Intended for healthcare professionals

Education And Debate

Your letter failed to win a place…

BMJ 1997; 315 doi: (Published 13 December 1997) Cite this as: BMJ 1997;315:1608
  1. Eyal Shahar, associate professora (
  1. a Division of Epidemiology, University of Minnesota, Minneapolis, MN 55454-1015, USA
  • Accepted 4 March 1997


The quality of published scientific work is evaluated at least twice—by a handful of reviewers and editors during peer review and by an unknown number of readers after publication. Editorial peer review sometimes helps authors to improve their manuscripts, but more often it helps editors to decide between acceptance and rejection. Just as important—or perhaps even more important—are the unsolicited opinions of readers. Many of the readers are as qualified as the reviewers whose opinions contributed to the editorial decision.1 2

The voice of the reader is heard through letters written by the relatively few who formalise their critique in writing. Letters are sometimes better thought out than the original article. They may identify inaccuracies that were missed by formal peer review or uncover flaws in design, analysis, or interpretation. Peer review does not preclude error.1 Although letter columns are considered important by editorial boards,3 the fate of correspondence on published work is rarely determined by peer review. The editor(s) usually make the decision whether to publish, and rejection notes to authors are often standardised and contain little, if any, scientific explanation for the decision. Vague statements such as “in the face of fierce competition, your letter failed to win a place” or “many worthwhile contributions must be declined simply for lack of space” are typical.

Anecdotal experience

The example I provide below illustrates the shortcomings of editorial practices. It is a “letter to the editor” (coauthored by Paul G McGovern) that was rejected with no specific explanation. Since the letter challenges unequivocally the main conclusion of an article, either the challenge or the original conclusion must …

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