The apparent trends we have observed over 6 years may be of interest to the medical research community. I was promised first authorship when I completed a project. The total non-US citizen population of faculty, staff, trainees, and students is not available. The increase in reported authorship disputes has been far greater than the increase in either total issues brought to the Ombuds Office or in the size of the population served. It occurred despite the Harvard Medical School's school-wide guidelines.
Females report more difficulties than males.
Non-US citizens may have similar problems coping with the credit assignment system. With the absence of other similar published evidence, it is only a supposition that similar phenomena are occurring at other medical research institutions. Departments should establish their own detailed, written guidelines on authorship practices and make them available to everyone. These guidelines should be discussed both prior to the onset of a relationship and regularly so that people are comfortable asking questions about their work and how it will be credited. It is unreasonable for institutions to promise that they can protect individuals from retaliation for coming forward to complain through formal grievance procedures.