Ethical considerations of assigning first authorship to medical students

Authorship on a medical research publication signifies a significant contribution to a study, with first authorship indicating the individual with the most substantial input. Unethical misuse and misinterpretation of authorship unfortunately persist, driven by increasing pressure on medical students to publish to secure competitive residencies. Assigning first authorship to medical students without meaningful contributions raises ethical concerns. We explore the root causes of authorship misuse, forms of authorship violations, and their practical and ethical implications for residency applications. We advocate for a shift toward a holistic evaluation of residency candidates, emphasizing the importance of fostering authentic and meaningful student research experiences. To uphold research integrity, authorship must be based on substantial contributions to study design, data collection, and manuscript preparation, ensuring fairness and credibility in scientific research.