Case Report - Do I need a faculty member?

[inspirationmd]

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So I am on an off service rotation and I saw a cool case. I wrote it up really quickly over the weekend and wanted to know in order to increase my chances of success for publication, do I need a faculty member name on it or can I go it solo and have a decent chance?

 

[mlw03]

i would think so, yeah.

 

[gutonc]

Not necessarily, but it is the "right" thing to do and, if the attending (and fellow, resident, other students) you saw that patient with find out you wrote it up, submitted and got it published without them, find out you did it, you'd better hope you're long gone from that institution when it happens.

Send an email that says, "hey Dr. Jones, I wrote up this case report on Mr. Smith we saw last week. Can you look over it and suggest a good journal that we can submit it to?"

 

[inspirationmd]

Not necessarily, but it is the "right" thing to do and, if the attending (and fellow, resident, other students) you saw that patient with find out you wrote it up, submitted and got it published without them, find out you did it, you'd better hope you're long gone from that institution when it happens.

Send an email that says, "hey Dr. Jones, I wrote up this case report on Mr. Smith we saw last week. Can you look over it and suggest a good journal that we can submit it to?"

Ok, the thing is I am kind of wary since all through med school I did the bulk of the work just to turn around an end up 2nd author or even further down because I was the low man on the totem pole. Don't get me wrong I am happy for the research opportunities I have had and I still get a little happy when I see my name on pubmed but for once i would like it to be obvious who did the work not who the attending is.

I will aend the email to the original attending since you are right it is the "right" thing to do. Three services ended up involved though it was our original patient so does each one need to be represented?

 

[gutonc]

I will aend the email to the original attending since you are right it is the "right" thing to do. Three services ended up involved though it was our original patient so does each one need to be represented?

If 3 services were involved and it was cool enough for you to think it needed to be written up, there is a 95% chance that somebody else who had a hand in the case is also writing it up as you speak. Perhaps they're being even more of a gunner than you are (which is a little hard to believe) and have already submitted it without your name on it at all.

Yes...you need to involve the other services in this. If nothing else, a courtesy email stating that you're about to submit this case is necessary.

 

[Janedoedoctor]

You came very close to making a huge mistake here.

Being a guest on the team, this was not YOUR patient in any way, shape or form. You didn't contribute significantly to the diagnosis or treatment. So what gives you the idea that you should be the only person to get the scientific credit for this case?😕 The mere fact that you sat down at your computer last saturday and typed out the story?

Most trainees (including myself) get robbed of their rightful authorship positions at least once during their training. I completely agree that IF you'll be the one to write most of the article and do the literature search, you should be first author. But who gets the opportunity to do the writing is ultimately decided by the attending(s) whose patient it was.

I don't think it is possible to get something published all by yourself as a resident. I don't think it would be right either. You didn't diagnose and treat this patient in your own backyard under your own responsibility. You were a guest on someone else's service, and the patient was there to see them, not you. At the very least you need to make the attending or the PD the last author to acknowledge this.

If you would really manage to get this case published with only your name on it, you would piss off a lot of people high on the totem pole. You don't want that.

 

[nitemagi]

Another serious consideration is to get a faculty that's publication savvy to be a co-author. They'll be able to help with editing, and may be able to look out appropriate data to include and exclude, as well as help in picking the journal to submit. Not all journals accept case reports, and those that do may have specific criteria they want in it. You'd be surprised how much politics goes into getting something published (including knowing the editors and their individuals likes/dislikes).

 

[inspirationmd]

Yeah I am glad that SDN is here. I almost made a total a** of myself and I want to thank all of you for talking some sense into me. Its really easy to get caught up and lose sight of how a positive action (ie publishing) could cause serious consequences (ie. being on the **** list of attendings I will see for a long time to come).

I spoke with the attending and she is on board. She will think about a list of journals to submit to. I'm going to email her my draft and see what she says. Next is catching a radiologist to give me some stills from the imaging. I know case reports are hard to get published nowadays so it might not even work out but its worth a shot.

Thanks again everyone!

 

[Buzz Me]

Trust me, you're going to want an attending experienced in submitting articles (especially case reports) to journals in order to proofread for you. Don't do it solo.

 

[Seldon1985]

In addition to what others have stated above (definitely pay attention to it), you'll raise eyebrows if/when someone sees a solo-author paper on your ERAS application, esp for someone at such an early academic stage. Like it's been said, get a faculty co-author on board that was involved with the case AND is publishing so that you can not only get your case report optimized for acceptance but also someone that would have the process streamlined.

 

[Shoushu]

you'll raise eyebrows if/when someone sees a solo-author paper on your ERAS application, esp for someone at such an early academic stage. Like it's been said, get a faculty co-author on board that was involved with the case AND is publishing so that you can not only get your case report optimized for acceptance

Almost all who apply by ERAS have only been co-author or as a minor author? A major-author/first-author publication must carry a lot of weight then?

I also didn't know it's so-hard to get even a case report published. There're thousands of medical journals, and tens of thousands of science periodicals . They don't seem to have much space for students, trainees.

I hear case-report, lit review, meta-analysis are the easier things to get published....

 

[inspirationmd]

Almost all who apply by ERAS have only been co-author or as a minor author? A major-author/first-author publication must carry a lot of weight then?

I also didn't know it's so-hard to get even a case report published. There're thousands of medical journals, and tens of thousands of science periodicals . They don't seem to have much space for students, trainees.

I hear case-report, lit review, meta-analysis are the easier things to get published....

The thing is you want it to be in a reputable journal not a full blown throwaway journal. The more established ones seem to have moved away from case reports and want original contributions mainly now except for brief research reports, special articles, etc. I actually have 2 2nd authorships on original research in major journals among my other stuff and it does help a lot with ERAS for academic programs as long as you can speak intelligently about the project and can clearly state what your role was. Anything below 3rd author honestly is just noted for the most part unless it's RCT studies/NEJM or Lancet type studies.

 

[inspirationmd]

I have two single author publications in respectable journals that were published when I was a medical student and this has never raised any eyebrows so I am not sure what you are on about. At one interview one professor did comment on this and asked if anyone had seen one of the papers prior to submission (which they hadn't), but seemed more impressed than anything else.

That said these weren't case reports and I have always discussed my intentions for writing up a case report with the relevant attendings. Where there are multiple specialties involved it is important to let them know if they have contributed meaningfully. If imaging is an important part of the case, then the radiologist should be involved as well. Sometimes there can be a competition between different departments for the write up so make sure you get the consent from the patient first. many journals have a consent form so I usually get the patient to sign the forms for all the journals I am thinking of submitting to and put a copy of the consent in the medical notes.

Great information regarding the single author publications. I did not know this could be done and will keep it in mind for the future. I think it would sharpen research skills and I would think its impressive.

To be honest I doubt the radiologist or surgeons will give a s*** given the angle I am taking to get it published which the attending likes. In fact the surgeons did not even do anything but watch the pt on their service before they discharged him. Going to speak to the research director for my residency and the original attending about proper etiquette regarding informing folks but I do not think anyone beyond the primary service will want to be on it.

 

[gutonc]

Great information regarding the single author publications. I did not know this could be done and will keep it in mind for the future. I think it would sharpen research skills and I would think its impressive.

To be honest I doubt the radiologist or surgeons will give a s*** given the angle I am taking to get it published which the attending likes. In fact the surgeons did not even do anything but watch the pt on their service before they discharged him. Going to speak to the research director for my residency and the original attending about proper etiquette regarding informing folks but I do not think anyone beyond the primary service will want to be on it.

This is a reasonable and appropriate approach. You're probably correct about the other services not caring about the write-up but it's common courtesy to let them know about it.

(I say the following as a committed ivory tower academic)...It's amazing how butt-hurt some people in academics can get when they feel they've been slighted, especially by somebody "below" them on the totem pole. And they tend not to forget it.

I've said this before in other settings but it bears repeating here. Medicine is a world where permission is relatively freely given but forgiveness is not. You're too early in this process to start crossing people, even ones you don't think will ever matter.

 

[Law2Doc]

...

I don't think it is possible to get something published all by yourself as a resident...

perhaps not in this particular circumstance. But solo resident publications are not at all uncommon -- a lot of us have them. In this particular case it makes sense to involve the attending because 1. It's his/her patient so ethically you ought to at least give them the option of being involved, 2. Bigger names increase the odds of getting published or accepted by the specialty organization meeting, 3. In a peer review setting where folks may question your findings it's nice if someone with an actual attending level job is there to help defend controversial positions/findings/statements, 4. Folks who have published more tend to be better at getting things in the format they need to be and will be helpful in writing it up, 5. To the extent you need a support staff to make up posters, help edit etc, an attending can mobilize the troops in ways you can't.

 

[adam6]

Lots of good advice in this thread. I agree with the balance of the opinions. Regarding informing other involved services - this is certainly the courteous thing to do. However, people should provide meaningful contributions to the publication to be included in the authorship list. Institutions usually have written policies about authorship and not just "tagging people." Though I am quite certain there are many (political) exceptions ha ha.

 

[mlw03]

I'm a pathologist and I was lucky to get on a few papers with admittedly little effort beyond taking photomicrographs. I'm not sure how I feel about this overall to be honest. Do I deserve a publication for such little effort compared to the lead author? My brother is a PhD student and has told me MDs seem to have much longer author lists than PhDs. Looking at journal articles in medicine, I don't doubt him.

 

[Buzz Me]

I'm a pathologist and I was lucky to get on a few papers with admittedly little effort beyond taking photomicrographs. I'm not sure how I feel about this overall to be honest. Do I deserve a publication for such little effort compared to the lead author? My brother is a PhD student and has told me MDs seem to have much longer author lists than PhDs. Looking at journal articles in medicine, I don't doubt him.

Where are you among the authors? Second, third, fourth?

 

[Mattchiavelli]

The thing is you want it to be in a reputable journal not a full blown throwaway journal. The more established ones seem to have moved away from case reports and want original contributions mainly now except for brief research reports, special articles, etc. I actually have 2 2nd authorships on original research in major journals among my other stuff and it does help a lot with ERAS for academic programs as long as you can speak intelligently about the project and can clearly state what your role was. Anything below 3rd author honestly is just noted for the most part unless it's RCT studies/NEJM or Lancet type studies.

Yeah I was talking to my old advisor about this, she says there is a movement to bring back the case report's legitimacy but it "hasn't reached critical mass." Not to pee on any parades, cuz I had a cool case I wanted to try to publish too that got the kibosh put on it. Help it reach critical mass and try to publish it!

 

[mlw03]

Where are you among the authors? Second, third, fourth?

third or fourth i think. somewhere nestled towards the end, where i belonged.

 

[Valadi]

I've said this before in other settings but it bears repeating here. Medicine is a world where permission is relatively freely given but forgiveness is not. You're too early in this process to start crossing people, even ones you don't think will ever matter.

Whoa this is deep. I'm going to make sure to keep it in mind.


What a lot of people have been doing recently is nestling case reports into reviews. It's worth considering if you can't get the case report alone published.