ART AND PRACTICE OF PEDIATRIC DERMATOLOGY Pediatric Dermatology 1–4, 2015
So You Want to Be in Journals, or What Happens When You Press “Send” Virginia P. Sybert, M.D.*,† *Pediatric Dermatology, Group Health Cooperative, Seattle, Washington, †Division of Medical Genetics, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington
You’ve developed a hypothesis and designed your protocol. You’ve gotten human subjects approval, recruited your cases, completed your study, performed the analyses, written the paper, and sent it to the best journal. Then you wait. You’ve seen the greatest case ever. It’s a new disease. It’s a new variation on an old disease. You are burning to share your experience with others. You write the case report and send it to the best journal. Then you wait. What goes on behind those closed doors? What happens to your submission on its journey back to you with an acceptance, recommendations for revision, or polite refusal? The purpose of this piece is to take you behind the curtain and tell you what we do as editors and reviewers when we receive your manuscript. I will use the first person singular often because I am describing what I do, not very different from my colleagues, but still individual. I can guarantee that most of my confreres have the same approach, and what I tell you will serve you well wherever you submit your work. My experience includes having published more than 100 peer-reviewed papers. (n.b. I am still waiting to receive an acceptance letter for my own work that says, “We loved this and will publish it immediately. No revisions requested.”) I have been a reviewer for and been on the editorial boards of, among others, JAAD, JID, BJD, Journal of Medical Genetics, Clinical Dysmorphology, Experimental Dermatology,
American Journal of Medical Genetics, American Journal of Human Genetics, Pediatric Dermatology, and Archives of Dermatology. I am currently an associate editor for Pediatric Dermatology, and in this capacity I receive between five and seven submissions weekly. So trust me, I know what I am writing about. Those of us in academic practice need to publish. Those of us in private practice want to publish. We publish because we have something important to say; we publish to push the boundaries of our communal knowledge a little further; we publish to advance our careers. We get little or no training in how to do so. Writing classes are not part of the medical school curriculum, and I have yet to hear of a training program that goes beyond, “You ought to write that up,” in preparing us to step into the world of the scientific journal. To frame the discussion of what is involved in the editorial process, I want to make several points first. I want to accept your manuscript. I want our journal to be replete with excellent papers that educate and inform our readers and move our field forward. I want our subscribers to be reading everything in our journal because each article is interesting and valuable, even if not directly relevant to everyone’s practice. I want to support you. I want young investigators to be encouraged to investigate more. I want clinicians to be encouraged to critically evaluate and question dogma, to use each patient as a potential answer to an unanticipated question. I want to make you happy. It
Address correspondence to Virginia P. Sybert, M.D., UW Box 357720, Division of Medical Genetics, Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98195, or e-mail: fl[email protected]. DOI: 10.1111/pde.12573
© 2015 Wiley Periodicals, Inc.
1
2 Pediatric Dermatology 2015
often seems to authors that the editors and reviewers are their adversaries. This is not true. We look for reasons to accept your work. We give you the benefit of the doubt. We assume that you have done everything you can to polish and maximize the value of your manuscript. Most reviewers and editors will devote hours to reviewing a manuscript and will make what they believe to be constructive criticism. If you do receive a rejection and it contains specific comments, consider them carefully before submitting your article elsewhere. They’ve been made to help you, not to discourage you. What do I do when a submission is routed to me as Associate Editor? First, I read the manuscript. I check to see what category the authors have chosen. A brief report or a case report is different from an investigative study. The journal’s requirements and instructions for formatting are different for each of these. Is the category appropriately chosen? Is the submission of the right length? A 2,000-word brief report is going to come right back to you without review. I will come back to these questions again to double check after I have read your submission in its entirety for content and language. I read the abstract, then the body of the paper and the conclusions. I do this first to determine if our journal is the right place for it. Sometimes papers that would find an acceptance in one type of journal are inappropriate for another and are rejected not for quality, but for fit. We will usually state this in the response letter, along with suggestions of where else you might consider sending it. An example of this would be a report of a new mutation (variant) in a known gene causing a known disorder. This would be better housed in a mutation report journal than in ours, whose audience is primarily clinical. On the other hand, the discovery of a new gene causing a known disorder or a new clinical condition would be of interest and direct value to our readers. Is the English acceptable? Grammar and spelling (or typing) are important. If you don’t care enough about your paper to proof it, you are sending a message that I shouldn’t care about it either. If you are not a native English speaker, you will be well served by having one review your manuscript before submission. We recognize the challenge of writing in a second language and envy your linguistic strength, but the bar is the same for all; the paper must be well and clearly written so it can be clearly read. We will not send a submission out for review if we can see that the reviewer will be spending more time proofing than reviewing for content.
Is the submission formatted correctly? Are the journal’s requirements met? Is it within the word limit? Do I like the font? (Just checking to see if you are still paying attention. We don’t care about the font.) Are the tables and figures necessary? Do they add to the value of the paper? Do they make points that cannot be made better in the text? Are the references formatted correctly? The journal has clear instructions regarding all of these, and if you ignore them, woe unto you. Above all, does the paper teach something new? Is the question it attempts to answer important or interesting? The youngest case of disease ever reported, the first case of a disorder in a specific ethnic group, or your adventures in correcting someone else’s misdiagnosis are examples of brief or case reports that are likely to be rejected out of hand. The case report that expands our differential diagnoses, changes our approach, or adds to our understanding of disease mechanisms is a case report that will go out for peer review. Is the study design reasonable? Do the data support the conclusions? Are the statistical analyses adequate and correct? Does the writing make the point(s) clearly and succinctly? Poorly structured papers often reflect poorly designed studies. If your numbers are inadequate to support your conclusions, it is likely I will reject without review. I am given many submissions in my fields of expertise, but often am out of my depth in a subject area in which I have little knowledge or experience. These submissions receive the same initial review by me because the criteria listed above are not field specific, but I will depend upon our outside reviewers for critical analysis. Journals vary in how they screen articles before sending them out for review. Some have an editor in chief or senior associate editor review a manuscript before sending it out for review. Others have associate editors review and decide on their own whether to send a manuscript for review. In that case, if a submission does not pass initial muster with the associate editor, it will go back to an editor in chief for a final decision. Submissions that pass the associate editor hurdle will then be sent to at least two reviewers. We have a pool of volunteer reviewers with a broad range of expertise. We try to limit the number of manuscripts we send to reviewers because reviewing is time-consuming, unpaid, and often thankless work. We vet our reviewers; those who do not give the papers they receive careful and thoughtful review tend to be weeded out. You are asked specifically for names of potential reviewers. This is because we assume you know the literature
Sybert: The Editorial Review Process
and the experts in the field better than we might and can help us find the best reviewer for you. It is not because we want the names of friends, colleagues, collaborators, mentors, or relatives. We may or may not invite your preferred reviewers. You are also asked to let us know if there are people you would prefer not to review your paper. We know that there is competition out there, and you might prefer that someone else not see your work before it is in press. We all have enemies; we don’t want to subject you to yours. It usually takes 2 to 3 weeks for your submission to go through the managing editor’s process and arrive in my inbox. Manuscripts usually sit for less than a week in an associate editor’s hands before being acted on. Those that are selected for review usually go to at least two reviewers. Often a reviewer will decline and a new person needs to be selected. Occasionally this can take an unconscionably long time (recently I had nine reviewers decline), in which case I may take sole responsibility for the review or may ask the authors if they would like to retract their submission and submit elsewhere or continue to wait until we are successful. Once someone has agreed to review for us, we ask that they complete their review within 3 weeks. This too can create a snag in the process. With all the best intentions, reviewers are still often late or forgetful or have bitten off more than they can chew. When this happens despite gentle remonstrations to them, I again will go with whatever review I have (assuming at least one of the reviewers was productive) and my own assessment or continue to search for another reviewer. When the reviews are received, if they are dissimilar, I may choose to be the final arbiter myself, or I may send your manuscript out to a third reviewer. This too will delay the final decision. If the reviewers have arrived at a similar assessment, the editorial decision is relatively straightforward: we will reject your paper with the reviewers’ comments and our own; we will request that you undertake major revisions in your paper and inform you that we will send it out for re-review at that time, with no guarantee of final acceptance; we will accept your paper but request minor revisions; or we will accept it as is and offer our heartiest congratulations. If your work is rejected, do not ignore the comments. The reviewers’ and the editors’ comments are meant to help you improve your work, not to cut you to the quick. If your paper has been rejected without specific comment (approximately one-quarter of all the submissions we receive will be turned back without review), it doesn’t mean it might not find a home elsewhere. Occasionally the editors will decide that a
3
manuscript that has received recommendations for rejection still has some value for us, and we will work mightily with you to bring it to a state that we feel can justify publication. If your paper has been accepted with minor revisions, your revised manuscript will usually go straight to the queue for publication with cursory review. If major revisions have been requested, I will carefully look at your responses and may send it back to the original or new reviewers as well. You do not have to agree to all the requests for revision. You may hold your ground and rebut the comments if you believe the reviewer is in error. We do listen to you. Nonetheless, you should question why the reviewer(s) has (have) misunderstood you. Could your writing be clearer? Can you make your points more cogently? Can you reanalyze your data and support your conclusions more effectively? The associate editor and the reviewers will look at your figures and tables. Poor-quality photographs can kill a submission. Poorly structured tables that cannot be readily read and that do not supplement the narrative will diminish the likelihood of acceptance. Is your writing clear or does the use of jargon make it difficult to read and obscure the message? I strongly recommend that before you send us your sweatedover manuscript, have your mother (or BGF [best guy/girl friend]) read it, or imagine being your mother reading it. She should be able to understand what you are trying to say. Avoid using acronyms (e.g., BGF) that are not generally accepted or may be confusing. Anyway, the purpose of this essay is to tell you how an editor reviews a submission (or at least what this editor does), not how to write, and there are many very good papers that do this. I have annotated several for you at the end of this article. In the late 1970s, I had the privilege of attending a 2-day writing workshop given by Dr. Joseph Garfunkel, then Editor of the Journal of Pediatrics, and Dr. Robert Merrill, then Associate Editor. I learned more in those 2 days about how to write a scientific paper than I had ever thought there was to know. We had to submit a manuscript in progress for their review, and in addition to a general discussion, each of the attendees had a one-on-one meeting with one of them to dissect and resurrect our manuscripts. This summer, at the Society for Pediatric Dermatology meeting in beautiful Coeur d’Alene, Idaho, Buddy Cohen and I hosted a manuscript writing session, and people actually came. There was laughter, so I think we were successful. We would be delighted to do it again if there is enough interest. Let the course directors know.
4 Pediatric Dermatology 2015
Let me leave you with the same point with which I began. I look forward to the opportunity to review your work. I look forward to the collegial give-andtake of the editorial process and to having you send us your very best work, to which I, and our reviewers, will give our very best attention. We are all in this together. RECOMMENDED READING Ezeala C, Nweke I, Ezeala M. Common errors in manuscripts submitted to medical science journals. Ann Med Health Sci Res 2013;3:376–379. You are not alone in having difficulty writing a publication ready manuscript. Crowson MG. A crash course in medical writing for health profession students. J Cancer Educ 2013;28:554–557.
Written for medical students but still has good advice. Garfunkel JM. How to write a scientific paper and get if published. Adolesc Med 1994;5:405–418. As cogent and helpful today as it was 20 years ago. Note the typo in the citation as given in Pub Med. Happens to even the best. Lilleyman JS. How to write a scientific paper—a rough guide to getting published. Arch Dis Child 1995;72:268–270. “If a paper is not worth writing, it is not worth writing well.” This is fundamental. You must have something of value to impart.
So You Want to Be in Journals, or What Happens When You Press “Send” Virginia P. Sybert, M.D.*,† *Pediatric Dermatology, Group Health Cooperative, Seattle, Washington, †Division of Medical Genetics, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington
You’ve developed a hypothesis and designed your protocol. You’ve gotten human subjects approval, recruited your cases, completed your study, performed the analyses, written the paper, and sent it to the best journal. Then you wait. You’ve seen the greatest case ever. It’s a new disease. It’s a new variation on an old disease. You are burning to share your experience with others. You write the case report and send it to the best journal. Then you wait. What goes on behind those closed doors? What happens to your submission on its journey back to you with an acceptance, recommendations for revision, or polite refusal? The purpose of this piece is to take you behind the curtain and tell you what we do as editors and reviewers when we receive your manuscript. I will use the first person singular often because I am describing what I do, not very different from my colleagues, but still individual. I can guarantee that most of my confreres have the same approach, and what I tell you will serve you well wherever you submit your work. My experience includes having published more than 100 peer-reviewed papers. (n.b. I am still waiting to receive an acceptance letter for my own work that says, “We loved this and will publish it immediately. No revisions requested.”) I have been a reviewer for and been on the editorial boards of, among others, JAAD, JID, BJD, Journal of Medical Genetics, Clinical Dysmorphology, Experimental Dermatology,
American Journal of Medical Genetics, American Journal of Human Genetics, Pediatric Dermatology, and Archives of Dermatology. I am currently an associate editor for Pediatric Dermatology, and in this capacity I receive between five and seven submissions weekly. So trust me, I know what I am writing about. Those of us in academic practice need to publish. Those of us in private practice want to publish. We publish because we have something important to say; we publish to push the boundaries of our communal knowledge a little further; we publish to advance our careers. We get little or no training in how to do so. Writing classes are not part of the medical school curriculum, and I have yet to hear of a training program that goes beyond, “You ought to write that up,” in preparing us to step into the world of the scientific journal. To frame the discussion of what is involved in the editorial process, I want to make several points first. I want to accept your manuscript. I want our journal to be replete with excellent papers that educate and inform our readers and move our field forward. I want our subscribers to be reading everything in our journal because each article is interesting and valuable, even if not directly relevant to everyone’s practice. I want to support you. I want young investigators to be encouraged to investigate more. I want clinicians to be encouraged to critically evaluate and question dogma, to use each patient as a potential answer to an unanticipated question. I want to make you happy. It
Address correspondence to Virginia P. Sybert, M.D., UW Box 357720, Division of Medical Genetics, Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98195, or e-mail: fl[email protected]. DOI: 10.1111/pde.12573
© 2015 Wiley Periodicals, Inc.
1
2 Pediatric Dermatology 2015
often seems to authors that the editors and reviewers are their adversaries. This is not true. We look for reasons to accept your work. We give you the benefit of the doubt. We assume that you have done everything you can to polish and maximize the value of your manuscript. Most reviewers and editors will devote hours to reviewing a manuscript and will make what they believe to be constructive criticism. If you do receive a rejection and it contains specific comments, consider them carefully before submitting your article elsewhere. They’ve been made to help you, not to discourage you. What do I do when a submission is routed to me as Associate Editor? First, I read the manuscript. I check to see what category the authors have chosen. A brief report or a case report is different from an investigative study. The journal’s requirements and instructions for formatting are different for each of these. Is the category appropriately chosen? Is the submission of the right length? A 2,000-word brief report is going to come right back to you without review. I will come back to these questions again to double check after I have read your submission in its entirety for content and language. I read the abstract, then the body of the paper and the conclusions. I do this first to determine if our journal is the right place for it. Sometimes papers that would find an acceptance in one type of journal are inappropriate for another and are rejected not for quality, but for fit. We will usually state this in the response letter, along with suggestions of where else you might consider sending it. An example of this would be a report of a new mutation (variant) in a known gene causing a known disorder. This would be better housed in a mutation report journal than in ours, whose audience is primarily clinical. On the other hand, the discovery of a new gene causing a known disorder or a new clinical condition would be of interest and direct value to our readers. Is the English acceptable? Grammar and spelling (or typing) are important. If you don’t care enough about your paper to proof it, you are sending a message that I shouldn’t care about it either. If you are not a native English speaker, you will be well served by having one review your manuscript before submission. We recognize the challenge of writing in a second language and envy your linguistic strength, but the bar is the same for all; the paper must be well and clearly written so it can be clearly read. We will not send a submission out for review if we can see that the reviewer will be spending more time proofing than reviewing for content.
Is the submission formatted correctly? Are the journal’s requirements met? Is it within the word limit? Do I like the font? (Just checking to see if you are still paying attention. We don’t care about the font.) Are the tables and figures necessary? Do they add to the value of the paper? Do they make points that cannot be made better in the text? Are the references formatted correctly? The journal has clear instructions regarding all of these, and if you ignore them, woe unto you. Above all, does the paper teach something new? Is the question it attempts to answer important or interesting? The youngest case of disease ever reported, the first case of a disorder in a specific ethnic group, or your adventures in correcting someone else’s misdiagnosis are examples of brief or case reports that are likely to be rejected out of hand. The case report that expands our differential diagnoses, changes our approach, or adds to our understanding of disease mechanisms is a case report that will go out for peer review. Is the study design reasonable? Do the data support the conclusions? Are the statistical analyses adequate and correct? Does the writing make the point(s) clearly and succinctly? Poorly structured papers often reflect poorly designed studies. If your numbers are inadequate to support your conclusions, it is likely I will reject without review. I am given many submissions in my fields of expertise, but often am out of my depth in a subject area in which I have little knowledge or experience. These submissions receive the same initial review by me because the criteria listed above are not field specific, but I will depend upon our outside reviewers for critical analysis. Journals vary in how they screen articles before sending them out for review. Some have an editor in chief or senior associate editor review a manuscript before sending it out for review. Others have associate editors review and decide on their own whether to send a manuscript for review. In that case, if a submission does not pass initial muster with the associate editor, it will go back to an editor in chief for a final decision. Submissions that pass the associate editor hurdle will then be sent to at least two reviewers. We have a pool of volunteer reviewers with a broad range of expertise. We try to limit the number of manuscripts we send to reviewers because reviewing is time-consuming, unpaid, and often thankless work. We vet our reviewers; those who do not give the papers they receive careful and thoughtful review tend to be weeded out. You are asked specifically for names of potential reviewers. This is because we assume you know the literature
Sybert: The Editorial Review Process
and the experts in the field better than we might and can help us find the best reviewer for you. It is not because we want the names of friends, colleagues, collaborators, mentors, or relatives. We may or may not invite your preferred reviewers. You are also asked to let us know if there are people you would prefer not to review your paper. We know that there is competition out there, and you might prefer that someone else not see your work before it is in press. We all have enemies; we don’t want to subject you to yours. It usually takes 2 to 3 weeks for your submission to go through the managing editor’s process and arrive in my inbox. Manuscripts usually sit for less than a week in an associate editor’s hands before being acted on. Those that are selected for review usually go to at least two reviewers. Often a reviewer will decline and a new person needs to be selected. Occasionally this can take an unconscionably long time (recently I had nine reviewers decline), in which case I may take sole responsibility for the review or may ask the authors if they would like to retract their submission and submit elsewhere or continue to wait until we are successful. Once someone has agreed to review for us, we ask that they complete their review within 3 weeks. This too can create a snag in the process. With all the best intentions, reviewers are still often late or forgetful or have bitten off more than they can chew. When this happens despite gentle remonstrations to them, I again will go with whatever review I have (assuming at least one of the reviewers was productive) and my own assessment or continue to search for another reviewer. When the reviews are received, if they are dissimilar, I may choose to be the final arbiter myself, or I may send your manuscript out to a third reviewer. This too will delay the final decision. If the reviewers have arrived at a similar assessment, the editorial decision is relatively straightforward: we will reject your paper with the reviewers’ comments and our own; we will request that you undertake major revisions in your paper and inform you that we will send it out for re-review at that time, with no guarantee of final acceptance; we will accept your paper but request minor revisions; or we will accept it as is and offer our heartiest congratulations. If your work is rejected, do not ignore the comments. The reviewers’ and the editors’ comments are meant to help you improve your work, not to cut you to the quick. If your paper has been rejected without specific comment (approximately one-quarter of all the submissions we receive will be turned back without review), it doesn’t mean it might not find a home elsewhere. Occasionally the editors will decide that a
3
manuscript that has received recommendations for rejection still has some value for us, and we will work mightily with you to bring it to a state that we feel can justify publication. If your paper has been accepted with minor revisions, your revised manuscript will usually go straight to the queue for publication with cursory review. If major revisions have been requested, I will carefully look at your responses and may send it back to the original or new reviewers as well. You do not have to agree to all the requests for revision. You may hold your ground and rebut the comments if you believe the reviewer is in error. We do listen to you. Nonetheless, you should question why the reviewer(s) has (have) misunderstood you. Could your writing be clearer? Can you make your points more cogently? Can you reanalyze your data and support your conclusions more effectively? The associate editor and the reviewers will look at your figures and tables. Poor-quality photographs can kill a submission. Poorly structured tables that cannot be readily read and that do not supplement the narrative will diminish the likelihood of acceptance. Is your writing clear or does the use of jargon make it difficult to read and obscure the message? I strongly recommend that before you send us your sweatedover manuscript, have your mother (or BGF [best guy/girl friend]) read it, or imagine being your mother reading it. She should be able to understand what you are trying to say. Avoid using acronyms (e.g., BGF) that are not generally accepted or may be confusing. Anyway, the purpose of this essay is to tell you how an editor reviews a submission (or at least what this editor does), not how to write, and there are many very good papers that do this. I have annotated several for you at the end of this article. In the late 1970s, I had the privilege of attending a 2-day writing workshop given by Dr. Joseph Garfunkel, then Editor of the Journal of Pediatrics, and Dr. Robert Merrill, then Associate Editor. I learned more in those 2 days about how to write a scientific paper than I had ever thought there was to know. We had to submit a manuscript in progress for their review, and in addition to a general discussion, each of the attendees had a one-on-one meeting with one of them to dissect and resurrect our manuscripts. This summer, at the Society for Pediatric Dermatology meeting in beautiful Coeur d’Alene, Idaho, Buddy Cohen and I hosted a manuscript writing session, and people actually came. There was laughter, so I think we were successful. We would be delighted to do it again if there is enough interest. Let the course directors know.
4 Pediatric Dermatology 2015
Let me leave you with the same point with which I began. I look forward to the opportunity to review your work. I look forward to the collegial give-andtake of the editorial process and to having you send us your very best work, to which I, and our reviewers, will give our very best attention. We are all in this together. RECOMMENDED READING Ezeala C, Nweke I, Ezeala M. Common errors in manuscripts submitted to medical science journals. Ann Med Health Sci Res 2013;3:376–379. You are not alone in having difficulty writing a publication ready manuscript. Crowson MG. A crash course in medical writing for health profession students. J Cancer Educ 2013;28:554–557.
Written for medical students but still has good advice. Garfunkel JM. How to write a scientific paper and get if published. Adolesc Med 1994;5:405–418. As cogent and helpful today as it was 20 years ago. Note the typo in the citation as given in Pub Med. Happens to even the best. Lilleyman JS. How to write a scientific paper—a rough guide to getting published. Arch Dis Child 1995;72:268–270. “If a paper is not worth writing, it is not worth writing well.” This is fundamental. You must have something of value to impart.
