Co-first author

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Endoxifen

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How are co-first authorships viewed by MD and MD/PhD programs? My PI wants to combine two manuscripts into one paper, putting both the original first authors (me and a resident) as co-first authors. At my level of training, any authorship is a good authorship. Still, I’d like to be aware before going in if this co-first is really just a glorified second. Thanks!

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It'll be equally impressive as first-authorship. As science gets more collaborative nowadays, it's harder and harder to determine authorship order and we've seen a lot more co-authorships lately or even manuscripts where the authors claim to all have contributed equally to the project. Gone are the days where the lone scientist can conduct all the experiments for a project by him/herself.
 
You don't need manuscripts to be looked at favorably by MD or even MD/PhD programs, so either first or second would be excellent for you.

As for co-authorship, if it's real, the manuscript will have a little asterisk saying "* these authors contributed equally to this work". As long as that's in place, you have a first author paper.
 
It'll be equally impressive as first-authorship. As science gets more collaborative nowadays, it's harder and harder to determine authorship order and we've seen a lot more co-authorships lately or even manuscripts where the authors claim to all have contributed equally to the project. Gone are the days where the lone scientist can conduct all the experiments for a project by him/herself.
You don't need manuscripts to be looked at favorably by MD or even MD/PhD programs, so either first or second would be excellent for you.

As for co-authorship, if it's real, the manuscript will have a little asterisk saying "* these authors contributed equally to this work". As long as that's in place, you have a first author paper.

So co-first author = first author? Just wanted to clarify because some SDNers in Physician Scientists argue that co-first author = second "first author" = glorified second author because the paper is cited as first "first author" et al.
 
So co-first author = first author? Just wanted to clarify because some SDNers in Physician Scientists argue that co-first author = second "first author" = glorified second author because the paper is cited as first "first author" et al.

Yes. Co-first author = first author. It literally means that there are two first authors.

When there are two people, someone has to be listed first (usually the person with the name closest to A in the alphabet), but that's why the manuscript always has some way to denote that there are multiple first authors. If you end up listed second but you are a co-first author, anyone can just look at the manuscript and verify that.
 
So co-first author = first author? Just wanted to clarify because some SDNers in Physician Scientists argue that co-first author = second "first author" = glorified second author because the paper is cited as first "first author" et al.

This point is much more nuanced than I could describe because that would just open up a whole new can of worms and confuse everybody else. For pre-meds, co-first author = first author. Both super impressive. When you put it on your CV or list it, you can use the asterisk notation to denote co-first authorship. I wouldn't do something like change the actual order of the citation since that might seem misleading if people don't look into it deeper.

In more nuanced terms, academia has always struggled with co-authorship because it's relatively new as I said and we don't really know how to deal with co-first authors. Do we say "X and Y, et al." or stick with "X, et al."? Or do we just list the PI since that will likely be the better known name and gives the reader a better sense of where all this work is happening? So the problem is, while co-first author means that the author who is spatially second in the author list still contributed significantly to the work - at a level that is equal to that of the first author - practically this means that he or she gets the short end of the stick. The first spot has always been given the most "prestige" but in terms of substance, which is what matters here, co-first authors are the same.
 
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