Crossing into medical journalism
A move from medical writing into journalism can turn on authorship as well as on writing skill: whether the writer needs to put their name to the work. The work asks for investigation as well as scientific writing, and no fixed qualification gates entry: people have come to health journalism from literature, from the laboratory, from a research career, from the clinic and through internships and junior editorial posts, and one career can run across journals, broadcasting and medicine itself. The work pays less than medical writing, its outlets have moved online, and those who do it name what it gives back.
Authorship and the byline
For one science journalist, being an author and writing as a journalist means more than writing well: it also means assuming a point of view that others may challenge. Her career was driven by her love of words more than by anything else, and also influenced by the issue of authorship. She never practised ghostwriting as the medical literature defines it, bringing a hidden intellectual contribution to a published article, but she gave up her copyright to her clients, and her writing was published for communication or medico-marketing purposes. It was genuine writing that should have been credited to an author, closer to review articles on science markets and policy than to writing formatted for communication, marketing or medical writing. She did not feel strong enough to take a point of view others might challenge, so it was easier for her to give up her rights than to put her name to what she wrote. As she sharpened her writing, a gap grew between that fear and her wish to be identified as an author, a conflict that stayed unconscious until watching a film about a ghostwriter made her understand that she needed to write on her own.
In her view, for medical writers who are attracted to writing, communication and journalism may be an interesting option for career evolution. Anyone drawn to writing should ask whether they feel the need to be an author. If not, communication and corporate journalism could provide good opportunities for narrative writing. Those who want to write as named authors should be aware that the move involves a cultural shift: writing as a journalist requires being neutral and having no conflicts of interest. She achieved that neutrality by writing about topics far removed from medical writing, which felt a little frustrating at first and which she now appreciates, and she has to trust the journalistic approach of seeking the truth, which differs from the approach she learnt in her scientific studies.
What the work asks and what qualifies for it
A medical writer moving into medical journalism will find that an understanding of scientific writing helps, but will need to be able to investigate and critically analyse and not only summarise or describe. Medical journalism demands an investigative nature, the ability to critically evaluate evidence and the ability to rapidly produce engaging pieces of wide interest.
It is possible to be both a medical writer and a medical journalist, but it involves a change of mindset: the information an academic conference abstract requires is very different from what a news story on the same study needs, and so is the style of writing, and many medical writers find the transition difficult. Some may find switching between the two styles of writing challenging. Doing both is a middle path that might not be easygoing, because the work is different and its deadlines intense. Some medical journalists work full time and others do it as a sideline to a medical or academic job. One freelance medical writer, writing in 2015, had worked regularly as a scientific and medical journalist alongside that main job ten years earlier, until, for various reasons, medical writing took over and a magazine the writer had contributed to for two years folded.
In-depth knowledge of drug development and rigorous scientific training could give a medical writer a competitive edge, provided the writing and communication skills are developed in the right way. Formal journalism qualifications and in-depth experience are an asset, but what matters more than anything is a good writing style, a desire to disseminate scientific stories and the ability to learn quickly, and a journalist must love words. Excellent writing skills and an ability to learn quickly are probably more important attributes than journalistic qualifications or deep knowledge.
For the editor of the magazine Pulse, interviewed in 2017, there are no fixed qualifications, although a journalism qualification is always helpful. A freelance medical journalist who writes regularly for The BMJ holds that a journalist needs a scientific background, though not necessarily in medicine (hers is a biology degree), the ability to write and some sort of journalistic training. That training is harder to get on the job now that the big newsrooms of publications such as Doctor, Pulse and GP are gone, which she calls a great shame, because that is where most people learnt a lot.
Routes in
One route runs from literature. A medical reporter described in 2007 took a BA in English literature and a master's in science writing, then wrote for medical trade publications. In 1981, at a journalist friend's urging, he began interviewing for medical reporter posts in big cities with competitive newspapers, and his big break came when one paper's medical writer abruptly quit. His career took root while he grew up with a brother who had what the 2007 report, in the usage of its time, calls mental retardation. He spent so much time explaining the condition to other children, wanting them to stop using the slur then current, that he could not stop, and he has simply expanded his range: he explains every medical and public health issue imaginable to the biggest audience he can find.
Another route runs straight from the laboratory bench. A scientist with more than eight years in research and a doctorate in cellular and molecular biology, completed in 2014, began working remotely for a US-based digital health news service for patients and caregivers immediately after she left the bench for a medical writing career, as she recounted in 2020. She wrote more than 20 articles a week, most of them on the latest developments in research and treatment in chronic diseases: neurodegenerative, oncological, respiratory, muscular, metabolic, inflammatory and autoimmune. The job meant reading multiple studies, interpreting trial data, speaking to doctors and scientists, interviewing patients, and combining journalistic skill with scientific knowledge. Experienced journalists mentored her in preparing interviews and writing articles that kept readers engaged to the last paragraph, and she found patient stories particularly rewarding to write.
A route can also run out of a research career by way of formal training. One freelance medical journalist in Germany, writing in 2013, never dreamt of working with words and had very mixed marks at school in German, his native language, but felt a strong early interest in research, and reporting on research in medicine is not far from that. He is a biologist with a doctorate in immunology, and as a postdoc the funding for each of his two posts was limited to two years and the hospital where he worked rarely offered permanent positions to biologists, so he had to choose between moving elsewhere to continue an academic career and doing something completely different, and he decided to leave science. Over the years, friends and relatives had asked him to explain his work, and he had always felt the need to explain it in lay terms. That passion, with his enthusiasm for the internet, led him to a one-year training course to become an online journalist, which ended in three months of practical work in an editorial office, which he spent at the publisher of a magazine given free to pharmacy customers. He stayed there for a two-year formal journalism traineeship. One of the chief editors taught him to write for lay readers, to explain what DNA means and to use images to explain medical processes, and then helped him establish himself as a freelance by commissioning a number of articles from him. He went on to write regularly for an agency's online newsletter for physicians, and he has never regretted the decision.
A route can also run out of clinical practice. One triple-board-certified physician took a 90% pay cut when she left her medical practice to become a television health reporter, and her passion is communicating health information to the public and teaching patients how to make decisions that improve their quality of life.
Two health writers built their way in through internships and an editorial assistant's post. One took an honours degree in chemistry and, while doing chemistry research, fostered her writing in a select group, mostly of graduate students, that met weekly to discuss and edit articles about research at her university. She held internships at a research journal, a national laboratory and a chemical society. During the journal internship she wrote a number of news pieces and one feature article, which won an award. The internship led to a post as assistant editor of another journal, where she writes news pieces, assesses manuscripts, facilitates peer review and edits articles. The other has written about health and medicine since earning a journalism degree in the magazine sequence. She began as an editorial assistant at a psychology magazine and went on to write and edit health content for print and web publications, as editor of a psychological association's magazine, consulting editor for a clinic's magazine and health editor and producer for AARP's website.
How wide one career can run
One career ran across a journal, television, radio, research papers and a blog. The physician, who died in 2011, took a degree in aeronautics and then a master's in biomedical engineering, during which he decided to become a doctor. He devoted most of his life to communicating medical topics to the lay public: senior editor of a major medical association's journal and director of its department of scientific affairs; executive director and managing editor of The Patient Channel; medical editor for a city television news station; resident physician for a public television health programme; host of a radio medical segment on national public radio; author of more than seventy major scientific papers and of textbook chapters; and, from April 2010, a blog chronicling his own treatment for acute myelocytic leukaemia. The blog presented medical information in an easy-to-understand manner, with warmth and humour.
The same career took in epidemic investigation. He played a central part in the US Centers for Disease Control and Prevention's toxic shock syndrome task force, created to investigate the 1980 outbreak, and for the work received the agency's Alexander D. Langmuir Prize, the highest award for epidemic investigation. He received the John P. McGovern Award for outstanding contributions to medical communication in 1991, and his honours for his talent in medical communication included a fellowship in medical journalism from the medical association whose journal he edited, a broadcast journalism fellowship he was the first physician to receive and a lifetime achievement award from a medical communicators' body; his work in commercial television was recognised with two Emmy awards.
A career can also run from journalism into medicine, at a cost. A veteran science and health journalist who had written for major newspapers and magazines enrolled in a post-baccalaureate premedical programme and went to medical school at 38, because writing about medicine had made him want to be part of it; such programmes, available to older applicants, offer the necessary courses and application advice. Medical school meant horrendous hours, intense academic requirements and 40 to 80 hours a week, with the anxiety of avoiding mistakes keeping him alert in hospital, followed by a residency application process he likens to applying to medical school all over again. In 2012 his advice to a fellow journalist considering it in their thirties was to be ready, because it is ten times harder than they can imagine, and he found it worth it despite the constant fatigue and frustration. He intended to keep writing, and expected the writing to be much more informed.
Another career ran from journalism into medicine and kept both. After an English degree, one physician spent nearly ten years as a journalist at ABC's Good Morning America, and chose medicine, according to a 2019 newspaper article, after watching another journalist save a woman during a whitewater rafting competition. She took a post-baccalaureate premedical programme, went to medical school, stayed there for a residency in internal medicine and joined the school as a clinician and teacher. Since the early 2000s she has written the Diagnosis column of the New York Times Magazine, and in 2020 she received an award for her work to bring the process of medical diagnosis to the public in an approachable way. The column inspired the television series House, on which she was a technical consultant, and became the source of an anthology and of a 2019 television series.
Pay and how the work arrives
By 2015, the rise of web-based communication and the decline in revenue from print had changed the job market for medical journalism and suppressed pay levels, as readers and publishers increasingly expect content free or for very low fees. Medical journalism is unlikely to make anyone rich, extremely unlikely on one account, and its pay rates are lower than in medical writing. There are still opportunities, according to the Association of British Science Writers (ABSW). Freelancing in it can be fun but is hard work unless someone regularly pushes work to the freelance. Otherwise freelances must keep pitching ideas to editors, each pitch takes time and effort to research, and editors receive far more ideas than they can use. A writer approaching an editor should first research the publication or website thoroughly and look at its guide for contributors.
The freelance medical journalist in Germany finds that freelancing can be a hard business but at the same time very fulfilling. He most often chooses his own topics, and the price is that his stories earn him a fraction of his former salary as a scientist and less than he would earn as a journalist employed by a publisher; there is no way to be in the lap of luxury with the job, and it is hard work for the money. As he sees it, many doctors write for free while on call, which undermines the fees paid to professional journalists, some editors simply use articles written by the press officers of companies or associations, choosing cheap but not independent information, and many readers do appreciate the quality they get from genuinely independent journalists.
Such quality cannot be free, on his account. Information about an illness and the best ways to treat it should, in his opinion, be the product of reading many original publications, talking with experts and learning by visiting scientific meetings, which he likens to putting together a jigsaw. The result has to be judged on whether it is of sufficient quality to give to a physician treating patients, or whether it will increase a patient's knowledge of their disease. Every now and then a news agency or journal editor asks him for a labour-intensive news story on diseases and treatment options for a couple of euros, and in his view they would not make such offers if there were no market for cheap medical information.
The Pulse editor's summary is that nobody does journalism for the money, and that freelance opportunities are many because many publications are understaffed and the area is so complex. The BMJ freelance does not think it that well paid either, but values that it is flexible and can be done from home a lot of the time. By her account, payment in 2017 depended on where a piece was published and how long it was, at roughly £120 to £200 for a news story and £250 to £500 for a feature. In an earlier staff post she travelled a bit to cover scientific conferences abroad, at a time when pharmaceutical companies would pay the costs, and some freelances she knows are still taken to conferences by pharmaceutical companies to write stories or conference reports. Relying on journalism to pay the bills without a regular outlet for the work can, in her experience, be stressful.
Many medical journalists are employed as editors or staff reporters by a media organisation, but the competition is intense and companies are cutting back. Unless they have established work streams, freelances often struggle to get published and face competition from unpaid amateurs.
Where the outlets and the demand have gone
The Pulse editor lists print, online, social media and word of mouth as the channels, and describes a revolution in recent years towards online and social, a very different model of communicating with an audience. He enjoys them all, and while there is nothing like holding a printed journal, what he probably enjoys most is interacting with readers, through the instant reaction and two-way conversation online and through social media, from which he learns a great deal. The BMJ freelance lists newspapers, consumer magazines, scientific or professional journals, online journals, websites, and publications from public relations or pharmaceutical companies, and notes a shift towards more online content: a lot of magazines aimed at doctors, such as GP and Doctor, no longer exist or exist only online. She began as a news reporter on a weekly clinical magazine for general practitioners that has since closed. She then moved to a larger weekly newspaper for general practitioners covering clinical and political news, which has since closed too; there she was clinical editor and then news editor, competing with rival titles for the good stories and the best coverage of issues such as pay deals, the British Medical Association's annual meeting and health reforms. She then became news editor at The BMJ, where there were no in-house journalists at the time and she commissioned freelances from around the world to write most of the news stories. She had a number of features published in The Guardian in the late 1990s, and stopped writing for it when its health section shrank.
Asked whether there is demand for medical stories, the Pulse editor describes huge interest in them, because they have an impact on everyone, and says a good story gets picked up by the national media or television news more often than one would think. The BMJ freelance thinks demand is definitely decreasing.
Getting started
Advice for budding medical journalists tends to be the same across sources: simply start writing, keep going, and reach out to a wide range of potential outlets. Researching the published content of journals, websites and magazines is a good way of seeking inspiration, and a newcomer can approach companies that use freelance writers, submit original pieces or suggest new ideas, and ask for feedback where a submission is unsuccessful. The websites of the ABSW and the Medical Journalists Association are excellent resources, and editors use them to source freelance journalists.
The Pulse editor advises starting to write and getting it published, whatever it is and wherever. He started out freelancing for a national newspaper, simply pitching ideas to one of its editors, and his magazine runs internship programmes for new journalists, for which competition is fierce.
According to the ABSW, the best way to decide whether science journalism is right for someone is simply to have a go: blogging, writing for a university, corporate or professional magazine, or taking an evening or online writing class are all ways to get started. By 2015, blogging and tweeting were standard parts of many science writers' work, and they are suggested as ways to build up a body of writing and get noticed. Guides to find out more include the ABSW's basics of science writing, The Science Writers' Handbook, the Council for the Advancement of Science Writing's guide to careers in science writing, and the National Association of Science Writers' answers for new and aspiring science writers. Medical writers interested in journalism can start by writing blogs on sustainability and the climate crisis for online platforms, Medium being one example.
The science journalist who weighed authorship found the impulse to assume it through a writing course on short stories, a story published in 2011 and opinion columns accepted by Libération and Le Monde, and in her view other medical writers could look for more straightforward ways. Medical writers could also seek opportunities within their own professional environment that could gradually help them improve their communication skills. Writing for patients, for example, is a good exercise, as it requires the writer to take the reader's point of view into account.
Training and courses
Medical writers attracted to writing could seek education programmes in journalism and communication, or attend workshops on communication and writing skills within EMWA's education programme. In one workshop leader's experience, such workshops are particularly useful for medical writers who have never written for communication purposes, because they make them aware of the need to target an audience and how to do so, notably by mastering writing techniques. Increasing numbers of science writers in the UK come through one of the degree courses in science communication. Heavily advertised courses that promise to refund the fees of anyone who does not earn them back through writing call for caution, and courses from professional or academic providers are likely to be of better quality. The World Federation of Science Journalists offers a free online course in science journalism that gives an overview of its different aspects and training in writing techniques.
For someone who wants to make reporting on sustainability and climate science a career move, courses are offered both online and offline. Courses in medical and environmental journalism and communications listed in 2021 include:
- the International Environmental Communication Association's ten-week online course in environmental communication research into practice
- the Thomson Foundation's self-paced online environmental journalism course
- edX's self-paced online course in strategic communication for sustainability leaders
- the University of California Santa Cruz's one-year offline master's programme in science communication
- Texas A&M University's flexible offline MSc in science and technology journalism
- New York University's sixteen-month offline programme in science, health and environmental reporting
- MIT's one-year offline graduate programme in science writing
- Michigan State University's environmental journalism programmes
- the University of Lincoln's one-year full-time offline MA in journalism (science and environment)
- Poynter's News University online courses in environmental journalism
- the World Federation of Science Journalists' self-paced online science journalism course
- UNESCO's online training and resource kit on media as partners in education for sustainable development, a toolkit rather than a course
- a toolkit from the Forum for African Investigative Reporters
What the work gives back
Medical journalism is a stimulating, sometimes fast-moving career.
For the Pulse editor, a journalist can make people laugh, cry or feel angry, and perhaps occasionally change their view of the world, which is an incredible power and also a responsibility. His publication's campaign of several years for additional support for struggling general practitioners and practices about to close has helped lead to a major support package from the National Health Service. The BMJ freelance enjoys working to deadlines, finds that the work can be interesting though very boring at times, and finds that getting her head around a complex topic and putting it across clearly can be very satisfying. She finds features more work than news and ultimately more satisfying, values that a news story can be done and dusted quickly and then forgotten, and likes the flexibility of freelancing, which is great for someone with children who wants to work from home. Seeing her name in a national newspaper was a thrill.
Not having studied medicine, the freelance medical journalist in Germany has learned a great deal about diseases and therapies, patients and doctors, and feels much more confident at distinguishing bad studies from good ones and at explaining difficult issues so that non-experts understand them. Patients, in his view, should not feel at the mercy of doctors but should be able to talk to them on the same level, and by giving them high-quality information he hopes to help them take part in decisions about their treatment. He loves to write about work that helps people recover from diseases for which, ten or twenty years earlier, they would have been told there was no hope. In his first years writing for the agency he mainly wrote about new research results being translated into the clinic, and more and more often he discusses controversial questions, such as when life ends or whether disability of a foetus is reason enough for an abortion. Asked whether it is a dream job, he answers yes and no: he would recommend the profession only to someone with much more passion for reporting fascinating facts and developments than for expensive holidays and cars, and he would cautiously choose it again.