March 25, 2018

Plagiarism: A Hidden Problem in Academic Medicine

Irène Mathieu. M.D. 

Dr. Mathieu is a resident in pediatrics and poet who lives in Philadelphia. For more of her work please visit her website: irenemathieu.com.

The last time I heard anyone explicitly lecture about plagiarism was around the fourth grade. An aspiring writer, I remember thinking that it sounded like such a horrific breach of integrity that I couldn’t imagine anyone needing to reiterate such a thing. True to my instinct, no one ever did. Except for a brief discussion of my college’s honor code, I never again received any specific education around plagiarism and authorship – not as an undergraduate or medical student, and not in the nearly three years that I’ve been a pediatric resident. I never thought that it would happen to me.

However I am still in residency and have had more than one unfortunate experience around authorship. These experiences have been professionally distressing and disappointing, as the perpetrators are my peers – pediatricians close to my level of training who purport to be interested in social justice and equity. One specific instance was particularly egregious.

A mutual mentor introduced me to a colleague a few years ahead of me in training who had similar interests and perspectives. I was very excited to meet this person several years ago, and I began to think about possible collaboration almost immediately. When I approached her about writing a commentary on a topic of mutual interest she said yes without hesitation. She was just out of residency, and I was a fourth-year medical student with quite a bit of time flexibility, so I offered to do the background research and write the initial draft. We discussed authorship extensively over email during this phase of planning, and agreed that I would be the first author, she would be the second author, and that we would later invite a more senior pediatrician to provide further direction and to be the third author.

Over several months I completed background research for the commentary and wrote multiple drafts, to which my colleague provided feedback and direction. I created a framework, laying out the problem as we saw it and potential solutions. After several rounds of edits, I felt the piece was finally approaching readiness for publication in a major journal. Then things suddenly shifted.

My colleague told me that she didn’t like my writing style and that she wanted to make sure any piece with her name attached was consistent with her personal style. Therefore she proposed making herself first author after making more substantive edits, and sent me a modified version that was organized differently from what I had been working on for weeks. I was taken aback, as she had seen multiple drafts and had not brought up this concern previously, so we discussed it further over the phone. We came up with an alternative solution. We would write two papers – one in which she was the sole author and would lay out the scope of the problem, and one in which I was sole author, in which I would cite the papers I had researched and lay out the solutions that I had drafted. We would submit them as parallel papers, with the hope that they might be published in successive issues of a major journal. I agreed to the plan because I didn’t want to lose the work that I had already done, but the whole situation left me with a foreboding feeling.

At this point our communication dropped off. Months passed. One day I opened the latest issue of a major journal – the one in which we had been aiming to publish – and saw the article. There were the problem and the solutions, in a framework nearly identical to the one I had originally developed, complete with the data and citations that I had researched. My colleague was the first author, and two other people were second and third authors. My name did not appear anywhere in the piece, not even in the acknowledgments. Perhaps worst of all was how I discovered that the manuscript had made it to press.

I had no idea what to do, and I still don’t. No one taught me what steps you are supposed to take when you have been plagiarized. While I believe this piece was important and I’m glad that it found a home in a prominent place, my trust in my colleagues suffered from the betrayal. I flinch now when I come across her name, and even when I sat down to write this piece I had the same sick feeling in the pit of my stomach that rose up when I first saw the published paper.


I still want to be an academic pediatrician, and I trust that most of my present and future colleagues are people of integrity and good intentions. But I wish that at some point in the last ten years someone had crafted a lecture around authorship, how to reduce the chances of being plagiarized, and what to do if it happens. I know that many of us in academic medicine are bent on productivity and that we face intense pressure to publish. However this should not be at the expense of integrity and ethical teamwork. As a future mentor to medical students and residents, I will use my experiences as learning opportunities. Hopefully the day will come when plagiarism is omitted from medical education, not because it is uncomfortable to discuss, but because it no longer happens.

9 comments:

  1. Vic Strasburger MDMarch 25, 2018 at 2:16 PM

    Dr. Mathieu should write to the Journal, explain the situation, and ask that her name be added to the manuscript.
    In 100% hindsight, she should have insisted on being 1st author on the manuscript. I often co-author with others — if they write the 1st draft, then THEY are the 1st author!

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  2. I think this might qualify as academic misconduct and perhaps there is an anonymous reporting mechanism that can be employed? I think that depending on the dynamics of individuals involved and their relationship to the residency, that writing directly to the journal seems unlikely to lead to a favorable outcome.

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  3. First step would be to address the author of the paper and if no acknowledgement or solution, the author should take it up with her academic institution / residency director.

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  4. Vic Strasburger MDMarch 26, 2018 at 8:23 AM

    p.s. I'd suggest going to your Dept. Chair and asking them to write to the Journal, explaining the situation. You could also file a complaint with your medical school's Ethics Committee. I chaired our University's Academic Freedom & Tenure Committee for many years, and this kind of situation was right up our alley.
    Please let me know what you decide -
    vstrasburger@salud.unm.edu

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  5. Thank you for sharing your experiences Dr. Mathieu. I'm very sorry this happened - it must have been a difficult position to be in as a trainee when you felt you were working with someone who had become a trusted mentor. This is not the first I've heard of writers being edged out of publications after significant contributions. I'm so glad you discussed authorship up front and disappointed your collaborator did not adhere to the initial plan. Thank you for sharing your story to help others be more aware of this issue.

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  6. I empathize. A couple of years ago I wrote a blog on food marketing to children. Healthy kids contacted me and asked if they could put it up on their site. They wanted all the specific references to ads and companies removed, so I spent 2 days editing. When it came time to put it up, they did not want to put my bio on it and, when I insisted, told me that the article did not fit their site after all. A few months later they put up the same basic article written by one of their own people. When it’s done at the top and ignored, it becomes pervasive.

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  7. Committee on Publication Ethics outlines clear mandates when accusations of plagiarism arise. The steps to take are relatively clear. You should write a letter to the editor of the journal that published the manuscript, and outline your concern. You may even want to send a draft of your original writing to support your claim. Per the guideline from COPE (https://publicationethics.org) the editors have an obligation to investigate the concern, and if needed remedy with either retraction, or correction/erratum, or in your case, may even add you as an author. Above all, you should call out the injustice done to you, and not be silent on the issue. Your work deserves the recognition you earned,

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  8. I am so sorry this happened to you, Irene. I agree with going to your department chair. I would also contact your institution's legal department, which likely has a specialist in intellectual property. When I was plagiarized by a fellow (private practice, not academic) pediatrician last fall, I was very fortunate to have the backing of both my dept chair and legal department. I think that legal could also help advise you as you navigate the path of contacting the journal, which I absolutely support. My legal dept sent a cease and desist letter to the plagiarizer who is now required to obtain written permission from both my institution and myself before he uses even edited forms of my material again. My dept chair also sent a letter to the chair where my material was presented without my permission or attribution. I am shocked and appalled that educated professionals can do this so shamelessly and claim ignorance as if they were former Death Eaters under the Confundus curse. I think you are very brave in sharing your experience and hope you will have full legal and collegial support in taking the next steps to reclaim your hard work.

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  9. Several years ago American Journal of Public Health presented a panel of student authors at an annual American Public Health Association conference. A major issue raised by these doctoral and post-doc public health students was plagiarism by more senior professionals and mentors. This is more common than any of us would like to think. The steps suggested like contacting the journal, Dept. chair, and institutional ethics committee are essential.

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