and accountability. By addressing these issues, departments can create an environment where mentorship thrives, and research retains its integrity. The medical community must prioritize ethical collaboration, ensuring that authorship reflects genuine contributions and fosters trust among researchers.

• Ethical authorship practices are essential in medical research to ensure fair recognition of contributions, foster trust among collaborators, and maintain academic integrity – particularly in postgraduate settings where power dynamics can skew credit distribution.
• Clear communication and predefined authorship roles at the beginning of a research project can prevent disputes, protect intellectual property, and ensure that contributions are recognized according to established guidelines such as those from the ICMJE.
• Institutions must implement conflict resolution mechanisms and promote mentorship ethics to protect junior researchers, resolve disputes impartially, and cultivate a healthy academic environment that supports genuine scholarship over hierarchical dominance.