UP FRONT
Guest Column
Perish to Publish: Repeated Episodes of
Peer Rejection During the Publication Process
By David B. Sykes, MD, PhD; Michael T. Sykes PhD; and Darren N. Nichols, MD
n adults – sensitive adults,
in particular – who con-
sider themselves academics,
repeated episodes of peer
rejection can have serious
emotional repercussions.
We (David B. Sykes, MD, PhD,
and Darren N. Nichols, MD)
experienced multiple repeated
episodes of peer rejection, or
MREPR, in our attempt to publish
a 1,200-word essay in the medical
education literature. 1 This journey
from first submission to final ac-
ceptance provided new insights
into the process of publication and
the emotional consequences of
recurrent rejection.
Author and biochemist Isaac
Asimov wrote that “Rejection
slips, however tactfully phrased,
are lacerations of the soul, if not
quite inventions of the devil.” The
phrase “inventions of the devil”
sounds rather dramatic, though
certain editors come across as
lacking key components of a func-
tional soul.
The FIGURE outlines our 11
submissions to nine journals over
a period of 915 days. Ten of these
submissions resulted in rejec-
tion, with a variety of proffered
explanations. Many journals were
kind, saying that they felt quite
badly that they could not accept
our work (“gentle rejection”).
Others suggested that our work
was perhaps best placed elsewhere
(“deflective rejection” or “It’s not
you, it’s me”). Still other journals
coldly cited the ratio of submis-
sions to accepted papers as a
rationale (“statistical rejection”).
Throughout the process, our
manuscript underwent major
reworkings. During this period,
many colleagues read and made
changes to the paper; whole
paragraphs were both created and
omitted. On day 365, our seventh
submission went back to our
original target journal (“Journal
#1”). The column editor rejected
our resubmission within 24 hours
ASHClinicalNews.org
with the following comment:
“This manuscript is nearly identi-
cal to one you submitted one year
ago, which was rejected.”
This comment surprised
(DNN) and saddened (DBS) us. It
also prompted us to seek the help
of an available expert (Michael
T. Sykes, PhD) to analyze the
similarities among the various
manuscript drafts. As one can
see clearly in the FIGURE , the
resubmitted manuscript showed
only a 55-percent similarity to
the original. We were asked to
resist forwarding this graph to
the journal editor, as it was felt to
represent rather passive-aggressive
behavior on our part.
Remarkably, just when we
thought that we were running
out of journals to which the essay
could be submitted, the manu-
script slipped past the editors and
went out for its first peer review
on day 748. We were delighted!
We never expected the peer
reviewers to want so many ad-
ditional changes to a manuscript
that already bore little resem-
blance to the original. Comments
such as “title does not work” and
“very confusing” left us shaken,
but we remained motivated for
another rewrite.
Still, our reviewers were not
satisfied. We managed more
changes under the guidance of
“try to add dialogue” and “you
can do more,” bringing our paper
similarity score down to an all-
time low of 24 percent, at which
time the manuscript was finally
accepted for publication.
Joy at last!
Like a phoenix reborn, we flew
high on our lofty success in the
peer-review process. Laudatory
emails full of hyperbole flew back
and forth. Feeling invincible, our
tall lattés were upgraded to venti-
sized and gingerbread-flavored
– with little caloric or fiscal regard.
As though suffering from an edi-
torial Stockholm syndrome, the
Repeated Episodes of Peer Rejection During the Process of
Publishing a Brief Editorial
FIGURE.
TABLE.
Categories of Peer Review Rejection
Gentle rejection
• “I am sorry to disappoint you on this occasion.”
• “I am sorry to inform you that we will not be able to publish your
manuscript.”
Deflective rejection
• “We have considered your manuscript, but our decision is that it would be
better placed elsewhere.”
• “This is not something that we typically publish, and so we are not able to
use it as such.”
• “I enjoyed reading it, but this really isn’t for us.”
Statistical rejection
• “We receive over 8,000 submissions each year and accept fewer than 10%
of them.”
• “We receive a very large number of submissions each year and therefore
have to be highly selective.”
• “Our queue for such pieces now extends out to more than a year.”
pains of the submission process
melted away and we applauded the
reviewers for their cogent insights
and deep wisdom.
The careful reader may note
that our publication success was
inversely proportional to the
similarity of the original work
(now termed the “Sykes-Nichols
phenomenon”). What had become
of that first draft? With dogged
perseverance, we had ruthlessly
purged and abandoned whole sec-
tions of our precious text. Had the
MREPR truly translated into pub-
lication success? Or had we merely
reinforced a timeless academic
reality: In this publish-or-perish
world, papers sometimes need to
perish in order to be published. ●
REFERENCE
Sykes DB, Nichols DN. There is no denying it, our medical
language needs an update. J Grad Med Educ. 2015;7:137-8.
David B. Sykes, MD, PhD, is
assistant professor of medicine at
Harvard Medical School; Michael
T. Sykes, PhD, is a bioinformatics
scientist in San Diego and
the younger brother of David
Sykes; Darren N. Nichols, MD,
is associate professor of family
medicine at the University of
Alberta in Edmonton, Canada.
ASH Clinical News
13