Peer review process

The BMJ peer reviews all the material it receives. We give priority to articles that will help doctors to make better decisions - whether those doctors are practising clinical medicine, working in public health, developing and implementing health policy, or working mostly as researchers.

We aim to reach a first decision on all manuscripts within two or three weeks of submission. Rejection is often much quicker than this, however, and we reject about two thirds of all submissions without external peer review.

About half the original research articles we receive are rejected after review in house, usually by two medical editors. We aim to do this quickly so that we do not waste authors' time, allowing them to get on and submit the work elsewhere without unnecessary delay. The usual reasons for rejection at this stage are insufficient originality, or the absence of a message that is important to a general medical audience - leading us to the decision that, essentially, we do not think The BMJ is the right journal for the work.

For research articles we focus mainly on the research question: even when the overall subject is relevant, topical, and important we may reject the article because the study didn’t ask a research question that added enough. Of course, we will also reject work if it has serious flaws. We may screen a research article initially by reading only the structured abstract, so abstracts should be as complete, accurate, and clear as possible—but not unnecessarily long—and must be approved by all authors. We have produced a checklist to help authors decide whether The BMJ is the right journal for their research. If the work does not seem to fit in The BMJ, it may be better sent straight to another journal with a more specialist or local readership or a higher acceptance rate.

Open peer review

We ask reviewers to sign their reports and declare any competing interests on any manuscripts we send them. Reviewers advise the editors, who make the final decision (aided by an editorial manuscript committee meeting for some articles, including original research).

For research papers, The BMJ has fully open peer review. This means that most accepted research papers submitted from September 2014 onwards will have their prepublication history posted alongside them on

This prepublication history comprises all previous versions of the manuscript, the study protocol (submitting the protocol is mandatory for all clinical trials and encouraged for all other studies at The BMJ), the report from the manuscript committee meeting, the reviewers’ signed comments, and the authors’ responses to all the comments from reviewers and editors (read more in this editorial).

Peer review for original research

For original research articles one editor will usually take each article through from start to finish. The BMJ's team of research editors aims to read 98% of newly submitted research articles within two working days. If your article is potentially suitable for The BMJ that editor will ask a senior colleague to approve it, and, if that succeeds, he or she will send your article to two external peer reviewers.

The next step for your research article, if it is still in the running after peer review and assessment by The BMJ's clinical epidemiology editor, is full appraisal at our weekly research manuscript meeting. A statistics editor, your paper's editor, and The BMJ's research team will read and discuss your article's importance, originality, and scientific quality, and the editor will make the final decision. Everyone attending the manuscript meeting is asked to declare relevant competing interests at the start, and anyone with an important competing interest will either leave the room or speak last when the relevant article is being discussed (depending on the nature and extent of their interest).

Decisions made at the research manuscript meeting usually include one of: provisional acceptance (conditional on making satisfactory revisions), request revisions (when we remain interested in the article but have insufficient information to reach a definitive decision, and hope that putting reviewers' and editors' points to the authors will lead to a satisfactory revision and eventually to a decision), or rejection. We will send you a decision letter and report from the meeting as soon as possible; usually within a few days, but longer if we have asked for an additional detailed report from the statistics editor or another reviewer.

The report will list the names of everyone who took part in the discussion about your article. If your article is accepted and published the committee report - and your responses to this and all the reviewers’ comments - will comprise part of the pre-publication history that we will post alongside your published article.

Articles for the Analysis section of The BMJ go through a similar process and those that survive external review go to an editorial committee meeting where the editors make the final decision.

Some articles may also be seen by The BMJ's ethics commmittee and, in cases where the editor suspects serious research misconduct, by appropriate third parties.

We aim to reach a final decision on publication within eight to 10 weeks of submission for all articles. If we make an offer of publication subject to revision we usually ask authors to return their articles to us within the subsequent month.

Accepted articles are published on as they become ready, and is updated daily. Once published, articles are then be selected for a subsequent print issue.

The BMJ provides open access to peer reviewed research as part of its commitment to readers and authors. We make all our research articles freely available online and send them directly to PubMed Central (the National Library of Medicine's full text archive).

Author charges for research that has open access funding

The BMJ asks authors to pay a publication fee of £3000 per accepted research article. This only applies, however, when the funder of the research that is reported in the article has already pledged to pay for open access publication and when authors can claim The BMJ's fee, in full, from their funder for that specific piece of research. Consideration of the paper is not related to whether authors can or cannot pay the fee. We will only ask for the fee once we have accepted a paper. Seeking and processing fees will not delay editing or publication. Neither editors nor reviewers will know whether a fee is payable, and administrative staff will handle payments and all associated correspondence.

Article provenance

Who had the idea, and was the article externally peer reviewed? At the end of every accepted editorial, research article, clinical review, practice article, analysis article, feature, and head to head article The BMJ will add a statement explaining the article's provenance. The options are:

  • Not commissioned; externally peer reviewed.
  • Not commissioned; not externally peer reviewed.
  • Commissioned; externally peer reviewed.
  • Commissioned; not externally peer reviewed.
  • Commissioned, based on an idea from the author; externally peer reviewed.
  • Commissioned, based on an idea from the author; not externally peer reviewed.

Peer review for papers submitted by The BMJ's editorial staff

Editorials, news items, analysis articles, and features written by The BMJ's own editors do not undergo external peer review. Articles reporting original research done at the BMJ are independently peer reviewed.

Submitting an appeal

Peer review by editors and external reviewers is usually based on a mix of evidence and opinion and may not always lead to the best decision. We welcome serious appeals on research and other scholarly articles and many succeed. For opinion articles, where editorial judgment about readability and engagement weighs most heavily, an appeal is less likely to overturn our decision. Please don't send a revised paper to our online editorial office, however - the first step is to submit there a detailed rebuttal letter. We can consider only one appeal per article.