Contemporary biomedical research is performed by increasingly large teams. Consequently, an increasingly large number of individuals are being listed as authors in the bylines, which complicates the proper attribution of credit and responsibility to individual authors. Typically, more importance is given to the first and last authors, while it is assumed that the others (the middle authors) have made smaller contributions. However, this may not properly reflect the actual division of labor because some authors other than the first and last may have made major contributions. In practice, research teams may differentiate the main contributors from the rest by using partial alphabetical authorship (i.e., by listing middle authors alphabetically, while maintaining a contribution-based order for more substantial contributions). In this paper, we use partial alphabetical authorship to divide the authors of all biomedical articles in the Web of Science published over the 1980-2015 period in three groups: primary authors, middle authors, and supervisory authors. We operationalize the concept of middle author as those who are listed in alphabetical order in the middle of an authors' list. Primary and supervisory authors are those listed before and after the alphabetical sequence, respectively. We show that alphabetical ordering of middle authors is frequent in biomedical research, and that the prevalence of this practice is positively correlated with the number of authors in the bylines. We also find that, for articles with 7 or more authors, the average proportion of primary, middle and supervisory authors is independent of the team size, more than half of the authors being middle authors. This suggests that growth in authors lists are not due to an increase in secondary contributions (or middle authors) but, rather, in equivalent increases of all types of roles and contributions (including many primary authors and many supervisory authors). Nevertheless, we show that the relative contribution of alphabetically ordered middle authors to the overall production of knowledge in the biomedical field has greatly increased over the last 35 years.