In an interesting and useful workshop at @ESICM LIVES 2025, Darren Taichman, Deputy Editor and Online Editor of New England Journal of Medicine and Executive Strategy Editor for the NEJM Group, shared insight on submitting a meaningful manuscript for publication that makes an impact.
Writing a scientific paper is about more than just documenting your research; it's about making your work accessible and compelling to the people who will decide its fate. After spending years designing studies, securing funding, and conducting rigorous research, many scientists undermine their efforts by rushing through the writing process. The workshop explored how to avoid common pitfalls and maximise your chances of publication.
The path to publication is long and filled with opportunities for rejection. Your paper must first pass an editor's initial screening, then survive scrutiny from associate editors and multiple reviewers. If it makes it past these hurdles, it faces discussion by the entire editorial board and additional review. Throughout this process, editors and reviewers are asking critical questions: Is this work novel? Is it valid? Is it important? How innovative is it?
Some factors affecting acceptance are beyond your control. A journal may have recently published papers on your topic, or similar work might already be in the pipeline. These are simply matters of bad luck. However, many elements of successful publication are within your control, and that's where careful writing makes the difference.
The most critical mistake in scientific writing is failing to care for your reader. It is important to remember that many reviewers are reading your paper late at night after putting their children to bed, or early Saturday morning. They're doing this work on top of their regular responsibilities, and they have far too much to read.
Your job is to make their life easy. Don't treat your paper as creative writing or poetry. Give readers what they want, where they want it. Keep your introduction in the introduction, methods in the methods, and results in the results. Don't mix sections or force reviewers to hunt for information. A well-organised paper takes half the time to read, and a reviewer who can move through your work efficiently is more likely to view it favourably.
Less is almost always better in scientific writing. The only exception is the methods section, where additional detail may be necessary for clarity. Everywhere else, be concise. Get to the point quickly. Never exceed the word limit. However, using obscure abbreviations to save words is counterproductive. When readers encounter an unfamiliar abbreviation and can't remember what it means, they become frustrated. If you're not completely confident that everyone in your field knows an abbreviation, spell it out.
Several linguistic mistakes can make you appear either incompetent or dishonest. For example:
Association versus causation. You know the difference, but it's easy to slip into causal language when describing observational studies. Be honest about what your study design can demonstrate.
Statistical versus clinical significance. These are not the same thing. Don't pretend something is statistically significant when confidence intervals are impossibly wide, using phrases like "numerically less" to hide non-significant findings.
Post hoc versus a priori analyses. Be transparent about which analyses you planned and which emerged afterward. Post hoc observations can be valuable and sometimes more important than planned analyses, but they're hypothesis-generating. Acknowledge this honestly.
Presenting your data effectively is also important. The information you provide in your tables and figures must serve a purpose. Reduce extraneous information. Tell a story through simple layout and logical ordering. Keep comparisons close together to make patterns obvious. Your visuals should convey information quickly and clearly.
Papers do get rejected, and rejection hurts. You may want to scream, cry, and curse the people who failed to recognise your brilliant work. However, even if reviewers completely misunderstood your paper, there's a lesson for you. If they misinterpreted your work, you failed to communicate clearly. Put the reviews aside for a few days, then read them rationally. Ask yourself: Would these suggestions improve the paper? Were we actually wrong? Did we fail to communicate effectively?
Consider what the reviews reveal:
- If reviewers didn't think your question was important, your introduction may need work
- If they misunderstood your results, your methods, tables, or figures weren't clear enough
- If they didn't grasp why your results matter, strengthen your discussion
- Or perhaps you submitted to the wrong journal for your audience
If you're invited to revise, be prompt. Submit within the requested timeframe. If you need longer because experiments are required, communicate immediately. Taking too long might mean the journal's priorities shift or that the novelty of your findings fades.
In your revision cover letter, repeat all comments, explain what you did, and address every single point. Never insult reviewers or challenge their objectivity, even if you're convinced they're wrong. You can disagree politely and collegially, but don't be rude and don't use lengthy responses that avoid answering the actual question. If asked to shorten your paper, do it.
If your paper gets rejected, there is usually no benefit in appealing. Appeal only if there's been a major error; perhaps your figures weren't visible to reviewers, or everyone misunderstood something. If you do appeal, don't rewrite your entire paper and send an uninvited rebuttal. Instead, write a short letter explaining what went wrong and what you could do differently, then ask if the editor would be interested in seeing a revision. This approach respects the editor's time and gets you an answer without wasted effort.
Keep in mind that you've spent years on training, study design, funding, and conducting rigorous research. Don't undermine all that effort by rushing through the writing. Take the time required to write well. Your research deserves a paper that does it justice; one that makes life easy for reviewers, communicates clearly, and tells a compelling story. That's how good science reaches the audience it deserves.
Source: ESICM
Image Credit: iStock
