A global network for medical journal editors

Bruce P. Squires, MD, PhD

Canadian Medical Association Journal 1995; 152: 1757-1759

Paper reprints of the full text may be obtained from: Dr. Bruce P. Squires, CMAJ, PO Box 8650, Ottawa ON K1G 0G8; fax 613 523-0937

In the idyllic setting of the Rockefeller Foundation Conference Centre in Bellagio, Italy, on the shores of Lake Como, 22 people from 13 countries gathered from Mar. 13 to 17, 1995, to consider how the increasingly complex problems facing medical journal editors might be addressed. The result of the conference was the formation of the new World Association of Medical Editors (WAME).

The impetus for the Bellagio conference and for the founding of a world association of medical editors was provided by Drs. Suzanne and Robert Fletcher while they were editors of Annals of Internal Medicine. At a meeting of the International Committee of Medical Journal Editors (the Vancouver Group) in 1990, several members agreed that although the Group would not be involved formally in the planning it would help the Fletchers to prepare a conference proposal for submission to the Rockefeller Foundation for support.

In preparation for the conference, groups of four or five participants were asked to address the following questions:

What are the common purposes of medical journal editors and the skills editors need to achieve these purposes?
What are the day-to-day obstacles and challenges medical journal editors encounter in trying to achieve their goals?
Is there a need for a global organization of medical journal editors? If so, how can such an organization be formed?
How can medical journal editors create a global electronic communication network to discuss goals and needs and share information, ideas and solutions?
How can medical journal editors use their position to promote high-quality medical science and medical practice and improve standards of health in their regions and throughout the world?

The responses were distributed among prospective participants and formed the basis for discussion at the conference. At Bellagio the participants formed writing groups to prepare summary papers on each of the questions.

Common purposes

Participants agreed that the fundamental purpose of medical journals (and their editors) should be to promote the science and art of medicine and the betterment of health. Although different journals might concentrate on different aspects of that purpose, several goals are common to all:

to publish original, important, well-documented, peer-reviewed articles on clinical and laboratory research;
to provide continuing education in basic and clinical sciences to support informed clinical decision- making;
to enable physicians to remain informed in one or more areas of medicine;
to improve public health internationally by improving the quality of medical care, disease prevention and medical research;
to foster responsible and balanced debate on controversial issues and policies affecting medicine and health care;
to promote peer review as a vehicle for scientific discourse and quality assurance in medicine and to support efforts to improve peer review;
to achieve the highest level of ethical medical journalism;
to promote self-audit and scientifically supported improvement in the editing process;
to produce publications that are timely, credible and enjoyable to read;
to forecast important issues, problems and trends in medicine and health care;
to inform readers about nonclinical aspects of medicine and public health, including political, philosophic, ethical, environmental, economic, historical and cultural issues; and
to recognize that, in addition to these specific objectives, a journal has a social responsibility to improve the human condition and safeguard the integrity of science.

Required skills

Although the participants acknowledged that no medical journal editor can have a personal knowledge of every scientific discipline they agreed that medical journal editors should be physicians with clinical or research experience and substantial knowledge of the topics within the scope of their journal. They must be familiar with scientific methods and with the principles of research design, implementation and evaluation. They also need a firm grounding in the science, ethics and art of peer review, not only to select (or discharge) reviewers but also to evaluate the quality of peer review.

Given the complexity of the day-to-day work in any journal office, it was clear to participants that medical journal editors need a variety of organizational, management and communication skills.

The participants recommended that medical journal editors belong to the fourth estate. Even though they might feel more comfortable as members of the scientific community, editors need to understand journalistic principles and the need to safeguard editorial freedom in order to maintain the credibility of their journals.

Obstacles, challenges and needs

Most medical journal editors around the world work with limited support and little or no training. Often they are selected on the strength of their clinical or research ability rather than because of their knowledge of and experience in editing. Few have access to the large body of knowledge that constitutes the field of journalology, and many work in isolation from their peers. They also often lack the tools to access information quickly.

All medical journal editors must deal from time to time with threats to their editorial freedom. Nevertheless, editorial freedom is essential to establishing and maintaining the credibility of a journal, and editors may need the support of colleagues in order to preserve that freedom.

The participants agreed that there is a pressing need for education and training of medical journal editors; because of the lack of established standards, the quality of editing varies dramatically from journal to journal.

A global network

Four major associations already in existence meet some of the needs of medical journal editors: the Council of Biology Editors, in North America; the European Association of Science Editors; the International Federation of Science Editors, whose focus of activity is in southern Europe, the Middle East and Asia; and the International Committee of Medical Journal Editors (the Vancouver Group). All have done valuable service in educating medical journal editors, but none is global and none but the Vancouver Group is directed solely to medical editors. The Vancouver Group, albeit highly influential, has very few members (by choice), limited aims and insufficient resources to meet the needs of the global body of medical journal editors.

The participants proposed the formation of WAME to facilitate worldwide cooperation and communication among editors of peer-reviewed medical journals, improve editorial standards, promote professionalism in medical editing through education, self-criticism and self- regulation, and encourage research on the principles and practice of medical editing. Membership is limited to medical journal editors or former editors (editors being defined as those who make decisions about the intellectual content of manuscripts) who, with their journals, subscribe to general ethical and scientific principles and use peer review. Scholars who are interested or active in research into journalology are also encouraged to participate.

The participants at Bellagio elected officers and struck committees for an interim period to end in September 1997 (Appendix 1).

Linkage with regional organizations

The participants recognized that an important feature of the new organization could be linkage with existing or new regional groups of medical editors. To this end, medical editors of peer-reviewed journals in Canada are invited to indicate their interest in WAME and in the possible formation of a Canadian network of medical editors by communicating with the editor-in-chief, CMAJ, PO Box 8650, Ottawa ON K1G OG8; tel. 613 731-9331, fax 613 523-0937; abolster@hpb.hwc.ca.

The founding members are confident that the establishment of WAME and affiliated regional networks will facilitate communication, education and support among editors of peer-reviewed medical journals. The success of WAME will depend, however, on the interest and effort of individual editors and scholars who wish to improve the quality of medical editing in their own countries and around the world.

Appendix 1: Officers and committees of the newly formed World Association of Medical Editors

Officers
President: Richard Horton, The Lancet
Vice-president: Daniel J. Ncayiyana, South African Medical Journal
Secretary treasurer: John Overbeke, Nederlands Tijdschrift voor Geneeskunde
Officer at large: Drummond Rennie, Journal of the American Medical Association

Board of Directors
S.T. Lee (chair), Annals of the Academy of Medicine, Singapore
Saveli Bachtchinski, Kardiologiia
Robin Fox, The Lancet
Alejandro Goic, Revista Medica de Chile
Edward J. Huth, editor emeritus, Annals of Internal Medicine
George D. Lundberg, Journal of the American Medical Association
Samiran Nundy, National Medical Journal of India
Tom Mboya Okeyo, African Journal of Medical Practice
Richard Smith, British Medical Journal
Bruce P. Squires, Canadian Medical Association Journal
Patricia Woolf, Princeton University

Fund-Raising Committee
John Overbeke (chair)
George A. Gellert, Project Hope
Robert H. Fletcher, Harvard University
Richard Smith

Membership Committee
Bruce P. Squires (chair)
Alejandro Goic
Gabor Kapocs, Hungarian Medical Journal
George D. Lundberg
Samiran Nundy
Magne Nylenna, Journal of the Norwegian Medical Association
Tom Mboya Okeyo

Ethics Committee
Patricia Woolf

Electronic Network Task Force
Edward J. Huth (chair)
Saveli Bachtchinski
Iain Chalmers, the Cochrane Collaboration
Lois Ann Colaianni, National Library of Medicine
Suzanne W. Fletcher, Harvard University
George A. Gellert

CMAJ June 1, 1995 (vol 152, no 11) / JAMC le 1er juin 1995 (vol 152, no 11)