HealthEd: Unlocking the Secrets to Publication: Insights and tips for success from editors

Unlocking the Secrets to Publication: Insights and tips for success from editors

Osmosis Team
Published on Jun 5, 2023. Updated on Jun 7, 2023.

We sat down with Dr. Ximena Alvira to discuss the journal publication process in today's Osmosis blog, including her tips on reaching the ideal audience for your research, so your hard work will help as many people as possible. 

You've conducted your research program and are excited by the findings. You're confident your paper makes a real contribution to your field, but how do you ensure it's published in a reputable journal with the broadest circulation? 

Why conduct research?

It begins, as everything worthwhile in science does, with research. Research aims to address specific questions or problems, gather evidence, test hypotheses, and draw meaningful conclusions. It serves to expand our knowledge base, inform decision-making, drive innovation, and ultimately deepen our understanding of the world and its complexities. 

Furthermoreto practice evidence-based medicine, we need to generate evidence, which is done through research. Evidence informs safe and effective patient care. Relying on common sense just isn't enough when it comes to dealing with human lives, especially in the realms of designing clinical pathways and treatments. 

Similarly, to know where and how to get published, you need to conduct evidence-based research. There are around 30,000 biomedical journals, 6,000 of which lie within the field of medicine. Although this means you have a lot of potential publishing outlets for your work, it also means that these publications have very specific remits and editorial policies. 

It's also true that rejection rates remain high, even for very accomplished authorsFor instance, The Lancetwhich ranks first among all general and internal medicine journals globally, accepts only 5% of the papers it receives. The problem is one of volume and qualityEach monthThe Lancet receives hundreds of submissions, and they only have room to publish a small fraction of these.

The publication process 

Given the many pitfalls of submission, it pays to understand the editorial process and the complex route to publication. Here's an example of the submission and publication process at Elsevier: 

Many papers are rejected by the chief editor even before they reach the peer review stage. This is often due to technical errors, poor English, incomprehensibility, or lack of a clearly defined purpose.  

Those that pass this initial screening are sent out for peer review, and then those reviews are assessed by the editor. At this stage, one of four things will happen: 

  1. The paper will be rejected. 

  2. It will be sent back for additional peer review. 

  3. The authors will be asked to make amendments or revisions and then resubmit. 

  4. The manuscript will be accepted for publication.

Although the latter is the most desirable outcome, it's more likely that revisions will be requested. The revision process can involve several iterations before a final draft is accepted.

Common problems and pitfalls which lead to rejection:

  • The paper doesn't offer any new insights or proposals. 

  • The paper's hypothesis hasn't been made clear. 

  • The paper is over-ambitious in scope. 

  • The authors haven't made their research process clear. 

  • The paper is poorly structured and hard to follow. 

  • The English used is unclear or ungrammatical. 

  • The sample size isn't large enough to provide sufficient evidence. 

  • There are technical errors in the research methodology. 

  • The conclusions stated don't follow the evidence presented. 

  • The language used is too emotional and leading rather than neutral. 

That last point is a subtle one. It's easy to become caught up in enthusiasm when your research points to an extraordinary discovery. However, this emotion should not be present in your paper. Scientific papers present evidence and offer conclusions, but they leave any emotional response to the reader. 

In other words, avoid terms like "extraordinary," "interestingly," or "strikingly." By editorializing this way, you are telling the reader what to think rather than letting them reach their own conclusions. 

What do editors look for? 

Now that we've listed how an editor might object to your paper, let's take a more positive spin. What are they looking for? What would a dream manuscript contain, leading to an immediate acceptance (or a yes, following minor revisions)? 

An editor-in-chief scans through the titles, cover letters, and abstracts and then decides which papers to pass through to peer review. Which means it pays to spend time getting those three elements right. 

At the peer review stage, successful papers will tend to: 

  • Offer a clear and useful message 

  • Be delivered in a logical, standardized format 

  • Be easy to read. 

By standardized format, editors mean that it flows clearly, and includes the usual sections you'd expect from a scientific paper: an introduction, abstract, methods, results, discussion, limitations, conclusions, and so forth.

Ease of reading is too easily overlooked, as writers can become lost in technical jargon and may forget that the publication they're aiming at should have a general readership. In theory, any reader should be able to understand the paper, especially when we're talking about health research.  

Remember that competition is high. In 2022, Medline added 3,752 citation additions per day (three per minute)! If you want to stand out, ensure your work pleases an editor by fulfilling the following wish list: 

Aims and Scope 

The paper sits well within the aims and scope of the publication (more on that below). 


The research offers a positive practical impact – it can make a difference in clinical outcomes. Although blue-sky research – which is conducted without a specific practical application or immediate goal in mind – has a place in biomedical publications, health research should offer a practical contribution to clinical practice. In a word, your findings are useful. 

Research writer J.P. Ioannidis offered breakdown of clinical usefulness in his 2016 paper, "Why Most Clinical Research is Not Useful" and highlights features to consider.    



Journals like Nature, Science, or The Lancet, which have a large general readership, are highly focused on this aspect of a paper. Your manuscript should have one clear idea, and each section should contribute to the exploration of that one idea. 

One way to assess clarity is to have colleagues in a different discipline read your work. If they can understand it, readers of the large circulation journals will probably understand it too. If they can't, pay attention to their feedback and make revisions for comprehension. 


Ideally, the authors clearly state the purpose behind the research and clarify why publishing their findings is important. If the research offers something new, then state that upfront.


The writing is unbiased and neutral, allowing the reader to come to their own conclusions about the paper's findings. 


The methodology is valid, the study design is good, and the statistics reported, along with their presentation, are sound.  


Nothing is missing from the paper. For example, you've included a statement on the limitations of your findings, and all data is made available. All references are provided correctly. 


There are no technical errors in the data presented. Tables and figures are complete and clear.


This is related to clarity, but more specifically relates to the quality of the writing. The perfect paper reads easily without causing the reader to stumble over odd sentence construction or malapropisms. 

If your first language is not English, it's crucial to have a grammatically-adept native speaker proofread your paper before submission. Even when you're adept with English, it pays to have others review your work for typos, grammatical errors, overlong sentences, and other stylistic issues. 


Simply put, the paper's conclusions emerge naturally from the evidence presented. You have made a convincing argument based on the data you obtained in your research. 


This one is often overlooked. Keep paragraphs as short and concise as possible and ensure the writing is rich enough to maintain the reader's interest. 

Now let's turn to that all-important topic, a journal's Aims and Scope. 

Aims and Scope 

Given the huge volume of publications available in print and online, it makes sense that each one has highly specific requirements around the type of paper it publishes and the audience it's trying to address. 

Fortunately, all journals have their "aims and scope" listed on their website or in their publication. It may not always be called "aims and scope," but there will be a statement somewhere regarding what each journal is seeking. 

Pay close attention to this, and you won't waste valuable time submitting to the wrong journalwhich will do little to help increase the visibility of your work. 

For instance, the new Elsevier journal "Rare" specifically publishes articles concerning rare diseases from the science community, plus patients and carers. There would be no point in sending that journal an article about Leukemia since it's not rare.  

On the plus side, Rare's "aims and scope" include nine separate areas of interest, including ethics, technologies for diagnosis, health economics and public policy, and patient contributions to research.  

Their aims and scope are specific but wide-ranging within the specialist arena of rare diseases. There should be plenty of opportunities to offer articles that pique their editors' interest. 


It may seem daunting to negotiate all the expectations and preferences of journal editors to get your work published. However, a few key recommendations will keep you from tripping over the first hurdle.  

These are: 

  • Research what specific journal editors are looking for (aims and scope). 

  • Compose a paper with a clearly defined purpose. 

  • Structure your arguments logically in an easy-to-follow manner. 

  • Write in clear, simple English where possible. 

If there was one phrase to remember above all others, it would be the importance of a target publication's "aims and scope." Begin there, and you'll give yourself the best chance of producing a paper fit for publication. 

About the Author 

Dr. Ximena Alvira is a medical doctor, doctor in neuroscience, and a medical writer with over 25 years of experience to share. She's given more than 190 workshops in health research and publication worldwide and has been with Elsevier since 2012.