After a recording of “Straight From the Cutter’s Mouth: A Retina Podcast,” the episode’s participants — Benjamin Young, MD, Bilal Ahmed, BS, and Jayanth Sridhar, MD, delved further into the topic of how to engage in the world of publishing academic papers and writing for trade journals. Here, they share that discussion.

Benjamin Young, MD: What are the biggest differences between writing a medical scientific, peer-reviewed article and a trade journal article?

Jayanth Sridhar, MD: When writing in any format, the 2 most important factors to consider are (1) the target audience and (2) the general expectations for the format. When composing a peer-reviewed, medical scientific article, your audience primarily consists of clinicians and scientists hoping to gain knowledge or insight by reading your work. There generally exists an expectation for noncolloquial, neutral language that simply presents a hypothesis, a methodology, a data set, and conclusions from study results. Your readers and editors expect your work to meet all 4 of the Journal of the American Medical Association (JAMA) benchmarks: authorship (Who are the authors? What are their credentials?), attribution (are there accurate references to validate statements?), currency (When were the data collected? When was the article composed, submitted, and published?), and disclosure (Are any conflicts of interests for the authors clearly stated?).

Medical trade journal articles fill a different, but important, role in supplementing the scientific literature by synthesizing peer-reviewed published data with real-world experiences and anecdotes written colloquially for a clinician audience. Trade journals have their own audience considerations: You may be writing for physicians in general, eye providers in general, ophthalmologists specifically, or retina specialists specifically.

Bilal Ahmed: Do you have a particular order or system to start writing a manuscript?

JS: Everyone will approach this differently, and there are no wrong answers (besides not writing at all). I advise starting by composing the abstract, which forces the writer to succinctly state the objective of the study (purpose), how the study was conducted (methods), what the study demonstrated (results), and the major take-home points from the study (conclusions).

Similar to writing an outline for an essay, putting together an abstract first organizes the rest of the manuscript. The methods and results section of the paper will be easiest to write, as simple extensions of the corresponding abstract sections, although your readers may benefit from pictorial or tabular representations of methodology or data (via figures or tables). The Introduction for your paper will be a synthesis of the literature search that drove your research question in the first place and your purpose. The discussion for a paper is often the most labor-intensive section that requires the writer to critically evaluate the study results, put them in context for the reader, based on previously published work, and offer take-home points toward those conclusions from your abstract (requirements may differ for trade journals).

BA: Do you factor in word limits when writing?

JS: I usually tell my mentees to simply write the paper and then evaluate to get a sense of what article length is the best fit. It is easier if you have an idea of where you plan to submit your work before you start writing. Knowing the journal and article subtype will save time later with reformatting, while also avoiding a drastic mismatch where you end up having to shave a significant amount of writing to fit a word count. This is where experience comes in, and, hopefully, the corresponding author for the paper can take a critical look at the study and make decisions early on about the target journal.

BY: I will soon transition to a phase in my academic career where I will fill the corresponding author role. Any tips on this transition? How do you handle edits when working with less-experienced writers?

JS: Understand that, as the corresponding author, you are ultimately taking responsibility for the written work as the point person. Early in the writing process, get a sense of how experienced your mentee is by asking open, frank, nonjudgmental questions. Depending on level of experience, he or she may need guidance on how to get started. Next, review the first draft critically, and offer your revisions before other senior coauthors. This demonstrates that you have respect for the process as well as your role.

Deciding what to directly revise yourself vs requesting a revision is a personal decision that varies paper to paper. Try to empower your mentees to step up and improve. For example, I may send a note to my mentee asking them to add references or to rewrite a certain section. On the other hand, I may simply take over and rephrase part of the discussion because my understanding of retinal surgery is greater at this point in time than my mentee’s. You will learn over time how to be an effective editor, while still allowing your mentees room to grow.

BA: Is it a bad sign if we have to revise a paper internally multiple times?

JS: No! Revising is part of the process, and my general philosophy is the more revisions you do before the submission, the fewer revisions you will do down the line. Given how competitive academic publishing is, you usually only get one chance to present your work to a given journal. Make it count.

BY: How do you organize edits when there is a large team of coauthors?

JS: Tracked changes in word processing software makes this easy, and you can certainly use the merge function to combine different versions. Personally, I prefer to send each draft to a small group of authors at a time with a set order of reviews and revisions to avoid multiple electronic copies floating around. Always remember to run a final draft by the entire team before submitting. If someone is a coauthor, they contributed significantly to the work in question, and anyone listed as a coauthor is standing by what is written, so it is important to make sure all collaborators are satisfied with a draft before submission.

BA: Any tips for the submission process to journals?

JS: Three words: Read the instructions. Each journal has a clear set of guidelines for how articles and abstracts should be formatted, what information should be on a title page, and how to format figures and tables. The most common reason articles will bounce back to your corresponding author will be a flag from the editorial office for not following the rules. Otherwise, the submission process is fairly straightforward.

BY: How do you decide where to submit your article?

JS: Where have similar articles been published? That’s the easiest way to get a sense of the type of journal that will accept articles on a certain subject. I always advise to aim high for journals that are well-read in your field. If considering an unfamiliar journal, read about its scope and aims on the website to decide whether it is a good fit.

BA: If my manuscript gets sent back by the editor with revisions, does this mean it was accepted?

JS: Not necessarily. In fact, to fight this common misperception, most editors will include a disclaimer in the same email stating that submitting revisions does not guarantee acceptance. Getting queried for revisions is better than out-right rejection, but your chances of acceptance are highly variable depending on a few factors: First, how feasible are the revisions? If you are being asked to capture a whole data set that is not realistically within the scope of your analysis, then chances of publishing success are slim. On the other hand, requests for simple clarifications may bump up those chances. If you decide to submit revisions, be polite and humble in your response to reviewer and editor comments. Be timely as well; anecdotally I have found that authors who have faster turnaround submitting revisions have more success.

BY: How do you handle situations in which you disagree with a reviewer or editor comment?

JS: Early in my career I thought that to publish you needed to make every requested change at the revision stage. During my fellowship, one of my attendings showed me that as long as you demonstrate that you reasonably took the comments into account, and you elucidate your reasoning for disagreement in your response letter, this is not a requirement. Again, be polite and be humble enough to consider whether the reviewer or editor has a point but, ultimately, it is your manuscript, and you should feel comfortable with how it is published.

BA: Have you ever experienced so many rejections that you decided a manuscript was unpublishable?

JS: Not yet, thankfully! My personal record was 9 rejections for a paper based on a project started by a senior resident who graduated. I took over the study and finished it before my own graduation. The major reason for rejection each time was methodological problems from the initial study design, which made fixing the paper difficult. My opinion, based on the old adage, is if at first you do not succeed, try, try again. Get back to the drawing board, look at your rejection letters critically, and rejigger your manuscript as much as you are able. Persistence will win out as long as your paper is not fundamentally flawed. If you are trying to publish data that is either not unique (eg, a case report on a well-known entity) or just flat out wrong (ie, your numbers do not add up), then you may want to consider calling it quits or pivoting to a non-peer-reviewed trade journal in the case of a non-unique case presentation.

BY: Any final words of wisdom?

JS: Good luck! I cannot claim to be an expert on any aspect of publishing, but hopefully these pearls learned over my past decade of writing manuscripts will serve you well in your academic endeavors.