#KEYLIMEPODCAST 158: Dear Author. Nope. The Editors. Reasons for Rejecting a Manuscript

This study seeks to inform scholars about common reasons for internal editor review rejections, increase transparency of the process, and provide suggestions for improving submissions. Read on, and check out the podcast here (or on iTunes!)


KeyLIME Session 158:

Listen to the podcast

Read the episode abstract here.

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Meyer HS1, Durning SJ1,2, Sklar D2,3, Maggio LA1. Making the First Cut: An Analysis of Academic Medicine Editors’ Reasons for Not Sending Manuscripts Out for External Peer Review. Acad Med. 2017 Aug 1.[Epub ahead of print]

Reviewer:  Jon Sherbino (@sherbino)


If you are an education scholar, I can 100% guarantee that you’ve received this email. “Dear So and So, Thank you for your submission. Our journal receives many more submissions than it can publish. Unfortunately, we are unable to publish your manuscript. In fact it was a really easy decision.. your paper is a real stinker…” Ok, you have definitely received a rejection letter from a journal editor, but the last sentence is really specific to my submissions.

If navigating the world of HPE peer reviewed publication is a complex process, than this paper is for you.


This study seeks to inform scholars about common reasons for internal editor review rejections, increase transparency of the process, and provide suggestions for improving submissions.

Key Points on Methods

Each manuscript is reviewed by the editor-in-chief, deputy editor, and two associate editors. Each of the editors provide written comments and a recommendation (reject/send for review) to the EIC. Bimonthly phone calls among the editors to ensure a shared mental model (frame-of-reference) for the criteria regarding these decisions. There is no specific checklist.

This was a mixed methods study. Internal editors’ (not external peer reviewers) free text comments were reviewed using descriptive content analysis via a constant comparison approach. The articles themselves were not analyzed.

Bordage’s “top 20 reasons reviewers recommend rejection” was used as a sensitizing concept.

Two authors independently analyzed 20 sets of comments, collaborated to achieve consensus on a code for 5 rounds. Once the code was established, they continued independently for 100 sets of comments, reviewing any new findings. Inability to reach consensus was resolved via a third author, who served as a tie breaker.

This study received REB approval.

Key Outcomes

From December 2014 to December 2015, 1,273 submissions were internally reviewed (55% research reports, 15% innovation reports, 30% articles). Commentaries and reviews were excluded.

Approximately 65% of submissions were rejected overall, 29% after internal editor review. There was an average of 3 reasons for internal rejection per manuscript with a range of 1 to 9. (The manuscript with 9 reasons for rejection might have been mine).

There were 29 reasons for rejections, clustered under 9 themes:

  •  ineffective study question / design (92%)
  • suboptimal data collection (49%)
  • weak discussion / conclusions (37%)
  • unimportant or irrelevant topic to the journal’s mission (37%)
  • weak data analysis / presentation of results (33%)
  • text difficult to follow (24%)
  • inadequate or incomplete introduction (18%)
  • other (11%)
  • scientific conduct (5%)

Suggested recommendations for publishing your scholarship include:

  • Find the right journal for your manuscript (i.e. align journal mission with manuscript conclusions)
  • Craft a clear question and design
  • Demonstrate integrity and act responsibly as a researcher

Key Conclusions

The authors conclude:

“Findings suggest that clear identification of a research question that is addressed by a well-designed study methodology on a topic aligned with the mission of the journal would address many of the problems that lead to rejection through the internal review process.”

Spare Keys– other take home points for clinician educators

In 2013 30.5 M hours of peer review was conducted! As a surrogate marker, this statistic demonstrates that the literature (and submission) to the literature is rapidly growing. A reminder about the necessity of second order peer review (i.e. KeyLIME).

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