Professionalism is directly dependent on ability, competence and morality of the Chief Editor- Dr. George Lundberg


Professionalism and Medical Editors

Professionalism is directly dependent on
ability, competence and morality of the
Chief Editor - Dr. George Lundberg

Peer Reviewers are critically important; they are
never deciders but advisors

Shaukat Ali Jawaid
and Dr. Akhtar Sherin

NEW DELHI (INDIA): Scientific programme of the WAME conference held in India from October 2-4th 2015 started with an excellent presentation by Dr. George Lundberg who had served as Editor of JAMA for thirty years and is one of the founding members of WAME which was formed in Italy twenty years ago. The topic of his presentation was “What are the Global Pillars of Professionalism for the Medical Editors? Professionalism Dr. George Lundberg said is directly dependent on ability, competence and morality of the Chief Editor. He also mentioned about personal morality, societal ethics and public law. Speaking about the wheel of Trust he mentioned readers, authors, peer reviewers, owners, sponsors, institutions, advertisers, funding agencies, staff, students, public media, editorial board and the patients.

Dr. George Lundberg

Continuing Dr.George Lundberg said that medicine was a business as well as profession.  Medical editing is a profession and the profession exists to provide a service. Balance between the two is the key.  The characteristics of a professional   include self governance as individual and as a group, service to the poor without expecting him to pay, delivery of service not to the rich people only, authority on knowledge, altruism and sacrifice.  The Global Pillars include the International Committee of Medical Journal Editors (ICMJE), World Association of Medical Editors (WAME), Committee on Publication Ethics (COPE), World Medical Association etc.

The Editors, Dr. George Lundberg said must ask their readers what they want. Create a publication where authors will like to publish their good work. Making it difficult to publish is ridiculous. Make it easy, simple for authors to publish if they have anything to say. Beginning of relationship between the editor and author is registration of a paper; try to help the authors to improve their papers.

Sitting on the Dais during one of the sessions at WAME Conference held
at New Delhi India from (L to R) are Dr. Rod Rohrich, Vice President
WAME; Dr. Lorraine Ferris, President WAME and
Dr. Tom Lang, Treasurer WAME.

Trust relationship with peer reviewers. Promote the culture of peer evaluation, self criticism. Put art into science.  Peer reviewer who wishes to comment puts art into science.  Peer Reviewers are critically important. They are never deciders but advisors. Recognize them, respect them, help them and love them. Speaking about the owners Dr. George Lundberg said that the owners know how the medical journals are funded. There are various ways of funding.  Owners and Editors at times are different, their role must be defined. It is the owners who hire and fire the editors. As regards sponsors, there must be a written contract how it will function. Editors should have a veto power otherwise their reputation will be suspect. With the advertisers, editors should have a deal. Funding agencies include government institutions, Foundations which distribute funds. There should be a difference between Editorial and Editorial. Funding sources must be mentioned. Some one pays for all this as there is nothing free. Readers have a right to know who funds the Journal. As regards help by health institutions and libraries, the individual who creates a link can be of great help. Journals can be recognized by institutions and Editorial Boards. Money may not change hands in this. It should be a win win situation for both i.e. branding of journals and journals should be important for the libraries. For many years JAMA did not have an Editorial Board. Members of the Editorial Board should have a job description. They must know what you expect from them. Do not embarrass them, disappoint them. Do not pay money but give them due recognition so that they are proud to be a member of the Board.

Continuing Dr. George Lundberg reminded the audience that you are all students. Welcome them educate them, respect them. At times the students might know more than you. Students, residents in training can be elevated to the Editorial Board as members. While dealing with your staff, trust them and they should trust you. Hire people who are smarter than you, treat them with kindness, take group decisions, meet them one to one once a week. You always need to put money into the bank to have money. You need something; you will have to give something. He then referred to Gary Schnitzler’s ten rules concerning professionalism.  Consider public media as your friend. Medicine Dr. George Lundberg stated is money. Large dollars have small effects.  Now US Medicine was changing.


Some of the participants to the WAME Conference held at New Delhi India from October 1-4th photographed
along with WAME Executive and members of the organizing committee on the last day of the conference.

Talking about Conflict of Interest, this, Dr. George Lundberg opined was a complex, tricky, unsolved.  There is a battle for soul of medicine. New England Journal of Medicine won’t accept any manuscript for publication unless conflict of interest is mentioned. Money ignores the real elephants in the world. Psychiatrists need to declare conflict of interest more than any other members of the medical profession. Conflict of interest is a problem. Try to do the best you can, doubt everything you read. Predatories are everywhere. We need living medical journals. There is rapid learning through communications. New world is made better by information. Delusions are shared by many. Delusions between two is love and delusions with few is known as psychosis, Dr. George Lundberg concluded.

Responding to the questions Dr. George Lundeberg said that for Editors, Self Governance was No. 1 priority. Training needs of new generation of editors in developing countries also came under discussion.

Panel Discussion

This was followed by a panel discussion on professionalism and the role of Editors. It was pointed out that Editors should avoid taking actions, decisions which will lead to the demise of the journal. The journal must train its reviewers and it should be able to sustain itself.

Prof. Farhad Handjani: Participating in the discussion President of EMAME Prof. Farhad Handjani from Iran said that in many countries some faculty members are appointed as editors by the institutors without any training. As such there are going to be problems.  In Iran, there are at present about four hundred biomedical journals and almost 80% of them are sponsored, funded by medical universities. Problem with the editors is that they have no knowledge about it. Institutions, organizations ask someone in the faculty to start a journal and they are also asked to be its Editor as an additional responsibility. There is no infrastructure in place which should be created first before starting a journal.

Promotion based on the number of publications is becoming a problem for the faculty members. There is lot of pressure on journals and editors. Sometimes quality is disregarded but there is pressure to publish the manuscripts. There are not much resources. Not many countries have professional publishers. Universities are acting as publishers. In some cases the publishers try to take over the responsibilities of Editors which are causing more problems. Role of the publishers is to help and not take over the journals. As regards Editorial Boards, not many are there on merit. They just wish to add it in their CVs. In some cases, Editor is not the Goal Keeper but it is the editorial board members who take final decisions. Editorship is different in different countries. We in Iran have moved forward as regards peer review, indexing, visibility of the journals but we still need to do a lot more particularly as regards training of Editors. Role of Editors and Editorship is different in different countries, he remarked.

Charlotte Haug in her presentation referred to the responsibilities of an Editor in the light of ICMJE and COPE guidelines.  There is a business side of it as well.  As regards Web advertisements, editors do have a control on it. Make sure that advertising is not coupled to the contents of the journal. There is a possibility that you as an Editor may be influenced in controversial issues. Editors have responsibility to their readers to develop journals and it costs money. Editors should not be influenced by financial considerations.


Some senior founder members of WAME photographed during the
WAME Conference held at New Delhi recently.

George Lundberg pointed out that there are too many sandals regarding poor quality of research. Behind the washing lines we do washing and it is dirty. We are hopeful that the outcome is good. Research should be right in the programme and selective reporting of research should be discouraged. Research papers should answer real questions. It must report what they have actually done. We do not know who designed the study and it had no benefits of the intervention they tested.  But even then it should be published.  Editors should have acceptance, rejection check lists. They should be aware of research guidelines. COPE has recently initiated e learning course for Editors. There is lot of pressure on editors and it is extremely difficult to keep all the authors happy in scientific publishing.

Speakers speak about it. What does it prove- is it a threat to professionals? Pressure to publish is there in the West as well. Prof. Farhad Handjani remarked that if the Editors work, those who pressurize will stay away. Now there is a possibility of change in promotion policy in Iran. We should not be silent but speak about it. Research in implementation was much more important. Prof. Nundy from India remarked that we as Editors should be talking about the Health issues of our countries. Health Services is not so good in developing countries. Events which disappear in our countries after a few days should be constantly highlighted. Social and political issues need to be taken up strongly.

The salient features of the WAME survey on Professionalism and Medical Editors- How WAME can help were also presented in this session.  In all there were eighty one respondents from thirty one countries. More than 83% had more than six years of experience as editors. Twenty three areas of medical journal editor’s professionalism were identified which included ethics, research integrity, conflict of interest, evaluating research,   access to resources and   needs of editors. The respondents rated their expertise high in some areas and low in other areas. Access to resources was substantially low.

Ana Marusic talked about Editor’s independence. She referred to the pressure the editors have to face from owners, authors, pharmaceutical companies. Autonomy of the Editor, she opined, was very important because editor deals with the public and the society. WAME Guidelines help in drafting the terms of agreement for the Editors. Authority of the Editorial Board and the Editor should be clearly defined. Medical Council of India rules for promotion which state it will not recognize manuscripts published in online only journals also figured in the discussion. She highlighted the importance of training of faculty members round the year. It is also education for the authors and reviewers. More importantly an Editor of a Journal must be a paid professional, she remarked. It is desirable to put the peer review form on the website. Online training of peer reviewers can be organized. One should know how to select good reviewers.  There are ethical guidelines for peer reviewers. Editors should take stock of peer review errors in peer review. One can guide Editors how to rate the peer reviewers. There can be a flow chart to be followed once the review comes. There should be guidance for peer reviewers what will happen later on. Statistician should be involved in peer review. For training authors and Editors, one can have case studies like COPE guidelines which will be very useful. Journals should clearly state their peer review policy. One can plan online Webinars. WAME should help develop questions to evaluate reader’s response. How they rate the Journals? Social media can also be used to increase journal visibility. One can undertake a study as to who is accessing the website for which one can use Survey Monkey. Putting names of the reviewers on website, in print at the end of the year, certificates of appreciation and asking, inviting them to attend conferences are some of the ways to recognize their services.

Mr.Tom Lang speaking about statistics said that we can have flow charts, lists, Guidelines for Editors and Reviewers. Workshops can be organized for reviewers. Editors can ask for specific guidance.  We can have a Data Base of Reviewers for WAME members. One can identify regional resource persons and publish manual on How to edit a manuscript. We can also have a mentorship programme, he remarked.

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