Everything is hard the first time you try

From the editor


    This journal gladly publishes articles written by students. The students' supervisors must ensure that the manuscript has the quality required for submission.

    Photo: Einar Nilsen
    Photo: Einar Nilsen

    As a young assistant registrar with academic ambitions I had written my first manuscript intended for publication in an academic journal. The text had been thoroughly reworked and repeatedly rewritten, so when I put the manuscript (in paper format – this was in the pre-digital era) in the mail box of one of the department's professors, I expected recognition and a few proposals for amendments in return. In my opinion, the manuscript was practically ready for submission. That was not the case, however. On the contrary, the manuscript came back with innumerable deletions, additions and comments in the margins – all of it in red ink. It looked like a bloodbath.

    I am not alone in having experienced this. Such experiences can be hard to cope with, because many of us tend to perceive ourselves as quite good writers. Comprehensive criticism can be difficult to accept, even when it comes accompanied by constructive advice (1). The key lies in realising that writing an academic article is a completely different matter than writing school essays, blog posts, patient record notes, referrals and internal memos (2). Writing for publication in an academic medical journal comes with other and more stringent requirements with regard to form, precision and clarity (3, 4).

    The Journal of the Norwegian Medical Association is happy to publish articles written by students and young doctors and receives many manuscripts written by medical students with their supervisors as last author. Most of them are based on a mandatory project assignment as part of their medical studies, while others can consist of the project report itself, as permitted by the faculties' guidelines, for example at the University of Oslo (5). Some of them have turned into excellent articles – one of them even received the award for the best review article published by the journal in 2015 (6). However, many of the manuscripts are too weak or unfinished to warrant a painstaking and time-consuming process of revision. Our impression is that unfortunately, some supervisors have not contributed sufficiently to the manuscript before it is submitted. Such manuscripts will therefore often be met with a rejection.

    Manuscripts from medical students tend to be based on simple observational studies – you write up a patient material, as they say – or on a literature review about a limited topic. It is crucial that the supervisor takes an active part from the very beginning of the process – from the formulation of the research question, literature search and choice of methodology. The preparation of the text must take place in parallel with the data collection, interpretation and discussion, where the supervisor advises, checks, corrects and improves as needed. The research findings made by the authors and others must be interpreted and placed in context. This requires nuanced formulations and attenuated conclusions, to which many students may be unaccustomed. In short, the supervisor needs to function as midwife to the manuscript. The role of the journal is to help make this process as smooth and painless as possible, and to provide constructive feedback on how the manuscript can be even further improved. Everything is hard to do the first time you try. This also applies to authors of journal articles.

    When a submitted manuscript is based on a project report that has already been delivered, the publication of the project report in the faculty's web archive should be restricted, i.e. postponed until the academic article has been published (5). This is required in order to avoid a rejection with reference to the journals' ban on duplicate publishing – no reputable journals accept manuscripts or research data that have already been published elsewhere.

    Not all medical students will become researchers, but all doctors need to read and refer to research and academic articles. Writing a project report or a manuscript for publication in an academic medical journal is therefore an important part of the studies for a medical degree (2, 5). Receiving help in writing a manuscript and having it assessed by editors and peer reviewers is a good experience for all students, irrespective of their choice of specialty and further career. Good writing advice is easily available (3, 4), and the editors will be happy to receive more high-quality manuscripts from medical students. Happy writing!


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