1. Lights, Composition, Rewrite! Getting to Know the Cast of Characters at a Medical Journal Kenny Lin, MD Assistant Editor American Family Physician STFM Annual Meeting April 26, 2007

2. Who We Are Mark Ebell, MD, MS  Deputy Editor, American Family Physician  Associate Professor, Michigan State University College of Human Medicine Allen Shaughnessy, PharmD  Contributing Editor, American Family Physician  Clinical Professor of Family Medicine, Tufts University School of Medicine Kenny Lin, MD  Assistant Editor, American Family Physician  Assistant Professor of Clinical Family Medicine, Georgetown University School of Medicine

3. Why Are You Here? You would like to start writing You have started writing, but you would like to be published You have already published, but you want to be published in better journals Your Department Chair or Program Director says that you must write and be published to gain academic advancement

4. Tell us about your best and worst experiences writing for medical journals.

5. Dramatis Personae Publisher Executive or managing editor Professional editors Chief medical editor Deputy medical editor(s) Associate medical editors Editorial fellow Editorial assistants Peer reviewers Editorial board

6. Publisher Calls the shots Balances the books Pays the bills (by selling advertising) Hires and fires editorial staff Supervises executive or managing editor

7. Executive or Managing Editor Responsibility for setting and meeting all publication-related deadlines Supervises professional editors Works with chief medical editor to increase readership and develop new features

8. Professional Editors Improve manuscript readability Correct grammatical errors, make language consistent with journal style Proofread text and figures for errors Format manuscript for publication Review proofs with author

9. Chief Medical Editor First pass, final decision May reject manuscripts prior to peer review Evaluates peer reviews and makes decision to accept, revise or reject Selects associate editors and editorial board Hires editorial assistants Suggests and approves new features (e.g. Close-ups)

10. Deputy Editor Second-in-command Works closely with chief medical editor to determine journal’s content and direction May have specific focus (e.g. “Deputy Editor for Evidence-Based Medicine”) Coordinates several features and edits significantly more manuscripts than associate editors

11. Associate or Assistant Editors Ensure quality of scientific content Communicate directly with authors regarding peer reviews and requested revisions (via the “revision letter”) Edit revised manuscripts for publication Write CME quiz questions May also coordinate one or more features or special series of articles

12. Editorial Fellow (specific to AFP) Apprentice to chief medical editor for one year (e.g. July 2007 – June 2008) Primarily responsible for topic management and soliciting new manuscripts and editorials Serves as “art editor” - coordinates and approves cover and other illustrations Functions as junior associate editor; may edit selected manuscripts and/or serve as backup editor on features

13. Editorial Assistants Usual point of first contact for authors Responsible for the “nuts and bolts” Process and track new manuscripts Invite peer reviewers and collate reviews for chief and associate medical editors Route revision letters to authors and revised manuscripts to medical and professional editors

14. Peer Reviewers 1 FP and 2 “content experts” (specialty varies depending on topic) Provide written, page-by-page critique of manuscript that includes  Errors in scientific content  Suggestions for additional references  Suggestions regarding organization & focus  Overall rating of manuscript quality

15. Editorial Board Representatives from various medical specialties who provide guidance and feedback to the chief medical editor Encouraged to do some peer reviews May submit manuscripts themselves, or assist in soliciting other authors for specific topics or series

16. The Submission Process in a Nutshell: “Hurry up and wait” Processing by editorial office (2 weeks) Peer review (3 months) Decision Revision (2 months) Re-submission Medical editing (1-3 weeks) Professional editing and production (3-9 months) PUBLICATION! Fame and fortune (or at least, something to show your mother / kids / significant other)

17. The Decision: 4 Possible Outcomes ACCEPT “as is”  Congratulations! (This almost never happens) ACCEPT with revision  Congratulations! RECONSIDER with major revision  After re-write, treated as new manuscript with possible re- review. Still reasonable chance for acceptance. REJECT  If reason given was inappropriate topic, may try another journal.

18. “Great papers are not written – they are re-written.” Revisions are (almost always) inevitable If an editor requests revisions, that means your article is worth publishing. Do not be discouraged or intimidated by length or number of requested revisions!

19. The things medical editors look for (and ask you to fix in your revision) Is the scientific discussion … ?  Factually correct  Balanced  Appropriately organized  Complete  Current  A family practice perspective Catchy and representative title, headings, and subheadings

20. The things medical editors look for, continued Conflicts of interest, overly promotional or negative portrayals of drugs and devices Costs of comparable drugs, if applicable Misnumbered / misattributed references (up to 1/5 th of all citations in randomly selected manuscripts!) Evidence ratings (using SORT) for key clinical recommendations Quality / usefulness of tables and figures, and identification of source if not original

21. What does “Production” consist of and why does it take so long? Copyediting Layout Typesetting Proofreading the proofs. Last-minute final reviews by:  Professional editor  Copy editor  Medical editor  Author (you)

22. In what issue will my manuscript be published? Projections are approximate; content of each issue not set until the last minute. “Cover” articles (the lucky few) are usually scheduled well in advance. Timeline for other articles depends on advertising revenue. If fewer ads, must publish fewer articles. Can be a frustrating process: “probably November … delayed to December … January for sure …” Remember: hurry up and wait

23. Thanks!