How to Publish in Biomedical Journals

As an EMWA member, you probably reckon you're pretty good at writing. Well, this is an advantage when it comes to preparing publications, but it's not the whole story. Peer-reviewed journals have their own rules and conventions, and you need to understand them. One difference from regulatory writing is that you do not have a captive audience. If you want to get published, you must first persuade the reviewers and editor to accept your work. So, here is a 10-point plan to help you get published. Please note that although I have used the term "author" for simplicity, many of the roles could apply to professional writers or author's editors.

1. Choose the right journal

Consider the implications of your research, your intended audience and the message you want to communicate. Ask colleagues which journals they read and respect. Browse back-issues to understand the journal's scope. Check that the format you have chosen is acceptable (e.g., don't send a review to a journal that only publishes original research).

2. Keep the journal and your intended audience in mind as you write

Ask yourself, "Why would these people want to read my paper?" Check for specific instructions about length and format and stick to these.

3. When you've finished writing, read the Instructions to Authors again

Few things exasperate editors more than authors who ignore their instructions. Although ground-breaking findings are unlikely to be rejected because of a few typos, paying attention to detail usually pays off. The CONSORT guidelines provide an excellent checklist for the components of randomised trial reports and many journals ask authors to adhere to these. Get the latest version from www.consort-statement.org.

4. Start gathering the things you need for the submission package as soon as possible

By the time you come to submitting a paper, you will either be fed up after umpteen revisions or facing a deadline. Either way you will want to submit as quickly as possible. Check the items you will need (such as authors' signatures, copyright permissions) and have them ready at the pre-final draft stage to avoid last-minute stress.

5. Remember what the reviewers and editors will have to do

Most journals want everything double-spaced with wide margins on numbered pages. This is to help reviewers and technical editors mark their suggestions and queries on the paper. 

6. Facilitate masked review

Put author details on a separate title page (start the abstract on the next page). Do not include authors' names in headers, footers or file names. This will assist journals that remove author details before sending papers to reviewers.

7. Write a good covering letter

• Use headed paper to indicate where you work.
• Get the editor's name right: sending a letter to the previous editor does not inspire confidence.
• Describe, very briefly, what you found and why this will interest readers. 
• Briefly explain the key message and implications of your findings.
• Tell the editor why you are submitting to his journal.
• Show an understanding of the journal's readership and/or previous related publications. 
• Consult the Instructions to Authors for necessary wording, e.g., that the paper is not being considered for publication by other journals.

8. Submit your paper 

But only after having read the Instructions to Authors yet again to check that you've included all the bits and pieces.

9. Wait!

Journals usually acknowledge receipt of submissions and may assign a reference number for further correspondence. Once you have received this acknowledgement, all you can do is wait. A few journals (notably the pay journals and electronic ones) aim to make a decision in a couple of weeks. For the rest, decision-making usually takes from 3 to 6 months. 

Four things can happen to your submission:

• Outright rejection
• Rejection with an invitation to make major changes and resubmit 
• Acceptance conditional on responding to reviewers' comments
• Unconditional acceptance.

If your submission is rejected

Read the reviewers' or editor's comments carefully after the initial disappointment has worn off. Put them away for a couple of days, then read them again and decide, with your co-authors, whether to change the paper. 

Re-submitting to the same journal is not usually worthwhile. However, if you feel your paper has been completely misunderstood, or you are able to answer major criticisms, it may be worth appealing against a decision. In most cases, though, it is better to submit elsewhere.

If you get a conditional acceptance

Virtually all acceptances are conditional on the authors responding to the reviewers' comments. Remember that you do not have to make all the changes the reviewers suggest, but you do have to answer all their concerns. If you are unwilling to change something, you must give convincing reasons. 

After you have revised your manuscript, prepare a response describing what you have done. If reviewers number their comments, use this system for your response. If you have rejected a suggestion, give the reasons. 

If you come across errors or feel inspired to make changes not suggested by the reviewers, you should identify these in the response. In most cases, editors are happy to accept these, since it is easier to make changes at this stage than after typesetting. However, if you have had a conditional acceptance, count your blessings and don't rewrite your paper completely.

Some journals return revised papers to the reviewers, in other cases the editor decides whether the paper is now acceptable. Sometimes journals send papers to another reviewer, e.g., a statistician. Whichever applies, you will get a response to your revised submission. In some cases, you will be asked to make further changes. The same rules apply. 

When the paper is acceptable to the journal, you will get a final acceptance letter. Keep this in case you want to cite your work elsewhere before it is published, since many journals require evidence that a paper is "in press".

If you get an unconditional acceptance

CELEBRATE!

10. After your paper has been accepted

The next time you see your paper will be as proofs, but before it is typeset it will undergo technical editing. Editors of specialist journals may do this themselves, but in larger establishments this is done by sub-editors who are experts in preparing papers for printing and good at picking up errors and inconsistencies, and putting things into house style. 

Journals usually expect a rapid response to proofs, so make sure you keep the editor informed of any changes to the corresponding author's contact details. You can usually mark all changes on the proofs but it may sometimes help to add a covering letter. 

After you have returned the corrected proofs, sit back and wait for publication day. Or start writing your next paper!