A Crash Course in Medical Writing for Health Profession Students

J Canc Educ (2013) 28:554–557 DOI 10.1007/s13187-013-0502-0 A Crash Course in Medical Writing for Health Profession Students Matthew Gordon Crowson Published online: 23 June 2013 # Springer Science+Business Media New York 2013 Abstract The production of publications is a key component of one’s career advancement in medicine. The goal of this piece is to discuss five tips to help health profession students get started in medical writing. First, students should take full advantage of the time-saving resources at the local academic biomedical library. Second, outlining a manuscript is one of the essential first steps for producing a successful, high-quality publication. Third, planning the manuscript and writing efficiently is critical since many young authors are either in medical school or residency and do not have ample time to devote to the writing process. Fourth, communicating complex concepts, thoughts, ideas, and observations in a simple way is important and helps limit redundancies, awkward passages, and improves reader comprehension. Lastly, a student can maximize their chances at publication if they are persistent in how they approach manuscript submission. The chances for successful publication of a project can be increased if young authors consider the tips supplied here. Keywords Medical writing . Publishing . Education students. This leaves many budding authors with little or no training as they attempt to contribute to their respective fields of medicine, and further their careers. The lack of training and experience in medical writing can lead to author frustration, time lost, and rejected manuscripts. A recent study found that of the top ten reasons for manuscript rejection, six included entirely preventable reasons such as picking the wrong journal, incorrect submission format, not following journal article preparation guidelines, and mechanical issues in the methods, results, and discussion sections [1]. A student can decrease the chances of manuscript rejection with some foreknowledge of how to approach the medical writing process and avoid these causes for rejection. The aim of this article is to share five tips to help health profession students get off to a good start in medical writing. Specifically, this article will cover how young authors can tap into local writing resources, how to use an outline to decrease writing time and increase writing quality, how to become a more efficient writer, why writing simply is important, and how being persistent maximizes the likelihood of publication acceptance. The intended audience is for medical students, residents, fellows, or any new author looking to begin a productive career in medical writing. Introduction Medical writing is the vehicle of medical knowledge that transports our innovations and observations through time. The production of book chapters, conference abstracts, and journal articles can also be a key component of career advancement in medicine. Despite the importance of medical writing proficiency, few medical schools and residency training programs offer formal training for health profession M. G. Crowson (*) Geisel School of Medicine at Dartmouth College, 142 Kellogg Building, Hanover, NH 03766, USA e-mail: matthew.g.crowson@dartmouth.edu Tip # 1 – Tap into Your Local Publication Gurus Medical writing needs not be a solo sport. Students can tap into time-saving resources at the local academic biomedical library. Such resources include archived library grand rounds or conference presentations on topics such as how to produce high-quality publication-ready manuscripts [2], and subscriptions to periodicals or textbooks on the technical aspects of medical writing (i.e., American Medical Association Style Guide). A number of high-quality articles available through library periodical subscriptions have been written to help J Canc Educ (2013) 28:554–557 students and new authors get started with the technical aspects of medical writing [3–9]. Many academic libraries now have dedicated reference librarians who are facile with medical database (i.e., PubMed, EMBASE) search strategies. Enlisting the help of these librarians can save many hours of work in finding periodicals for your manuscripts’ background material. Perhaps the biggest benefit of all is that most library and reference librarian services are free or charge nominal fees for these services to members of the home academic institution. Local authors, publishers, and editors of medical periodicals or conference materials are another key resource. These mentors can be approached to provide a read-through of manuscripts for appropriate flow, logic, and content if the author is in the relevant field of medicine. One major reported cause of manuscript rejection is incorrect journal selection for submission [1]. An established medical author in the relevant field could help steer the young author towards more appropriate periodicals to limit this specific rejection risk. Moreover, established medical authors may be aware of upcoming journal theme issues specific to the young author’s manuscript, and this may increase the chance of submission acceptance. Tip # 2 – Outline, Outline, Outline Outlining a manuscript is one of the essential first steps for producing a successful publication. The process of outlining can be as simple as writing down the major headings, subheadings, and major points in a word processor document. This “topdown” approach is one method for producing an outline that clearly organizes the major concepts and talking points. After the basic skeleton outline is complete, the headings and subheadings are ready to be filled in with content and references. One major benefit of outlining is it allows for direct visualization of the organization and flow of the manuscript. Subheadings, talking points, and references can easily be cut and pasted around the document as the author analyzes the flow and structure of the manuscript in point-form. The author can also employ visual font features like highlighting, bolding, and strike-through to annotate the text or references as needed. Perhaps the largest benefit of outlining is the potential to save time. Many veteran authors agree that outlining a paper early in the writing process can save hours of work later by preventing organizational and flow errors. One veteran believes writing a paper without an outline is akin to building “a house without a blueprint of design and foundation. The end product ends up a mess of disorganized and illogical thoughts, redundancies, and irrelevant material—all of which makes the work much harder for the writer, sometimes impossible” [10]. Disorganized thoughts and poor flow lead to poor writing. Poor writing increases the amount of time required for edits and revisions later, and the probability of manuscript rejection 555 [1]. Time set aside for outlining as the author begins to put pen to paper—or fingers to keyboard—will save time later and will produce an organized manuscript with a better chance for favorable review by journal editors. Tip # 3 – Get Your Black Belt in Medical Writing Efficiency Becoming an efficient writer is critical since many young authors are either in medical school or residency and do not have ample time to write. One method for increasing efficiency is to have a central electronic repository of drafts, outlines, figures, data, and references. A USB thumb drive can serve as an electronic briefcase that can be used with any locally available (i.e., hospital, airport, or school) computer. This mobility enables the student to continue to work when they are on the run and away from their home computer. Some projects call for a large amount of cited references that need to be organized in one location and easily accessible. There are commercially available reference managers (e.g., EndNote) that can secure their reference data off-line, on an USB stick, or in an online cloud location accessible from any internet-enabled computer or mobile device. Writing is a creative process that is not necessarily conducive to being scheduled or planned. If a busy student or resident sets aside time at the end of the day to begin writing, s/he may be too tired or write meaningfully. This same author may also have fleeting thoughts of good sentences or ideas, but no means of capturing these thoughts as they come to mind throughout the day. This is why it is also important to Fig. 1 The white coat mobile office. USB electronic briefcase, writing implements, and portable hard copy references 556 keep pens or pencils, hard copies of references, and the USB briefcase close at hand (Fig. 1). Thoughts of a good sentence can be scrawled on the back of a patient census list for later inclusion in the manuscript. Key references can be printed double-sided and two pages per standard page to be folded and kept in a white coat pocket for easy access and reading. The USB briefcase with manuscript draft can be quickly pulled up on a ward computer should morning patient rounds end early. With significant time constraints and an unpredictable schedule, the student can find time to be productive by having an electronic central repository and the means to read references and capture thoughts close at hand. Tip # 4 – Write Simply Medicine is its own language unto itself. Even within medicine, the various specialties have their own “dialects” that can be difficult to interpret by physicians on the outside. Communicating our thoughts, ideas, and observations in a simple way through medical literature is crucial. One way to use simple communication is to use simple words in your sentences. Refrain from “thesaurus abuse.” It is desirable to sound intelligent and capable, but not at the expense of making your sentences incomprehensible and difficult to read. Having thematic redundancies or over-explained evidence and discussion points can make reading difficult. It would be a shame if a student obscures the manuscript’s key points or findings because of repeated referencing of pertinent background literature. Using the aforementioned outlining technique at the outset of writing will limit the incidence of redundancies. The author should be able to scan through an outline and identify where and how main points are being introduced and supported by evidence and the appropriate references. At times, it is necessary and economical to use heavy medical terminology to communicate a difficult concept or finding. In such cases, it can be helpful to read these passages aloud to verify that the material is palatable for the intended audience. Reading aloud will readily identify choppy, cumbersome, or awkward passages [10]. This method should also identify run-on sentences, or sentence fragments. As a difficult sentence is read aloud, a fix may become apparent as the author tries to talk through and smooth out a sticky or drawn-out sentence. Tip # 5 – Be Persistent It is unrealistic to think that a student will write a manuscript in one sitting that is fit to be accepted by a journal for publication. A student can maximize their chances at J Canc Educ (2013) 28:554–557 publication if they are persistent in how they approach writing and manuscript submission. Writing is a process that involves many outline versions, sentence and paragraph edits, manuscript drafts, and read-throughs. A student can save many hours of work by approaching the process with a well-organized outline and a flair for writing efficiency. However, even the most efficient student will require an appreciable amount of time and persistence to produce a successful manuscript. In fact, the student should expect to run into manuscript rejection with regularity. The best course of action in face of rejection is to keep with it. The student should anticipate rejection and be proactive in their approach to manuscript submission. The author should prepare a list of journals that may be acceptable for the type and scope of their manuscript. A numbered list of potential journals for submission can be arranged in descending order of journal prestige, impact factor, relevance, and/or likelihood of manuscript acceptance. In general, a manuscript can only be considered for publication with one journal at a time. If a desired journal rejects the manuscript, the young author should immediately proceed with submission to the journal that is next in line. Local authors, publishers, and editors can be invaluable resources for a young author in this process. They can serve as a “personal editorial board” for the student’s project and can aid in producing a list of appropriate journals. Conclusion Medical writing is fun, engaging, and can be important for a student’s career in a health profession. Chances for successful publication of their projects can be increased if young authors consider the tips supplied here given that many of the top reasons for manuscript rejection are entirely preventable. Above all else, the student needs to enjoy the process of writing and find her or his own way to make it a regular part of their daily routine. Acknowledgments The author would like to thank Dr. Joseph O’Donnell MD for his guidance and assistance in the preparation of this manuscript. References 1. Pierson DJ (2004) The 10 reasons why manuscripts are not accepted for publication. Respir Care 49(10):1246–1252 2. Sox H, Dant C. “The Biomedical Manuscript: Strategies for Getting Your Paper in Print from the Journal Editor’s and the Writer’s Perspectives.” Peer-Reviewed Biomedical Manuscripts Seminar Series [Grand Rounds]. Dartmouth-Hitchcock Norris Cotton Cancer Center. 13 May 2011 J Canc Educ (2013) 28:554–557 3. Cole P (1998) The only paper I ever wrote. 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