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Editorials |
1 From the Department of Radiology, Winthrop-University Hospital, 259 First St, Mineola, NY 11501 (D.S.K.); Department of Radiology, Phillips University, Marburg, Germany (H.J.W.); Department of Radiology, Universitätsklinik für Radiodiagnostik, Vienna, Austria (S.G.); Department of Radiology, North Shore University Hospital, Manhasset, NY (T.T.M.); Department of Radiology, Duke University Medical Center, Durham, NC (D.P.F.); Department of Radiology, Singapore General Hospital, Singapore (W.C.G.P.); and Department of Radiology, Indiana University, Indianapolis (K.A.). Received September 27, 2002; accepted September 28. Address correspondence to D.S.K. (e-mail: dsk2928@pol.net).
Index terms: Editorials • Radiological Society of North America
Since 1998, the Radiological Society of North America (RSNA), specifically the RSNA Publications Council and the Committee on International Radiology Education, have sponsored an editorial fellowship. Seven of us have completed this fellowship to date. At the behest of Radiology Editor Anthony V. Proto, MD, in this editorial we will attempt to distill these 4 years of experience with the RSNA Editorial Fellowship. We will share our comments and observations with potential applicants to the fellowship to convey what the editorial fellow should expect if he or she was to actually undertake it. Additionally, we will share our thoughts with the readers of Radiology in general. Although a few other biomedical journals have journalism fellowships (eg, the Fishbein Fellowship at the Journal of American Medical Association), we could find no published comments about the purpose, value, and experience gained from a medical journalism fellowship.
Structure of the RSNA Editorial Fellowship
The RSNA Editorial Fellowship is an opportunity for a radiologist with a strong interest in radiologic journalism, who has at least 3–5 years of experience at the attending level at an academic center and who also has served as a reviewer for a major imaging journal, to acquire an intimate understanding of the editorial processes involved in the production of a radiology journal. The fellow will learn about manuscript preparation and editing, peer review, journal construction, and electronic publishing. The radiologist may be from anywhere in the world but must be a RSNA member, be fluent in English, and if from outside North America, be affiliated with a national radiologic society. The radiologist spends 2 weeks at the Radiology office in Richmond, Va, as well as 3 days each in the RadioGraphics office in Bethesda, Md, and at RSNA Headquarters in Oak Brook, Ill. He or she also attends several editorial meetings at the RSNA Scientific Assembly and Annual Meeting and can visit Cadmus Communications, the printer of the RSNA journals.
Initial Goals and Expectations
As applicants to the RSNA Editorial Fellowship, we shared the desire to become more knowledgeable manuscript reviewers, authors, and readers of the radiology literature, and some of us wanted to become liaisons between our radiology departments and the editorial offices of Radiology and RadioGraphics. We wanted to gain an understanding of and an appreciation for the process of bringing issues of Radiology and RadioGraphics to publication. This included review of manuscripts; discussions about the rationale for accepting, rejecting, or reconsidering manuscripts; manuscript editing, design, layout, and printing; and communication with authors, editors, and copy editors. Before we undertook the editorial fellowship, we were all experienced authors and reviewers, but we wanted to know what goes on "behind the scenes" at major radiology journals. We expected the fellowship to be challenging, with long busy days; the fellowship lived up to our expectations.
Editorial Fellowship Experiences
Experiences at the Radiology editorial office.—As editorial fellows, we functioned at the deputy editor level for 2 weeks and found this portion of the fellowship the most demanding. We quickly realized that this was a working—not an observatory—fellowship. We performed original reviews of manuscripts, reviews of manuscripts with conflicting reviewer verdicts in the initial peer review cycle (such as a deputy editor would do), and surveys of manuscripts in later cycles of review to check for completeness and correctness of author revisions. As editorial fellows, we learned how to rapidly and effectively assess multiple manuscripts in a single several-hours-long session. Many of these manuscripts were in subspecialty areas other than our own—so we saw that many reviewer skills do carry over to the evaluation of radiologic manuscripts in subspecialty areas other than our own; as a result, this exercise made us better reviewers. We realized that being an editor is a Sisyphean task—just when you have completed examining a set of manuscripts and made decisions on them, another set of manuscripts is ready for review. We participated in daily manuscript meetings with Dr Proto, where our opinions, suggestions, and reasoning were always discussed in depth.
We also spent multiple sessions with the editorial office staff, learning the complex process of manuscript tracking and journal preparation. Detailed instructions were provided on journal construction—a process that is usually a large "black box" even to experienced authors—including individual issue construction and article ordering and figure preparation and layout. Mechanisms for equitable and timely peer review and for reviewer assignment and tracking were also covered. In the future, the online submission and review process will also be extensively covered. Dr Proto provided us with many insights into the work of an editor and the complex decision making that this job entails. We were also provided with relevant written materials, including reprints on medical publishing and the peer review process. We were surprised not only at how closely integrated we became in the editorial process but at how physically and mentally tired we were at the end of each busy day—even more so than at our "day jobs"—but we always believed that we had learned a great deal. Perhaps the most surprising aspect of the experience was the complex nature of editorial communication and decision making. One of Dr Proto’s comments in this regard was that "there are no shortcuts."
Experiences at the RadioGraphics editorial office.—As editorial fellows, we were able to compare and contrast the operations of Radiology and RadioGraphics and learned that despite the different missions and operational cycles of the two journals, the same skills of medical journalism readily carry over from one journal to another. As at the Radiology editorial office, Dr Olmsted, the editor of RadioGraphics, and the editorial staff spent substantial time with us in one-on-one tutorial sessions, covering all aspects of the functioning of the editorial office. Since the fellow arrives during the slowest time of the year (before the RSNA annual meeting, where the year’s submissions for RadioGraphics are solicited), the discussions have more wide-ranging topics and are more cerebral. Dr Olmsted and his staff described in detail how the educational material is selected; how manuscripts are processed; and the differences between the goals, format, and production of RadioGraphics and those of Radiology—differences that may not be obvious to the readers of these journals. Dr Olmsted noted that "consistency is critical" in editorial work. The role of Internet-based continuing medical education programs sponsored by the RSNA was also discussed.
Experiences at the RSNA headquarters and at Cadmus Communications.—At the publications office at the RSNA headquarters in Oak Brook, we observed various stages of manuscript preparation and learned the growing role of electronic journalism. There were in-depth discussions about manuscript editing, advertising, marketing, copyright issues, and figure and table formatting. Every step of journal production was covered, and for many of us the experience was the most eye-opening part of the fellowship, since this process is largely not known or understood by authors or reviewers. We gained important insight into why it takes months for articles to go from initial submission to publication. We spent time with the manuscript editors, who have an especially demanding job of conveying each author’s message, while crafting a journal each month that is uniform, clear, and accurate. Additionally, the managing editors of Radiology and RadioGraphics shared their philosophies and explained their roles in interacting with the editorial offices of their corresponding journals.
More recently, some of the editorial fellows have visited the Cadmus Communications printing facility in Virginia during their stay at the Radiology editorial office. This is another important "black box" for journal authors and readers. The various steps of the printing process were reviewed, which helped us to better understand the reasons for certain publication practices and schedules. Printing costs and current trends in presentation of figures, tables, and graphics were also explained, as were the choices of printing materials, the technical principles of printing and production tracking, and the distribution and shipping process.
Experiences at the RSNA Scientific Assembly and Annual Meeting.—The last week of the fellowship was spent at the RSNA annual meeting, where we gained a deeper knowledge of committee work, for example, by observing each editor’s meeting with members of their respective editorial board and with reviewers in order to get feedback and new ideas. Fellows have the opportunity to serve on one of the RadioGraphics subspecialty panels. Each year, the editorial fellow makes a brief presentation about his or her experience at the editorial board meetings.
Ethical Issues in Medical Journalism
All of us believed that complex ethical issues, which surprisingly arise on a nearly daily basis when running a major medical journal, were covered in detail. We were given confidential exposure to these dilemmas and their corresponding solutions as they arose in real time at the Radiology editorial office. We gained tremendous appreciation of the complexities of the editorial process and the professional, deliberate, and ethical strategies for dealing with and fairly resolving contentious situations, such as disgruntled authors, conflicting opinions of reviewers, and possible duplicate publications. Drs Proto and Olmsted discussed these and other situations that arise in communicating with authors, reviewers, and office staff. Nothing was trivialized or ignored, and discussions were open and frank. At times these discussions were surprising, and at other times they were sobering.
Other Surprises of the Fellowship
For us, the RSNA Editorial Fellowship was an extensive learning experience. It was highly organized, comprehensive, and enjoyable. It was part apprenticeship (and part site visit) that allowed the fellow to acquire, in a concise time period, a huge amount of information regarding the workings of a scientific journal and the understanding of what the daily job of an editor entails. We learned the editorial process, from the arrival of a manuscript at an editorial office to its publication in a specific issue of the journal. This remains a complex sequence that involves multiple people and many different abilities.
During the fellowship, we learned that running a major medical journal requires numerous skill sets that authors and reviewers almost never think about, particularly endurance and supreme organizational skills to juggle the numerous activities that occur simultaneously. There are innumerable layers of editing, reviewing, and coordination that go into each issue, which are hidden from the readers of a journal. Being an editor is analogous to being the conductor of an orchestra—numerous contributions from authors, reviewers, and journal production and staff members must be coordinated in a harmonious, fair, and cool-headed manner by using precise timing while under constant substantial pressure. To stretch the analogy a bit further, the editor’s job is even more challenging, because unlike the conductor, the editor has to coordinate all of these contributions from around the world, not just from one room. Also, the editor does not really get a chance to step off the podium for an intermission—the cycles of manuscript submission, peer review, and journal production are constantly renewed.
We also gained new appreciation as individual authors and reviewers when our work is submitted for possible publication or when we are asked to review a particular manuscript. Additionally, we were surprised at how much of a contribution we were able to make—the fellowship is a two-way street, and the editors and their staff, as well as the staff at the RSNA headquarters, are also always improving the process; during our stays they appreciated our thoughts and opinions.
Impact of the Fellowship
It is a bit early to say exactly how the RSNA Editorial Fellowship will impact our careers in the long term, but for all of us, the fellowship allowed us to think differently about the editorial process and has kindled new interests. As alumni editorial fellows, many of us have subsequently joined the editorial boards of major radiology journals, and all of us have been well prepared to carry out various tasks requested by editors, such as deputy editor review and editorial preparation.
Medical journals remain the primary source of information about scientific advances that can change how doctors treat patients, and most medical journals rely on the peer review process to ensure that high-quality research of relevance to the readership is published. Surprisingly little is known about what training is required for peer reviewers to do a good job (1). Despite this, the quality of a scientific journal is an important reflection of the quality and dedication of its reviewers (2). One of the results of the RSNA Editorial Fellowship is the development of a group of "super reviewers," as well as junior editors, who will now have knowledge beyond that of the typical peer reviewer, the latter of whom have almost always had no specific formal training in manuscript review. The RSNA Editorial Fellowship may ultimately benefit all of radiology as a specialty, because the fellows can share their newly acquired knowledge and skills with members of their departments by serving as the "in-house" consultant and editor and at the regional and national level in some cases, especially if the fellow is from outside of North America. Most editors of radiologic journals worldwide are not specifically trained for their job, and the RSNA Editorial Fellowship allows future or potential editors of radiologic journals to slowly grow into this important and demanding position.
Finally, the editorial fellow may also opt to conduct a research project on some aspect of radiologic journalism. There has been an increasing interest in the formal study of the peer review process (1), and one of us completed a research project following the fellowship in conjunction with the editorial offices of Radiology and RadioGraphics; this project was presented at the Fourth International Congress on Peer Review in Biomedical Publications (3) and a report has been published (4). Another fellow developed and co-edited a series of articles about biostatistics to aid readers and reviewers in more critically evaluating the radiology literature (5). Future editorial fellows will have the opportunity to perform similar research.
REFERENCES
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