Perceived Unethical Authorship Practices: A Survey Among Medical Students Interested in Plastic Surgery

Purpose: Authorship plays a crucial role in academic medicine. It significantly impacts residency placement for students, especially in competitive specialties like plastic surgery. Despite the existing guidelines, widespread ethical concerns remain unsettled. This study aimed to explore the understanding, perceptions, and attitudes of authorship practices among medical students interested in plastic surgery to evaluate the need for more comprehensive analysis and to generate hypothesis-driven insights to enhance research integrity. Design: An IRB-approved, anonymous 29-question survey was distributed to medical students interested in plastic surgery to explore their understanding, perceptions, and attitudes in authorship practices. Results: A total of 46 students met inclusion criteria. Although 82.6% reported awareness of authorship criteria, only 21.7% reported receiving any formal training. Misconceptions were common, as many students endorsed non-qualifying contributions as sufficient for authorship. Perceived unethical authorship practices, including ghost and honorary authorship, were reported by 32.6% and 52.2% of respondents, respectively. These were often reported to be driven by seniority, institutional norms, and publication pressure. More than a third of respondents reported experiencing unfair authorship orders. Over a quarter had experienced disputes, yet few were aware of or utilized institutional resources. Conclusion: Medical students interested in plastic surgery report frequent challenges related to authorship in research. These findings likely reflect a combination of misunderstandings of authorship criteria and true deviations from established standards, both of which have important implications for ethics education, mentorship, and institutional policies. As a preliminary analysis, these results support the need for further large-scale investigation to validate findings.