Intended for healthcare professionals

Career Focus

Publish and prosper

BMJ 1996; 313 doi: (Published 07 December 1996) Cite this as: BMJ 1996;313:S2-7070
  1. Tim Albert
  1. TAA Training, Castlebank House, Leatherhead KT22 7PG

    A list of publications is still a good way to impress selection shortlisters and interviewers. Tim Albert, who runs training courses in effective writing, tells how it's done

    My starting point is unusual but clear. You are the professional doctor; I am the professional writer. In order to succeed in your profession you first have to succeed (albeit briefly) in mine and become a published author in a peer reviewed journal.

    You will receive copious advice from your peers, most of whom will recently, and with great difficulty, have become published authors themselves. Whether they like it or not, their experience will colour their advice, and they will almost certainly leave you with the impression that the world you seek to enter is open only to those like themselves who are highly gifted.

    This article is different. It comes from the perspective of writing and editing rather than competing in science, and aims to show that getting published is not as difficult as some people might wish you to believe. It does this by challenging a number of myths about writing scientific papers, in the hope that you will be able to complete this task as soon as possible, and get back to something worth while like healing the sick.

    What is a good paper?

    Myth 1: A “good” paper will automatically get published. This begs the splendid question-what is a good paper?-that can occupy endless hours of useless debate and postpone publication indefinitely. It can also encourage writers to believe that the system is fair and logical.

    The best way to look on the world of medical publication is as an open market, like any other. Editors may surround themselves with layers of reviewers, but essentially their job is to select papers that will enable the journal to attract enough advertising and/or readers to survive. As a writer your job is easy: identify a product (article), match it to a market (journal), and sell it to a customer (editor). When you complete the sale you become an author and succeed in your task.

    Myth 2: Writing a scientific paper can be fitted in between real work. As with articles in the Sun and circus performances, it is easy to believe that what looks effortless has been quickly learnt. Not so. Writing requires time rather than talent. Go on a time management course, block off an hour or two each week. Set yourself clear goals: why do you want to publish? What must you do to achieve that? And by when?

    I know of one group of registrars who, in the early 1980s, realised that to progress up the slippery surgical ladder they needed publications fast. They formed a syndicate, set themselves a target of 10 publications each within a year, achieved their target, and subsequently became consultant surgeons.

    Myth 3: Only those who work in centres of excellence have a chance of getting published. As far as original papers are concerned, this is simply not true, according to a retrospective study of manuscripts received at the Journal of Paediatrics. “Major manuscripts from institutions with greater prestige were no more likely to be recommended or accepted for publication than those from institutions with lesser prestige.“(1)

    Myth 4: Get the title right before you start. The convention in scientific publishing is that a title should not be the most interesting it could be, but should broadly indicate the topic to be discussed, as in: “Tap water disease and vitamin A: a multicentre randomised trial.” Such a statement will not help you to write.

    What you need is to define your message, and for this you need to insert a verb. For instance: “Vitamin A cures tap water disease,” or “Vitamin A might cure tap water disease,” or even “Tap water disease affects only those who have taken large doses of vitamin A.” Once you have clarified your thoughts into a single sentence message you have completed the second hardest part of writing an article: deciding on what you are going to say. The hardest part now follows.

    Target your journal

    Myth 5: You don't need to decide on the journal before you have finished the article. Optimists think that an article intended for the North European Annals of Left Handed Surgery will somehow, during the course of the writing, improve so much that it can be submitted instead to the Lancet. This is not good marketing. Before you take your one sentence message any further ask which journal or group of journals would be interested in it. And then decide which one to aim for.

    It's not easy, but decisions seldom are. Taking this one will help in several ways. You can ask yourself again whether the journal would be interested. You can then tailor your writing specifically to that publication. You can read the Instructions to Authors, study the ongoing debates, analyse the style the editor has allowed, and even scan the advisory panel in case one of them turns out to be a relative (and can give you useful advice and not-perish the thought-pull strings). As your draft progresses, you can move the debate among co-authors on from Is it good? to Will it be accepted? (see myth 1).

    Myth 6: Start writing the methods sections as soon as you can. This encourages writers to set out on a journey without knowing where their destination might be. Hold back from the word processor-and plan. Try some brain storming, mind mapping, or what traditionalists refer to as thinking. Once you are clear about what you have done, prepare four brief plans, each answering the following specifications:

    • Introduction: 2-3 paragraphs on why we started

    • Methods: 4-6 paragraphs on what we did

    • Results: 4-6 paragraphs, with 2-5 figures or tables, on what we found

    • Discussion: 5-8 paragraphs on what it all means.

    Myth 7: Try to get it right first time. Many people think that making a mistake when they write the first draft will condemn them to hellfire forever. But the writing process is not an examination or a personality test; it should be creative and fun.

    Put aside, say, 10 minutes (quite enough for an introduction) and just start writing. Do not look back. Do not stop to check details. Do not fiddle with sentences just written. (If necessary turn off your computer screen). The objective is to download the information from your brain on to a piece of paper. Once you have done so you will have completed the first draft-and it will almost certainly have the makings of a coherent structure.

    Clever doctors don't rewrite

    Myth 8: Clever doctors don't rewrite. What counts is how the final version turns out. There is no alternative to polishing and polishing and polishing. Look at the details. Are the facts correct? Is the use of language ambiguous, or is the spelling misleading (a casual relationship or a causal one)? Don't forget the big issues: is the message still there? Is it right for your target journal? Is the style appropriate? Is the structure logical?

    Myth 9: The first sentence should grab the reader's attention. In proper journalism, this is a useful principle. But it is not appropriate when writing scientific papers. This is good news, because it means that you do not have to spend much time on honing the first sentence. Use one of a small number of options, such as the Potted Seminar (tap water disease is a condition that affects the central nervous system…), the Danger Ahead Scenario (tap water disease kills 3000 people a year…), or the Frankly Disputational (a lot has been written recently about tap water disease…). Choose one and move swiftly on.

    Don't buck the trend

    Myth 10: Write in good clear English. As much as it grieves me to say it, I no longer recommend writers to make an effort to put their scientific paper into good, clear English. Many books have been published advocating simpler sentences and (when possible) more familiar words, and most editors agree with them. But look in most scientific journals and these rules will be constantly ignored.

    Don't buck the trend. Follow the style. Remember the purpose is to get published, not to write well in the style of Orwell or Hemingway. (And if you wish to weep at the stupidity of this do so, but privately.)

    Myth 11: All authors must have had something to do with the paper. Editors feel that anyone who has his name attached to a paper should have had a significant intellectual involvement with it. This seems to me, as a writer, so obvious a point that it is not worth making. Unfortunately pressure to publish is such that the practice is otherwise. As a relatively junior doctor you may prefer to risk the opprobrium of the editor than that of your professor. How-ever, you should mention that, if it all turns out to be a pack of lies, you could all be in prison together.

    Myth 12: Editors are never biased. I would never dream of suggesting that an editor could be influenced by a trip to Las Vegas or the odd thousand in a Swiss bank. But, like all of us, they do make judgments on the basis of what passes before their eyes. Make sure that you follow the Instructions to Authors- would you trust the science of someone who disregards a request to double space his article? Use a clear type face. Write a courteous letter, giving full details of who you are, what you are sending and why. Be considerate.

    Myth 13: If you don't publish you are a rotten doctor and a failed human being. I fail to see the logic of this statement. If you have better things to do (like healing the sick, or going fishing) do them and don't feel guilty. I'm not too good at minor surgery myself, but that never stopped me considering myself a good writer.


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