Lack of Funds for Publications form a Threat to Young Medical Authors

Background: Young medical authors face several problems. One of them is their common limited access to funds that may be used to pay the Article Processing Charges (APC) of medical journals.

Objectives: It is investigated whether the APCs are high, indeed, and – if so – how this problem for young authors can be tackled.

Significance: It is important that good research is published in reliable and well-read journals. Measures should therefore be taken to avoid that young researchers publish in journals that are not or hardly read, only because they offer low APCs.

Methodology: Analysis of the APCs of medical journals is carried out by searching for the APC on the website of the hundreds of journals that approached the present authors during one year with a request to submit a manuscript.

Results: It is found that most journals have APCs that are too high for junior authors to pay personally. Almost all journals with an affordable APC have a quality below internationally acceptable standards and are not or hardly read (or cited). Young authors commonly see the advantages of publishing in low-APC journals on the short term, but they can difficultly overview the disadvantages on the longer term. This makes the ‘battle’ against low-quality journals difficult.

Conclusions: Young authors should be warned that choosing a journal on the basis of a low APC may affect their scientific reputation. All medical institutes and organizations where research is carried out should develop a procedure that enables young authors to avoid publishing in low-quality journals, by supplying grants to cover the APC asked by appropriate high-quality journals.

Each experienced researcher has once (co) authored his/her first article. Commonly this is a Ph.D. thesis, which tends to have been reviewed extensively by a supervisor, who also may be presumed to have helped the young scientist with instructions how to write a good scientific manuscript. In the course of time, experience grows and writing becomes more easy, though commonly still a hard work.

The first manuscripts submitted by a young researcher or practitioner tend to receive severe criticism by the reviewers. The criticism commonly regards both the science and the presentation. Revising the original manuscript, which took already so much effort from the young scientist, is – as a rule – considered a nuisance. It takes much time and much effort, and there is no guarantee that the revised manuscript will be accepted. If also a second and a third revision are required, which is not uncommon, particularly in the case of high-ranking journals [1], the author may even doubt whether publication of his/her study is worth all the time, effort and disappointment.

All researchers, including young ones, will agree that critical reviews are essential for the quality of a publication and, in more general terms, for the trustworthiness of science. This holds certainly for medical publications, because a lack of critical comments by reviewers may easily lead to low-quality, biased or even fraudulent publications [2]. Unfortunately, medical publications form the largest group of papers in which fraud was discovered after publication [3,4]. This poses a severe threat to public health, as treatments or medicines may be prescribed on the basis of literature with a dubious quality. Choosing an appropriate journal becomes ever more difficult, however, because of the rapidly increasing number of new (particularly medical) journals (Figure 1). This growth is exemplified by the launching of numerous journals that approached us with requests to contribute a manuscript (Table 1).

Figure 1: Years in which the first article, issue or volume was published in the numerous medical journals that invited the present authors in the past year to contribute. The growth of the number of journals is evident, but seems to slow down; it should be realized, however, that new journals need much time to collect names and email addresses of potential authors. Question marks indicate that the journal’s website does not allow tracing the year of the first volume.

Young vs. established authors

It is well known that the medical community as a whole is relatively conservative, so that manuscripts of young researchers or practitioners with new ideas that might represent true break-throughs in medicine are commonly reviewed more critically than manuscripts with ‘classical’ reports submitted by established colleagues. Consequently, a young researcher may easily become so annoyed by successive requests to revise a manuscript that he/she may decide to stop trying to have the material published, however interesting it may be for the medical community. Such a decision is not easy, but there is a second reason for young researchers to come to such a decision: the (often high) Article Processing Charges (APC) that most journals ask nowadays (Table 1). They can do so because of the publish-or-perish culture [5], introduced by managers at universities and other research organizations some 15-20 years ago. It is this management attitude that must be held responsible for the recent tsunami of new (mostly medical) journals that overflow the scientific community.

It is obvious from table 1 that there is a wide spreading in the heights of the APCs, but most journals ask APCs that must be considered far too high to be paid by young scientists (and practitioners!) personally (Figure 2). Journals may waive the APC (in whole or in part), but this is often a decision taken by the publisher (rather than by the journal’s Editor-in-Chief) and the author who applied for waiving is left in doubt about the decision commonly for a long time. Moreover, many journals tend to receive more manuscripts than they can publish, which obviously not only increases the critical assessment of submitted manuscripts, but also reduces the willingness to waive (in whole or in part) the APC for a specific manuscript.

Figure 2: APCs asked by the journals that approached us to contribute a manuscript. Where the journals indicate a range (see Table 1), the highest APC is taken for this figure because this tends to represent the APC for a research paper.

APCs tend not to pose a problem for established researchers, not only because they tend to have a significantly higher salary than junior researchers, but particularly since they commonly have a budget that they can use for the purpose, even without asking permission from a superior. Young scientists commonly lack such a budget, and they will be pleasantly surprised if a journal offers them complete or partial waiving of the APC, sometimes as an ‘offer that cannot be refused’. Accepting such an offer is tempting because they commonly have a lack of funds for publication of their manuscripts, in contrast to their established colleagues. Consequently, young scientists may easily be seduced to submit their manuscript to the journal that has sent such an ‘offer that cannot be refused’ or to another journal that has a very low APC (or even no APC at all). This is rarely the best choice, however, as the scope of such a journal need not coincide with the subject of the manuscript, and as the readers of the journal consequently need not be interested in the topic dealt with in the researcher’s manuscript.

Many, particularly young, scientists and practitioners that have no or little access to funds for paying an APC will recognize the above problem, but they should not feel unique: it has been recognized already long ago that a considerable part of the costs spent to medical research is practically lost because the results are not published or – more commonly – published in a journal that is not read by medical researchers or practitioners in the same discipline. Thus far, little has been done, however, to solve this problem, in spite of its relevance for society.

Young medical authors face several problems; some of them they can easily recognize and possibly handle themselves [6], but the negative effects of publishing in not well-chosen journals commonly become clear only on the longer term. The advantages of choosing the ‘offer that cannot be refused’ are, in contrast, clear immediately: not too critical reviews and quick publication. If also the APC is waived or reduced, it thus becomes very seductive to submit a manuscript to such a journal. Analysis of the authors that appear to become seduced by such journals indicates [7] that they are often young scientists who reside at universities or other institutes with low (or even absent) budgets for publishing.

There is, however, also a tendency that ever more medical scientists working at universities and hospitals with sufficient publication budgets choose such journals. Particularly the speed of publication seems a strong argument for choosing a specific journal, because of the publish-or-perish culture [5]. This development is unfortunate as it contaminates the medical literature with articles that cannot be traced easily by experts in the same discipline, if not included and searched for in established databases such as PubMed, MEDLINE and PubMed Central of the (American) National Library of Medicine [8]. This may well lower the quality of medical treatments in the long term

The number of medical journals is still growing rapidly, and so is the number of young medical authors that contribute to journals without sufficiently realizing what journals are read by specialists in what medical disciplines. The choice for a journal seems commonly to be made on the basis of quick reviewing procedures and quick publication rather than on considerations about the readership and scientific impact. Since this is unwanted for both the authors’ own scientific career and the entire society, measures should be taken to stop this development.

A good option would be to promote knowledge about the role and impact of scientific journals. This certainly should be a task for supervisors in university, but also for the experienced scientists that should agree (e.g., in their role as Head of a Department) with both the manuscript and the journal to which it is intended to be submitted. This is important because most articles published in not well-chosen journals will never be read by fellow-researchers, and even excellent articles in these journals will only rarely be referred to. This is a loss of money and effort that should – and can – be avoided by more information about publishing aspects during the university education of medical students.

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