Writing our way through academia: Our journey as young faculty and book authors

Barriers to scholarly writing and publishing in academic medicine

A recent College of American Pathologists survey indicated that the demand for pathologists has grown and is strong, because nearly one half of all respondents were seeking to hire at least one pathologist over the past decade.¹ As the shortage of pathologists and increasing workload continue to grow, finding the time and/or building the necessary scholarly writing skills in academia can be difficult. Previous researchers have identified several barriers to scholarly writing and publishing across various specialties in medicine.² Such barriers include inexperience in writing for scholarly publication, lack of confidence and writing-related anxiety, sensitivity to reviewers' feedback, and perceptions that publishing is optional but not required at their institution.^{2, 3} One way to reduce barriers is to encourage scholarly activity and publishing during medical school. A 2019 study reported that medical students who had published before graduation were more likely to publish more after graduation.⁴ In addition, opportunities to publish during residency could occur with the right mentoring from faculty in graduate medical education training programs.

It is also very easy to get discouraged when a paper is returned with lengthy comments from reviewers. This is especially true for young faculty trying to prove their worth to their institution and to themselves. Imposter syndrome is a frequent experience and certainly can be exacerbated by reviewers' comments. On the flip side, knowing when to challenge certain comments/feedback from reviewers is a delicate process that requires couth diplomacy.

Learning from the right mentor

As trainees and now young faculty members, both of us have been fortunate to have been mentored by some phenomenal mentors. These mentors demonstrated excellence through significant contributions to the field of cytopathology. There is something special about learning from the textbook that a mentor has written and having the opportunity to learn under that same individual. One critical value in a mentor is their ability to provide honest, timely, and constructive feedback. This feedback opens the door to building the mentee–mentor relationship. In addition to this, a mentor should be committed to the trainee and guide them through the process. In many ways, we were lucky because our mentors also afforded us the opportunity to co-author several articles with them during our time as trainees and even afterward. Another critical value of a mentor is the willingness to push the mentee to more ambitious goals. Without this added push, it is often difficult to grow into what you as a mentee are capable of.

Writing an article versus writing a textbook

A first and easy step to authorship is to start from writing and publishing an article. The first article can be anywhere between case reports/reviews, brief reviews, original research, systematic reviews/meta-analyses, and so on. It is never too late to start writing an article, and one should not be hesitant to approach colleagues and senior faculty at their institution to ask for help and suggestions. Starting as a first author and approaching your mentor with an idea and a concrete plan will give confidence to your mentor to support you and guide you throughout the process. It is also wise to discuss authorship and the order of authorship with your mentor from the inception of the project.

Original research articles are considered valuable when applying for a promotion in academia, whereas textbook chapters can bring real value to young faculty and trainees by affording the chance to thoroughly cover a topic with a comprehensive literature review and attention to the organization of high-yield figures and diagrams.

Having and sharing the vision

Writing a textbook can seem like an impossible task, but having a vision will guide you in the direction of success. As trainees, we either preferred reading the books by Rosai and Ackerman or Mills and Sternberg. However, this does not always have to be the way. Having the vision to do something totally different yet useful can be a huge success, especially when the textbook is the first of its kind. To accomplish something brand new, one must survey what is currently available. From there, comparing the pros and cons of each different tool is a valuable process that can help you visualize the perfect tool. With those items in mind, the next step in the process is to clearly outline the purpose and the scope of the book to be published. Although it is tempting to want to be the sole author of the book, it is important to realize that it is unlikely to be the best book for readers because of a lack of perspective. To share the vision, additional motivated academic individuals who would be valuable contributors are needed. Not only would they be valuable for content generation, but they could provide real-time feedback and insight to improve the book.

Identifying the right co-authors

As mentioned above, additional perspective is needed to create the best possible textbook. Identifying the right co-authors can be challenging because content generation for a book requires an extensive investment of time. With the shortage of pathologists and increasing case load, it is difficult to find individuals who are willing to dedicate their time to contribute. This may make the process of bringing the book to fruition more complex, but it will be worth it in the end. When reaching out to possible co-authors, it is important to consider a few things to ensure that they are the right person for the job. Individuals who have been publishing articles and involved in research should be the first to be considered for co-authorship. They already possess a foundation for academic writing and are usually updated with recent advances in their areas of expertise. Moreover, they may also have a trainee to contribute with them. This collaboration would allow individuals to have a mentoring experience while helping build academic writing skills for trainees or junior faculty. The second most important thing is that the leader of a team project must be very clear about the scope of the chapter, the expected time commitments, the order of the authorship, and preliminary timelines for submission. If there is a tight deadline for submission, it is worth setting up an earlier deadline for potential wiggle room. Frequent reminder emails of the submission date can be helpful to meet the deadline.

It is also wise to request a CV and go through the co-authors' publications and research expertise before offering them the job to determine their competency. There is nothing worse than having to re-write or write an entire chapter because it is below expectations or it was never even started by the co-author. In addition, the authorship order, royalties from the book, if any, and other forms of compensation for authors' contributions should be made clear ahead of the assignment. Is it wise to formally write a consent form and have them sign it before starting the project. If this is not done before initiation of the project, then there is a risk that the placement of their name in the book does not meet their expectations (i.e., front cover vs. chapter title page).

Selecting an appropriate publisher

Selecting an appropriate publisher is yet another challenge to get the book published. The majority of publishers are in this as a for-profit business and thus know which books will or will not sell. The best course of action is to identify an academic publisher that publishes textbooks in your specialty. These often will require a specimen chapter to submit to the publisher. After review, there will be a decision after internal review and market research. If a favorable decision is returned, a contract for publishing will be executed and will have specific terms, including deadlines. This is why it is important to meet deadlines if you intend to publish through this route. Other terms of the contract will include language with regard to copyright, royalties, liability, and other issues. The benefit of this process is that the costs are covered by the publisher as well as the marketing.

If you are using an academic publisher and its process does not suit your needs, there are other options for publishing textbooks. Such options include direct publishing (self-publishing) through companies like Amazon, B&N Press, and others. Although they may be less favored by academic institutions, it could be a good first step for young faculty members. Direct publishing offers some challenges because often you must pay for proofreading and editing, marketing, as well as ensuring your material appropriately formats into an e-book. A potential solution to reducing costs for reviewing/editing is to have individuals within the academic community review the manuscript. The challenge with volunteer reviewers is that they essentially have no obligation to do their best work reviewing because it requires more than just reading. Errors in the text that are not caught by reviewers can have a profound impact on the ability to sell the book because of negative reviews made after publication.

Another important consideration about direct publishing is with regard to the ownership of the content and the profit from the book. For example, some individuals are financially motivated to publish books, and they may take advantage of your work while you may not realize it. For example, if there is not an agreement in place, the individual who is directly publishing the book, under a business name or personally, may copy and paste such work into a future book without even asking or making you aware of it. Unfortunately, this occurs and, although unethical and a form of plagiarism, there is little that can be done if no agreement was ever in place.

Conclusion

In summary, the first step to writing a textbook is finding the right mentor who shares your vision. From here, a planned timeline for the completion of the chapters, the identification of reputable co-authors who share the passion of authorship, and finding the right publisher are all needed for the successful publication of a textbook as a young faculty member. The journey to writing a textbook can be difficult; however, in the company of a supportive mentor, dedicated co-authors, and a desire to contribute to the field, it becomes less daunting. We hope sharing our lessons learned will help future faculty member write their way through academia.