Over the last 2 decades, misrepresentation of publications has been documented among residency and fellowship applicants in multiple specialties.1–5 Misrepresentation includes claiming authorship of a nonexistent article, falsely claiming authorship of an existing article, and elevating author rank.1 This unethical behavior violates the integrity and trust instilled in the medical profession; both are essential for not only the care of patients but also the dissemination of knowledge. This publication misrepresentation also may distort match outcomes.4 Adopting stricter documentation requirements for application submission would enhance applicant accountability and likely reduce misrepresentation.
For published journal articles, the Electronic Residency Application Service (ERAS) requires the applicant to input standard citation information, and provides an optional field for the PubMed Identifier (PMID). However, the addition of this optional field to ERAS has not reduced the incidence of unverifiable journal articles.5 A more effective strategy would be to require applicants to upload a PDF of the article, thereby holding applicants more directly accountable and impeding misrepresentation. In addition, data entry fields could be added for the URL and the digital object identifier (DOI), which provides a permanent link to recently published articles. It would be reasonable to require completion of at least 1 of these electronic records, as it would be extremely rare for a recently published journal article to lack all of them.
For unpublished journal articles, ERAS requires applicants to describe the publication status as submitted, provisionally accepted, accepted, or in press. These categories are somewhat subjective. For example, it is unclear whether a journal's request for major or minor revisions constitutes provisionally accepted, or what threshold differentiates in press from accepted. In addition, ERAS does not request any mandatory or optional documentation to verify these assertions. Definitions and examples of publication status should be provided to encourage applicants to report the status accurately, and applicants should be required to upload acceptance, revision, or submission messages from the relevant journal.
Though ideally applicants would not be tempted to misrepresent their applications in the first place, these practical reforms could help prevent misrepresentation and restore integrity to the application process.
