Intended for healthcare professionals


Getting letters published in journals is good aim for medical students

BMJ 1999; 319 doi: (Published 30 October 1999) Cite this as: BMJ 1999;319:1198
  1. Barbara Hanratty, visiting lecturer in public health medicine (hssbh{at},
  2. Debbie Lawlor, visiting lecturer in public health medicine
  1. Nuffield Institute for Health, Leeds LS2 9PL

    EDITOR—The increasing emphasis on evidence based medicine in the NHS means that skills in critical appraisal will soon be as important for doctors as clinical competence. Many habits are established at medical school, so encouragement for students to review and publish work should start there. It is our impression that such motivation and support are patchy. To investigate this, we examined letters to the BMJ over three years and quantified the extent of medical student authorship. Authors often begin their careers by writing letters, and letters can be a marker of competence in critical appraisal. We chose the BMJ because it has a substantial student readership.

    We examined the letters sections of the BMJ from July 1996 to June 1999 (volumes 314-319) and recorded the total number of letters and the number with at least one medical student author. Medical students' letters were categorised into four types: author's reply; critical appraisal of a published paper; original work, which included case reports, case series, and other results of research; and viewpoint, which offered an opinion on any topic or article but without critical appraisal of the work.

    Twenty six (0.7%) of the 3842 published letters had at least one medical student author (table). Medical students from the University of Newcastle upon Tyne contributed six of the 21 letters from medical students in the United Kingdom (29%; 95% confidence interval 11% to 52%). All of the Newcastle letters were critical appraisals from fourth year students of epidemiology and public health and were written without coauthors. Four of the remaining 20 letters were from medical students writing alone. Coauthors were drawn from psychiatry (five letters); medicine (five); surgery (three); and pathology, general practice, neuroradiology, and medical laboratory science (one each). Two coauthors were in unspecified research posts, and one was a hospital director.

    Number of letters from medical students published in BMJ, by university or hospital medical school

    View this table:

    The performance of the Newcastle students presents a challenge to others involved in training. The assessment of teaching quality in universities is in its infancy, and a department's ability to motivate students will be hard to quantify. We believe that publication of critical appraisal letters by medical students has merit as an informal measure. As well as showing a skill that all doctors need, these letters are likely to stimulate interest in research and academic medicine. Setting out early on the quality spiral of publishing may help to raise standards. Perhaps we should consider replicating Newcastle's example across the United Kingdom.

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