Medical writing, editing and publishing

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  • http://ino.sagepub.com/for general practice

    InnovAiT: Education and inspiration

    http://ino.sagepub.com/content/7/6/370The online version of this article can be found at:

    DOI: 10.1177/1755738014531563

    2014 7: 370 originally published online 6 May 2014InnovAiTChantal Simon

    Medical writing, editing and publishing

    Published by:

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    On behalf of:

    Royal College of General Practitioners

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  • Medical writing, editingand publishing

    Although the core function of general practice is patient care, there aremany opportunities for GPs to get involved in other educational and aca-demic activities. Most GPs find academic activities a useful adjunct to their

    clinical work. As well as being educational and broadening horizons, such activ-ities stimulate GPs to think and reappraise their own clinical work and the work oftheir practice. This article aims to give an overview of the range of opportunitiesavailable within medical publishing and some tips on how to access thoseopportunities.

    The GP curriculum and medical publishing

    Relevant to medical publishing, RCGP Contextual statement 2.03: The GP in the wider professionalenvironment requires GPs to be able to:. Communicate effectively with individuals and groups. Promote the sharing of information and resources. Proactively seek to improve services by questioning the status quo. Develop and communicate aspirations for the improvement of services. Seek out, adopt and disseminate models of good practice. Actively seek to inform and influence decision-makers. Actively seek and take account of the views of others. Create opportunities to bring together individuals and groups to achieve goals. Take into account the needs, feelings, values and expertise of others, and. Demonstrate the ability to be an effective member and, where appropriate, be a willing leader of a team

    Contextual statement 2.04: Enhancing professional knowledge requires GPs to be able to:. Acquire the research and academic skills required of a GP that aid decision-making, which include a non-

    judgmental evidence-based approach to problem solving and recognising how individual bias may affect your

    interpretation. Be prepared to act as an educator within your local community. Understand that your opinion is often asked for as an expert, and that when given you should take care to ensure

    you understand the evidence or experience that underpins your own understanding, and be clear when you are

    stating an opinion based on experience rather than evidence. Understand that teaching others is more than imparting information

    Getting involved...........................................................Local initiativesIf you want to try your hand at writing educational mater-ial, there may be opportunities already within your ownpractice. If your practice produces a newsletter forpatients, consider writing a self-help article to be pub-lished in it. Alternatively, many practices have journalclubs or regular education sessions. Volunteer to lead

    one of these sessions and write some supporting educa-tional material for your colleagues. Another way to getinvolved at a local level might be to contribute to, or evenedit, your local RCGP Faculty newsletter.

    ReviewingPeer reviewing articles for journals, whether research-oriented journals or educational journals, is a good wayto find out how other people write. You will soon pick up..

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  • style points that you think are effective and others thatyou find annoying. It is also useful to review other peo-ples articles if you are intending to submit an article ofyour own to a journal, as it helps you to become familiarwith the style and the level at which articles are pitchedfor that particular journal.

    To become a reviewer for a journal, go to the journalshome page. Often you will be able to sign up to be areviewer online. In most cases this requires providingyour contact details and also some information aboutyour areas of expertise/interest. If that is not possible,contact the journals Editorial Office.

    Writing letters to be publishedIf you have strong feelings about information that is pub-lished in a newspaper or academic journal, consider writ-ing a letter to express your views. This is a much smallerundertaking than writing a whole article, but gives youinsight into the way that publications are put togetherand practice in getting your point across in a succinctand interesting way.

    Writing articles for journals and othermedical publicationsWriting an article for a journal is a good way to test outyour writing skills. Medical writing courses are available,often through local medical schools. These can providehelpful hints and also boost your confidence to write anarticle yourself. However, really the best way to learn isto have a go.

    First, pick your journal. The choice of journal will dependon the type of article that you want to write. For example,the British Journal of General Practice contains reports onoriginal research as well as review articles on topics ofbroad interest to GPs. InnovAiT contains educational art-icles linked to the GP Curriculum and is a useful resourcefor all GPs.

    If a complete feature article is too much to tackle firsttime around, what about writing a short discussion art-icle? For example, you could write an 800 word (singlepage) 10-minutes conundrum for InnovAiT, or a 1200word Debate and Analysis article for the British Journalof General Practice. InnovAiT also has a buddy schemethat pairs inexperienced authors with those who havepreviously written published articles. The buddy pro-vides informal feedback and advice during the writingprocess and before the article is submitted. This canhelp boost novice writers confidence, and is also likelyto result in a better article with a higher chance of accept-ance. If you would like to use the InnovAiT buddyscheme to help with writing an article for InnovAiT,please contact the InnovAiT Editorial Office.

    Once you have chosen your journal and before writingyour article, read a few back issues to get a feel for thejournal style. Go to the journals website to find out howto submit an article and download the authors instruc-tions. Make sure that when you write your article thatyou stick to the authors instructions. Many journals willsend your article straight back to you without consideringit further if it is not formatted correctly. If you have anyquestions contact the Editorial Office of the journal andask for clarification.

    Choice of topic is important. Good topics are ones thatinterest you, are small enough to tackle within a singlearticle, and are clearly defined. Decide on the scope ofyour article before you start writing and stick to yourremit. There is no right or wrong way to write an articlebut I find the formula outlined in Box 1 helpful.

    When writing an article, it is important to remember thatyour work should be original. Cutting and pasting mater-ial from other sources without permission from theauthor/publisher is illegal and most journals now havesophisticated electronic plagiarism-screening softwarethat checks every article for this type of borrowed mater-ial. Finding plagiarised material will result in immediaterejection of your article and could result in a GeneralMedical Council complaint.

    If you want to copy material legally for your article, suchas a picture or table from another source, then generallyyou must seek and gain written permission for its usefrom the person or organisation that owns the copyright.Journal policies relevant to material copyrighted else-where should be included in the author instructions avail-able from the journals website. If you are unsure, contactthe journals Editorial Office for advice.

    Once you submit your article, most respectable journalshave a peer review process. Your article is sent to otherpeople interested in the field for their feedback.Reviewers may be anonymous, but increasingly theyare required to identify themselves to the author.Reviewing is used by Editors to judge the quality andalso the suitability of an article for their journal. Gainingthe opinion of others is also useful to provide suggestionsto improve the quality of articles from the readers per-spective. It is important to remember that reviewers areasked to express an opinion, so will always make com-ments, both positive and negative, about your article. Donot take reviewer comments personally.

    Some journals have a huge volume of submissions andreject a large proportion of them. For example, the BritishMedical Journal rejects over 90% of its submissions, so donot be disheartened if this happens to you. Try to extractthe valid points that the reviewers have made in theirreviews, use them to improve your article, and theneither resubmit your article to the same journal (if ithas not been rejected) or revise its format to that ofanother journal style and submit it elsewhere...

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  • Remember that you do not have to incorporate all com-ments made by the reviewers; they are suggestions toenhance your work and not instructions.

    Writing booksWriting a book is a major undertaking, but it can be veryrewarding. If you want to write a book, the first step is todecide on a topic. Producing a book is an expensiveprocess, both in terms of your own time and effort andalso in terms of production costs. The advent of self-published e-books has enabled more people to createbooks, but if possible gain the support of a reputablecommercial publisher as this will minimise your owncosts, facilitate your book getting to the market intended,and you will benefit from the publishers experience,expert production team and contacts.

    Commercial publishers will not take a book proposal for-ward unless the project is commercially viable.Therefore, there must be an obvious market for a bookon the topic that you have chosen, and also a gap in theliterature already available on that topic.

    When you have chosen your topic, you need to puttogether a book proposal and prepare some samplematerial to submit to your chosen publisher. When build-ing the contents list of a book, the contents of an individ-ual chapter within a book, or even just the structure of aspecific topic within a chapter, I use the same basic prin-ciples, outlined in Box 1, that I use when writing an article.

    Most publishers now have pro forma templates for bookproposals, so contact the Medical Commissioning Editorof the publisher that you are aiming to submit your pro-posal to and ask. If they do not have a pro forma tem-plate, ask what they would like to see included in theproposal. Box 2 lists the information usually required.

    Medical book publishers send book proposals out forpeer review in much the same way as articles are sentout for review by journals. Be prepared to answer thecomments made by the reviewers.

    If your proposal is accepted, then the hard work starts. Itis very easy to get bogged down writing a book and ittakes a great deal of self-motivation to complete the task.Stick to your original remit; break the task down intomanageable chunks; and set yourself realistic targets tocomplete each task within a given time frame. When youare happy with the finished product, draw a line

    Box 1. Step by step guide to writing a medicalarticle.

    1. Think about what you would want to knowabout your topic.

    2. Think about what your target audience mightwant to know about your topic. Is the informa-tion that you want to know about the topic thesame as the information that your target audi-ence would want to know? If necessary ask rep-resentatives of your target audience so that youget a feel for their information needs.

    3. Think about where you will get the informationfor your article. Useful starting points are originalresearch articles, review articles, internet infor-mation resources, and guidelines such as thoseproduced by the National Institute for Health andCare Excellence.

    4. Collect the information that you will need andkeep a note of from where each piece of infor-mation was obtained.

    5. Read and digest the information that you havecollected. Select information that you want touse, and reject information that falls outsidethe scope of your article. Make sure you under-stand the topic and get it straight in your head.

    6. Organise the information that you want to useinto a series of five or six headings with a logicalorder. I view these rather like stepping stones toguide you through the article. For researchreports these stepping stones are standardised -Introduction, Method, Results, Discussion andConclusion. For educational articles determiningthe stepping stones can be more difficult. I try toconstruct a story to lead the reader through thetopic from introduction to conclusion.

    7. Rewrite each section so that it reads well and iseasy to follow.

    8. Add additional material that helps to illustrate thepoints made in the article. Additional materialwill vary according to the topic and style of thejournal. For example, a report of original researchmay benefit from inclusion of a table or graphicrepresentation of the results; an article for aneducational journal such as InnovAiT mightbenefit from a photograph of a condition, orcase study report.

    9. When you are happy with the content, ensurethe article is correctly formatted for the journal towhich you aim to submit it. Go through the art-icle and cut out additional words or informationthat does not contribute to the story that you aretrying to tell. I usually manage to reduce thelength of my articles by between 3050%.

    10. Leave your article for a few days then read itthrough again from start to finish to ensurethat: it reads well, is grammatically correct anddoes not contain any spelling or typographicalerrors. It may be useful at this point, especially

    (continued)

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    Box 1. Continued.

    if you have little experience of writing, to ask acolleague or friend to read through your articleand provide constructive feedback.

    11. Once you have done your own mini-review,submit the article.

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  • underneath the project and submit it, as it is possible totweak the contents forever and still find more to change.If you have made any errors, then there will be chancesto correct them at later stages in the production process.

    Writing material for electronic platformsElectronic publishing (e-publishing) has emerged as amajor player in the medical publishing world. Althoughthere are new techniques that can be applied to elec-tronic formats, the general principles of medical publish-ing apply. If you are interested in producing material forthis exciting new platform, contact the CommissioningEditors running e-publishing projects to obtain moredetails of how to become involved.

    The RCGP has a comprehensive e-learning programmewithin its Online Learning Environment (OLE). If youwould be interested in becoming an author for theOLE, please contact the RCGPs e-learning team at e-learning@rcgp.org.uk.

    Medical editing...........................................................Medical editors are managers who co-ordinate theproduction of written or electronic material for publi-cation. In general it helps to have done at least somemedical writing before taking on an editing project.An editors job is to have an overview of the wholetask and to ensure that everything produced by thepeople working on or submitting material to the pro-ject is in-line with the overall aims and objectives ofthat project.

    In the case of periodicals, this will involve determin-ing the structure of the whole journal or a section ofthe journal for which you are responsible. It willinvolve deciding what goes into each issue of thejournal and the order in which that material will bepresented. For books, the editing process involvesformatting the book to give the material within itan identity, and cutting material and/or moving itaround to give the overall effect that is envisagedfor the book.

    You can make your own opportunities for medical edit-ing, for example, by submitting a book proposal withyourself as the editor of the book. Alternatively, youcan apply for an advertised medical editors post.Opportunities exist at all levels and often, for jun-ior editor posts, no prior experience of editing isnecessary.

    In addition, some journals (such as the BJGP and BritishMedical Journal) provide short-term internship opportu-nities and sometimes attendance at hanging committeeswhere papers are discussed in relation to acceptance forpublication. These can be useful avenues through whichto gain experience of medical editing without long-termcommitment.

    Payment and fees...........................................................Payments and fees vary widely. Most respected aca-demic journals published on behalf of or by academicinstitutions do not pay their authors for their articles,nor do they pay the reviewers of those articles.Commercial publications may pay fees. If you areunsure whether a fee is payable, ask before you writeyour article. Editors of journals do get paid, but fees areextremely variable and often only amount to a small hon-orarium plus expenses.

    Authors and editors of books are either paid a fee by thepublisher on completion of the project or a percentage ofthe profits from the sale of the publication (royalties). Ifyou agree to a flat fee payment, then you are guaranteedsome financial return for your efforts. If a percentage ofprofits is paid, then you may not see any profit from thehard work that you have put into producing your bookfor up to a year after publication - and then only if thebook sells. On the other hand, if you happen to write abestseller, the financial rewards may be considerablyhigher.

    Competitions and prizes...........................................................For me, just seeing something that I have written in printalways gives me a thrill, whether I am paid for my work ornot. However, for others writing to win a competition orprize is their driving force.

    Box 2. What to include in a book proposal.

    . Title of the book

    . List of editors/authors

    . Aims of the book

    . Structure of the book what will this book looklike? Will this be a full colour photographic picturebook, a portable Handbook, or a large, traditional

    textbook? Is this book intended to be part of an

    existing series?. Outline of contents this is usually an estimate of

    the total length of the book, list of chapter titles

    and estimate of the number of pages each chapterwill need, and summary list of topics that each

    chapter will cover together with the number of

    pages allocated to each topic. Market assessment what is the target audience

    and how big is the market?. Information on competing books. A brief curriculum vitae for each of the authors. A sample chapter this gives an idea of the style

    and focus of the proposed book, so it is important

    to get the sample chapter right

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  • Perhaps the most prestigious prizes for doctors who writebooks are the British Medical Association (BMA) annualbook awards. These are awarded every year in a range ofclinical categories at a dinner in London. The winners ofthe individual categories then compete for the overallBMA Book of the Year award.

    There are numerous prizes and awards that can begained for writing single articles. For example, theRCGP awards prizes for research papers and essays onspecific topics such as the history of general practice. TheRCGP website lists upcoming awards and deadlines forsubmission. The Royal Society of Medicine also givessimilar awards with several available within the field ofprimary care.

    Copyright and authorspersonal rights...........................................................Copyright issues are a minefield. In the UK, whenever aperson writes a journal article, letter, online article, or anyother form of written material, that material is known as awork. The author automatically owns the copyright forthat work until it is formally assigned to another person ororganisation.

    In order to publish a work, a publisher must seek per-mission to reproduce it from the author. Publishers dothis in one of two ways:. Assignment of copyright the author assigns the

    copyrights of the work to the publisher, usually forthe whole duration of copyright (although theauthor still retains moral rights). The publisher oftengrants certain rights back to the author, such as theright to reproduce their own work for non-commercialpurposes.

    . Licence to publish the author retains the copyrightbut signs a licence agreement that grants exclusiverights to the publisher. These rights are usuallyexhaustive and may include the right for the publisherto reproduce the work in all formats throughout theworld for the full duration of copyright.

    For the majority of medical publications, there is littlepractical difference for the author between the twomethods. However, copyright law is complex and youwould be wise to seek professional advice before com-mitting to any assignment of copyright, or licence to pub-lish agreement, for a major work such as a book.

    The Copyright, Designs and Patents Act (1988) also pro-tects the personal rights of authors over their work.These rights are known as moral rights. Becausemoral rights are personal, they cannot be transferred toa publisher. The moral rights include the authors right tobe credited as the author of a work (attribution right),and integrity right or the authors right to object to

    derogatory treatment of their work. Derogatory treat-ment includes modification of a work that distorts it, oraffects the authors reputation. Further advice on copy-right and on personal (moral) rights can be obtainedfrom the UK Intellectual Property Office (www.ipo.gov.uk).

    Summary...........................................................Medical publishing is a huge and varied field; gettinginvolved can be both educational and stimulating. It isa flexible adjunct to clinical general practice with whichanyone can engage at any level - from preparing a news-letter for the patients of your practice to editing a majortextbook. I hope that reading this article will encourageyou to have a go. Further information about gettinginvolved with writing or reviewing for InnovAiT can beobtained by email from: editorialoffice@innovaitjournal.co.uk

    Key points. Any GP can get involved with medical publishing. Opportunities for writing, reviewing and editing

    are many and varied ranging from in-practice pub-lications to worldwide best-sellers

    . When creating any written piece, think of theneeds of the audience that you are targeting,take an evidence-based approach, and ensure alogical flow of information from start to finish

    . Take heed of reviewers comments and do nottake any criticism of your work personally; use allfeedback in a constructive way to enhance yourwork

    . Know your rights with respect to your own workand ensure that terms and conditions for publish-ing your work are negotiated and agreed inadvance

    References and further information

    . British Journal of General Practice homepage.Retrieved from http://bjgp.org/

    . British Medical Association. (2014). BMA medicalbook awards. Retrieved from http://bma.org.uk/about-the-bma/bma-library/medical-book-awards

    . InnovAiT homepage. Retrieved from http://ino.sagepub.com/

    . InnovAiT. (2014). Manuscript submission guide-lines. Retrieved from www.uk.sagepub.com/msg/ino.htm

    . Intellectual Property Office. (2011). Copyright:essential reading. Retrieved from www.ipo.gov.uk/types/copy.htm..

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  • . Oxford University Press. (2014). Author resourcecentre. Retrieved from http://global.oup.com/academic/authors/?ccgb&langen

    . RCGP. (2014). RCGP awards. Retrieved fromwww.rcgp.org.uk/about-us/rcgp-awards.aspx

    . RCGP. Contextual Statement 2.03: The GP in thewider professional environment. Retrieved fromwww.rcgp.org.uk/GP-training-and-exams/GP-curriculum-overview.aspx

    . RCGP. Contextual Statement 2.04: Enhancing pro-fessional knowledge. Retrieved from www.rcgp.

    org.uk/GP-training-and-exams/GP-curriculum-overview.aspx

    . Royal Society of Medicine. (2014). RSM awards.Retrieved from https://www.rsm.ac.uk/academ/awards/awardsdate.php

    . SAGE. (2014) Publishing your book with SAGE.Retrieved from www.uk.sagepub.com/bookAuthEdit.nav

    Dr Chantal SimonExecutive Editor, InnovAiTEmail: innovait.editor@rcgp.org.uk

    DOI: 10.1177/1755738014533030

    ............................................................................................................................................................

    AKT question relating to managementof angina

    Single Best Answer Question

    You see a 53-year-old man with angina. He has beenexperiencing more frequent episodes of exertionalchest pain recently, but is currently pain free. He istaking bisoprolol 10 mg daily and glyceryl trinitrate(GTN) as required. On examination you note thefollowing:

    Blood pressure 134/82 mmHgPulse rate 68 beats per minute, regular

    According to current guidance, what is the SINGLEMOST appropriate management for this patient?Select ONE option only.

    A. Add amlodipineB. Add aspirinC. Add diltiazemD. Add isosorbide mononitrateE. Add nicorandil

    Answer DOI: 10.1177/1755738014533031

    Dr Michael NandakumarGP, The Fairfields Practice, Nottingham

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