My Journey as a Medical Ghostwriter: How I Broke Into the Field

Why I became a medical ghostwriter, what I've learned, and why I'm ready for change

I've been working behind the scenes as a medical ghostwriter for over 13 years. Recently, I tried asking for career advice in an online community of medical writers, and well... it didn't go so well.

I never imagined my post would upset some members so deeply. I felt like I was unwanted, maybe even seen as a threat. So, I quickly deleted my post and felt really awful about it.

Today, I’m here to tell my side of the story. Before you judge, let me share why I took this path and how I navigated through challenges and necessity over the years.

Why and What I Did Wrong?

I’ve been a ghostwriter throughout my whole medical writing career. It’s been over 13 years since I started my freelance journey back in 2011. I've ghostwritten almost all types of academic literature. Just see my medial writing portfolio.

Please don't misunderstand; I'm not boasting! I know you consider this as contract-cheating. However, even if you consider this academic misconduct or dishonesty, I believe I wouldn't have the skills and experience I have today if I hadn't done so.

To be honest, I was, and still am, not in a position to enroll in a prestigious institute like yours. What you learned from your institute about academic research and writing, after paying a hefty amount and studying for about 4-5 years, I learned it through a process called on-the-job learning.

My clients, in a way, unknowingly sponsored me to learn how to write in order to complete their work.

When I started my freelance career, my financial condition was too dire. Being in one of the poorest regions of the world, my first priority has always been to make ends meet.

Unlike you, I didn’t have the flexibility or luxury to choose between different job options! I had to take the chance by bidding on those odd job posts in freelance marketplaces, hoping to get some work.

How I Broke into the Field of Medical Writing?

About a decade ago, I got a freelance gig writing a scholarly book chapter on the neurophysiological effects of a specific therapy, using the Harvard reference style. When I got the gig, I didn’t know anything about the therapy.

Although my background was in Pharmacy, the therapy was totally alien to me. And to be honest, I had limited understanding of drug pharmacology at the time. Any sane person would have straightly said "no" to the gig as soon as they realized its difficulty and complexity.

But I couldn't afford to turn it down. My financial situation was so dire that I struggled to afford baby food for my child. It was like a do or die situation for me, where I couldn't let the amount held in escrow slip through my fingers without giving a fight till the end. So, I turned to Google to find all the free resources available online, which led me to explore PubMed and Sci-Hub.

At that time, I had no idea how to do a proper search on PubMed. I started with a basic search, found some relevant papers on my topic, and then checked Sci-Hub for their availability. After downloading them, I read the articles thoroughly a few times, scrutinized the citations, and followed the trail from one paper to another.

It took days just to grasp the core of the topic. Four days in, I wrote the first line, and it took another three days to complete the entire chapter of about 3,000 words. Upon submitting the final version, my client was so pleased with the work that she offered me the opportunity to write the entire book. That project restored the self-confidence I had been missing for years.

Since then, I’ve never looked back—even when a job seemed too challenging, I had the confidence to apply. This experience eventually led me to journal manuscript writing.

READ: How to Become a Medical Writer(↗️)

My Thoughts on Ghostwriting

You might accuse me of academic misconduct or contract cheating, but that doesn’t mean my voice shouldn’t be heard. Regardless of your opinion, ghostwriting has always been a burning issue in academia (DeTora et al., 2019; Padillah, 2023), and I believe it will always be!

Despite many reforms suggested over the years (Leo et al., 2011; Bosch, 2011; DeTora et al., 2019), none seemed to work out. Interestingly, a recent survey by McDowell et al. (2019) found that 50% of respondents admitted to ghostwriting a peer review report, even though over 80% considered it unethical. Table 5 of their study was particularly striking!

This issue is even more prevalent in other parts of the world, especially in Asia and the Middle East, where many are not even aware of what ghostwriting actually is.

I'll quote another recent study by Hamza et al. (2022) here. They reported that, of the 682 students included in their study, 60% were unaware of academic misconduct, and 70% had never received any formal training on academic integrity.

With the introduction of advanced LLMs like GPT4o, Claude 3.7 Sonnet and Gemini, academic misconduct will become even more widespread in the coming days. Unfortunately, as Elkhatat et al. (2023) pointed out in their recent investigation, we still lack reliable AI content detection tools.

The authors tested several AI detection tools, including OpenAI, Writer, Copyleaks, GPTZero, and CrossPlag, but found that all of them produced false positives when evaluating human-written content. The problem I found with these tools is that they consider any polished writing as AI written.

Why Have I Written This Long Post?

I’ve been in the ghostwriting loop for over a decade now and I wanted to break free from it. But I couldn't!

And with no valid AI detection tool in the corner, it will become increasingly difficult to distinguish between AI-generated and human-written content. If the situation worsens in the future, you never know, but you may end up doing what I am doing now.

I’ve already seen many PhD holders doing ghostwriting jobs in freelance marketplaces. The number will surely rise in future!

Thank you all!

References

• Bosch, X., 2011. Exorcising ghostwriting… Ghostwriting could potentially have serious repercussions for science and should therefore be treated as research misconduct. EMBO reports, 12(6), pp.489-494.
• DeTora, L.M., Carey, M.A., Toroser, D. and Baum, E.Z., 2019. Ghostwriting in biomedicine: a review of the published literature. Current medical research and opinion, 35(9), pp.1643-1651.
• Elkhatat, A.M., Elsaid, K. and Almeer, S., 2023. Evaluating the efficacy of AI content detection tools in differentiating between human and AI-generated text. International Journal for Educational Integrity, 19(1), p.17.
• McDowell, G.S., Knutsen, J.D., Graham, J.M., Oelker, S.K. and Lijek, R.S., 2019. Co-reviewing and ghostwriting by early-career researchers in the peer review of manuscripts. Elife, 8, p.e48425.
• Hamza, M.A., Al Assadi, F.R., Khojah, A.A., AlHanaki, R.M., Alotaibi, N.T., Kheimi, R.M., Salem, A.H. and Marar, S.D., 2022. Contract Cheating and Ghostwriting among University Students in Health Specialties. Journal of Empirical Research on Human Research Ethics, 17(5), pp.536-544.
• Leo, J., Lacasse, J.R. and Cimino, A.N., 2011. Why does academic medicine allow ghostwriting? A prescription for reform. Society, 48, pp.371-375.
• Padillah, R., 2023. Ghostwriting: a reflection of academic dishonesty in the artificial intelligence era. Journal of Public Health, p.fdad169.