Multiple First Authors in Dermatology Publications: An Oxymoron?

First authorship peer-reviewed publication in medicine and other scholarly fields is prized by authors and highly respected by other academics because of its prestige and community acknowledgement about responsibility for the reported work. First authors may eventually be rewarded for their effort by preferential selection for prestigious and competitive positions (such as medical school admissions and dermatology residencies), and on the faculty level, with promotion and tenure. Traditionally, there was usually one first author. First authorship in multiauthored should ideally identify the person most responsible for the publication. Typically the person who initiated the work, wrote the first draft and coordinated all revisions, submitted the work, responded to reviewers, corrected the proofs, etc is listed as the first author. The UTMB DIG recently became aware that a highly innovative and respected dermatology journal published an article this month with two “first authors” (seehttp://escholarship.org/uc/item/5037g18h ). Will this become a growing trend in the dermatology literature? Would it ever be possible that all the authors of a multiauthored work could be first authors? Will selection committees treat each of the multiple first authors as the first author? Or will they concluded that a multiple first author publication really does not have any first authors? Hopefully academic journals will address this concern and issue future guidelines, if they have not already done so.