What constitutes an author on a paper? Who qualifies for authorship? How many authors are allowed on 1 report? How should they be listed? How should they be cited? Although conducting the research, analyzing the data, and writing the manuscript may be the key elements of a scientific report, these questions are asked frequently. At times, the issues can be puzzling and a source of consternation. In this Editor's Message, we provide some thoughts. When we were residents in the 1980s, Neurosurgery allowed a maximum of 7 authors per paper; any more required approval from the Editor-in-Chief. Dr Edward Laws, Neurosurgery Editor-in-Chief from 1987 to 1993, told me recently (D.K.) that authorship number was a key concern even then. At the Journal of Neurosurgery, cited references list only the names of the first 3 authors, followed by “et al.” Because of that, often the first 3 author positions were more highly coveted. In some reference styles, 6 names are listed before et al, so positions through the sixth author are coveted. As a benchmark for the broader world of medical publishing, the International Committee of Medical Journal Editors recommends 4 criteria, all of which must be met to earn authorship1: 1. Substantial contributions to the conception, design, acquisition, or analysis of data; 2. Drafting or critically revising the manuscript; 3. Final approval of the manuscript; 4. Agreement to bear responsibility for the integrity and accuracy of the work. Certain journals identify which of a list of individual criteria each author of an article is considered to have met. What is our neurosurgical tradition for authorship? Often, the first author has performed a preponderance of work and may have had the primary responsibility of writing the manuscript. The second author commonly has had a similar significant role. Occasionally, these individuals may choose to state that they were “cofirst authors,” which may be of importance to university promotion committees, other oversight boards, or even department compensation schemes. Typically, the “senior author,” or corresponding author, may be listed last—but sometimes first, particularly if the report represents a body of work to which they had long committed their career or that they developed from start to finish and wish to claim the recognition that the first author position reflects. Of course, some studies are recalled by the name of the first author and not the last. The 1990 “Patchell” study on brain metastasis resection is a well-known example in surgical neuro-oncology. The number of authors listed per report has been increasing over the past decade.2 In the early 1980s, there was a mean of 2.8 authors per article in Neurosurgery, then by 2000 approximately 4.5, and during 2016 to 2020, 7.97. The numbers are virtually identical for the Journal of Neurosurgery. How did this change? First, there have been far more multicenter studies. Registry-based science with numerous contributors and multicenter studies that aimed to collect larger pools of data have provided new avenues for often stronger science than could be provided from single institutions. Older readers will recall that such studies used to be listed under a limited number of key authors followed by “and the XYZ arteriovenous malformation study group” or something to that effect. The entire author list would be in the acknowledgments section of the article only. More recently, we have seen a more middle ground, listing a large author group that could include 10 to 25 or so names. Who should qualify? As an example, one such group is the International Radiosurgery Research Foundation, created to address scientific questions beyond what most single centers could study. When a project is proposed by a specific group, it is evaluated by a research committee. If approved, a data collection spreadsheet is made and author guidelines are proposed (usually 2-4 authors per center maximum). When I have been involved (D.K.), we typically suggest 2 to 3 authors from our own institution. Those proposed coauthors provide data from our prospective registry together with other fields as needed from our medical record: 1 author representing data collection, study oversight, and manuscript review; one representing data collection and auditing; and one for data analysis. There are many such collaborative multi-institutional groups. Truly important work has come from spine registry science and other similar initiatives. Larger author pools go along with better science. John Ioannidis3 from Stanford has written on the quality of the medical literature and why many published articles could, in fact, be “wrong.” He provides some guidance on how to address these shortcomings.4 In a prior Editor's Message, I discussed the reproducibility of good science because we aim toward consistency and validation. One key proposal was for more multicenter studies. Neurosurgery Publications has changed the listing of authors on the article title page to horizontal as opposed to vertical. We did this because as the number of authors increased, the length of the vertical listing increased. When an image of the abstract was used in a slide, this led to the need to use a reduced magnification, making the image harder to read. With a horizontal listing of authors, the title, authors, and abstract can be shown more prominently. There is another evident recent dynamic: application toward neurosurgery residency, at least in the United States, has changed. Some differences include virtual interviews at some programs, standardized reference letters, and lack of medical school step 1 board scores, meaning that it may be harder for programs to judge applicants on their academic merits. To fill that void and to distinguish themselves, many applicants feel that they need to be authors on more published research reports, as a sign of their commitment to the specialty. Some even take a year off of medical school for additional research time. As they work towards authorship on as many articles as possible, in whatever journals deem their work suitable, the numbers climb further. Quantity may be the short-term goal over more in-depth and higher quality research experiences. This dynamic moves along with the growth in annual neurosurgical topic manuscripts for all journals per year, which was around 2000 in the early 1990s, 3000 by the mid-2000s, passing 6000 in 2017, and recently up toward 8000. Our goal at Neurosurgery Publications is to attract the best science and to provide a formal archive for the work of contributing authors. Listed authors should have contributed meaningfully to the submitted science. We support all those who do work to create the best message for our readers, whether they be the scientific community or the general public. Douglas Kondziolka, MD, MSc Editor-in-Chief, Neurosurgery Publications New York, New York, USA Fred G. Barker II, MD Associate Editor, Neurosurgery Publications Boston, Massachusetts, USA