By J. Michael Homan, MA, Director of Libraries, Mayo Clinic

Two articles in Academic Medicine’s November issue underscored issues of integrity and professionalism based on the misrepresentation of unpublished manuscripts in residency applications. Although the Grimm and Maxfield study on the ultimate publication rate of unpublished manuscripts listed in residency applications did not include potential scientific misconduct such as plagiarism or image manipulation in their scope, one might logically conclude that some of these issues may have been present in the context of the general increase in instances of plagiarism and other examples of scientific misconduct in academic institutions. Mushlin and Katz noted that residency program directors may choose to overlook certain problems in residency applications by attributing any errors to naiveté.

There is undoubtedly some if not a significant amount of naiveté represented in the cohorts of medical students applying for residency programs. Applicants who have not had sufficient scholarly writing experience may not completely understand the language of scholarly publication, including the publication terms expressing a manuscript’s status in the peer review process. For inexperienced writers, terms in the Electronic Residency Application Service (ERAS) system like “in press” and “accepted” may mean approximately the same thing.

Further, style manuals differ on publication status terminology. While ERAS uses the term “in press,” the National Library of Medicine recommends using “forthcoming” to mean accepted for publication but not yet published:

Forthcoming material consists of journal articles or books accepted for publication but not yet published. “Forthcoming” has replaced the former “in press” because changes in the publishing industry make the latter term obsolete. 

Unintended errors like publication misrepresentation in the residency application process due to inexperience, or instances of plagiarism, could be addressed in the medical school curriculum by including additional opportunities for:

• Writing experiences;
• Instruction and drills in writing originally;
• Experience strategizing on journal submission routes;
• Experience uploading manuscripts to text-matching software to detect potential problems;
• Experience reviewing and interpreting author guidelines in key journals;
• Preparation of manuscripts for submission to journal publishers.

Text-matching programs in particular can be very instructive and powerful teaching tools by uncovering instances of matches caused by sloppy writing habits (e.g., forgetting to add quotation marks around direct quotes) or self-plagiarism – and in advance of manuscript submission. Professionalism and trust are the key concepts in Grimm and Maxfield’s study and highlighted in Mushlin and Katz’s commentary, but nothing trumps actual experience with original writing and participation in the scholarly publication process as potential solutions, particularly when guided by a trusted  mentor or experienced peer.