Training programmes and curricula

A medical-writing curriculum connects writing and editing activities to the skills they develop, provides opportunities to practise and assesses competence before or after training.

A dedicated clinical writing rotation

A structured medical-writing rotation can address a gap in pharmacy residencies that require a publishable manuscript but rarely provide formal writing training. ¹ Faculty should have medical-writing experience, such as publishing in peer-reviewed journals and reviewing for biomedical journals. ¹ The curriculum introduces reasons to publish, manuscript types, authorship and acknowledgements, manuscript composition, submission and publication, and peer review; residents must prepare a manuscript intended for publication, with appropriate assistance, by the end. ¹ In a US academic medical centre’s programme reported in 2014, five postgraduate year 2 residents had completed the rotation and five resident-written manuscripts had been accepted in peer-reviewed journals. ¹

Publication-writing modules

Writing and editing modules for publication writers should address the components of scholarly publication, be continually developed and form a well-organised curriculum; they can also serve academic writing and editing internships. ² A curriculum proposed in 2013 pairs 16 modules’ activities with the skills they develop: ³

Module	Activities	Skills developed
1. Writing, editing and reviewing a paper	The writer reviews a paper comprehensively and corrects style, format, syntax, language, science, content, logical flow and overall impact, upgrades the medical terminology, checks the validity of the scientific knowledge and the methodology, reviews scientific nomenclature, improves readability, performs a structural review, advises on format, and confirms the number and format of keywords	In-depth analysis, effective communication of findings, critical appraisal, assessment of novelty and impact, attention to detail, substantive and copy editing.
2. Writing and editing a cover letter	Improving the text and tone by highlighting the study's importance, writing statements acknowledging contributors or declaring competing interests, and suggesting possible reviewers	Synthesis of study highlights, microediting, attention to detail, understanding of novelty.
3. Clarifying journal decision letters	Analysing and clarifying the editor's decision after peer review, rewording or simplifying sentences for clarity while preserving their meaning.	Critical thinking, in-depth analysis and interpretation, simplifying sentences.
4. Rewriting and editing conditionally accepted papers	Determining the editor's exact decision, re-editing the newly added parts, proof-checking the rest for consistency and logical flow, and assisting with the point-by-point responses.	Critical appraisal, assessment of scientific knowledge and study depth, clearer author responses, appropriate revisions.
5. Writing and editing responses to reviewers' comments	Editing or rewriting point-by-point responses, upgrading the explanations of the revisions made in the text and cover letter, and building persuasive science-based rebuttal.	Analysis and interpretation of comments, critical evaluation of the manuscript and responses, assessment of scientific knowledge and depth, concise responses.
6. Rewriting and editing a paper for another journal after rejection	Analysing the original journal's comments, rewriting newly added text to address salient comments, and advising on the choice of a new target journal.	Critical thinking and analysis, appraisal of peer-reviewed journals, text rewriting.
7. Writing and editing posters and slide presentations	Organising and streamlining text, checking figure quality and resolution, and evaluating and editing layout and appearance.	Detailed preparation, microediting, attention to detail, layout design and organisation of text and figures.
8. Writing and editing oral presentation scripts and coaching presentations	Editing the script for a spoken tone that invites audience interaction on the technical content, recording the presentation, coaching delivery and correcting pronunciation.	Interactive scripts, audio-file preparation in different formats and delivery speeds.
9. Styling a paper to the guidelines for authors	Rewriting and styling to the target journal's instructions and clarifying unclear points of those instructions for the authors.	Attention to detail, assessment of deficiencies/unnecessary parts, journal appraisal.
10. Supporting online submission	Preparing all required files, figures, tables and disclosures in the correct formats and assisting authors through successful online submission.	Mastery of submission software, preparation of files, online submission proficiency.
11. Annotating galleys	Checking the galley for errors of formatting, punctuation, terminology, spelling, typescript and headings, and making concise annotations in the PDF.	Attention to detail, accuracy in making annotations in the PDF file.
12. Citing material found only online	Citing non-print material associated with journals, publications ahead of print, e-pages and e-publications, e-letters, post-publication peer reviews and data supplements.	Citation of and familiarity with online materials, citing electronic materials.
13. Writing and editing references	Correcting in-text citation format, checking the accuracy of every reference and formatting to the journal's guidelines.	Attention to detail, accuracy in following journal instructions, reference formatting.
14. Abstract writing and editing	Rewriting an abstract to the target journal's style, word limit and structural requirements while keeping the key findings prominent.	Concise study summation, mastery of rules in abstract editing, meeting requirements.
15. Communicating with authors	Building and maintaining a collaborative relationship, clarifying ambiguous passages, developing a feedback mechanism, and writing polite queries where the author cannot discuss the point immediately.	Improved communication, discussion synthesis, enhanced author–editor relationship.
16. Ethical issues in medical writing	Reading and understanding material on conflicts of interest, financial disclosures, duplicate publication and other declarations, and attending meetings or conferences on publication ethics, so that the writer can meet the target journal's requirements and correct ethical statements in the text.	Familiarity with ethical issues/legal implications in medical writing, accuracy in editing ethical statements/declarations.

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Programme development and support

In 2010, MD Anderson Cancer Center’s scientific-writing programme served faculty members, many of whom were non-native English speakers. ¹⁹ Development followed five steps: identifying focus groups, assessing needs, training curriculum developers, developing the curriculum and producing a workbook for the target students. ¹⁹ The needs assessment found that many faculty and postdoctoral fellows did not understand scientific-article structure, and most postdoctoral fellows did not know how to write introductions and discussions. ¹⁹ The three-day programme ran several times a year, with classes limited to 22 participants and three editors assigned to each. ¹⁹

Its three-day curriculum covered: ²⁰

1. Workshop introduction and precourse assessment; preliminary steps in manuscript writing; the introduction; publication ethics.
2. Methods and results; peer review; the discussion.
3. Cohesion and clarity; abstracts; effective titles; postcourse assessment.

²⁰

The programme’s lessons were: ²¹

• Even participants with rudimentary English fluency benefited.
• Mixing native and non-native English speakers worked well.
• Participants should be ready to write a paper to gain maximum benefit.
• Finding examples was difficult; the programme could be adapted to specific departments.
• Instructors became better editors.

²¹

Its recommendations were: ²⁰

• Focus on structure rather than fine points of English, and use many good and bad examples.
• Secure sustainable support for the time and money required, including administrative support.
• If the budget is limited, recommend good books and annotate relevant examples for students.

²⁰

At Peking University Health Science Center in 2010, courses for young faculty and doctoral students ranged from two weeks to a semester and covered a similar scope, with students whose English proficiency was lower than in the MD Anderson programme. ²⁰ Sustainable support and collaboration with native English-speaking instructors were needed. ²² Challenges included the absence of a system for evaluating native Chinese-speaking instructors’ teaching and demand for English-writing help exceeding formal training provision. ²³

Formal medical-writing training in China began in the early 1980s with a China Medical Board-funded biomedical writing and editing programme. ²⁰ More than 300 researchers, clinicians and English teachers attended between 1996 and 2007; most subsequently worked in medical writing and editing, some edited English-language Chinese medical journals and a few taught medical writing at medical schools. ²⁰ Institutional leaders in China were described as generally supportive of English-writing training because many were research scientists who needed that help themselves. ²³ Surveys of authors’ needs and training outcomes, with positive feedback shared with institutional decision-makers, can help secure support. ²³

A series integrated with institutional services

In 2012, the University of Arkansas for Medical Sciences Office of Grants and Scientific Publications offered investigators an annual grant-writing workshop one morning a week for four weeks. ²⁴ Its first session introduced grant writing, submission and grantsmanship, including writing for reviewers; later sessions examined NIH application sections while emphasising review criteria. ²⁴ About half of each session was spent in editor-led small groups, and attendance was limited to about 25 according to the number of editors available. ²⁴ The series facilitated collaboration across colleges and departments, generated requests for editing services and became part of curricula including a clinical and translational sciences certificate in an oncology fellowship. ²⁴ Its purpose was to improve the quality of grants received for editing, and the office considered it successful on that basis. ²⁴

The office also offered a one-hour manuscript-preparation lecture primarily for medical residents, many of whom had not published and might be unfamiliar with peer review. ²⁵ It covered authorship, standard manuscript sections, target-journal selection, submission, peer review and responses to resubmission requests. ²⁵ These offerings addressed a gap the office perceived in graduate and medical-school curricula, leaving many residents and postdoctoral trainees unfamiliar with grant applications and manuscript submission unless a faculty member had time to teach them. ²⁶ In 2012, the workshop cost $250 per attendee, the lecture was free to departments and workshop attendees co-authoring with faculty could receive one free editing round of approximately ten hours to encourage manuscript submission. ²⁵

Competency assessment

Publication-writing competency can be assessed before training, afterwards or both, and used to set expectations or evaluate performance. ²⁷ A proposed 2013 assessment lets the writer or supervisor rate 14 areas on a PAGE scale: poor, average, good or excellent, with poor and average indicating a strong need to improve. ²⁷

The 14 areas and their requirements are: ²⁸

1. Language and syntax: consistently correct grammar, punctuation, spelling, hyphens, capitalisation, units, typographical errors, terminology, sentence construction, references, structure, format, logical flow and relevance, and explain corrections using published writing and editing rules.
2. Ambiguities: identify and correct ambiguities and inconsistencies in text, tables, figures and references.
3. Structure and format: write or edit to the target journal’s requirements for sections, headings, text, abbreviations and units.
4. Word counts: rewrite or edit titles, abstracts and main text to required character or word counts.
5. Ethical statements and disclosures: write or edit those relevant to the manuscript.
6. Brevity: identify sentences or parts that can appropriately be removed.
7. Author guidelines: advise on content requirements or edit and style the paper accordingly.
8. Science, content, design and logical flow: assess and correct these, evaluate the reliability of results and defend corrections scientifically.
9. Sources of errors: identify possible mistakes that may bias findings.
10. Adaptability and flexibility: interact and discuss in depth with authors across medical fields.
11. Teamwork: provide personalised support within the editor–author team during writing and full editing assistance after peer review until acceptance.
12. Priorities: set priorities across multiple articles.
13. Independent work and decisions: work competently and quietly alone, recognise personal limitations, welcome constructive criticism and improve work and relationships.
14. Collegial interaction: work well alone or with others, interact harmoniously and remain polite and open to suggestions.

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