Why Peer-Reviewed Articles Get Rejected – Lessons from Medical Journal Submissions
Throughout the years, I’ve collaborated with numerous researchers to assist them in submitting their manuscripts to medical and scientific journals. While each submission is unique, I’ve noticed recurring patterns in why papers are rejected.
Here, I will share the five most common reasons manuscripts fail to pass peer review and the strategies I’ve used to help my clients achieve successful publication.
1. Submitting to the Wrong Journal: The Leading Cause of Rejection
One of the most frustrating types of rejection is the “desk rejection,” which occurs when a paper is rejected before it reaches peer review. A major issue is selecting the wrong journal. I’ve witnessed brilliant research being turned down simply because it didn’t align with the journal’s scope.
How to Fix It:
Read the journal’s aims and scope; don’t assume that every medical journal is interested in your study.
Identify a suitable match using journal selection tools such as Elsevier’s Journal Finder, Springer’s Journal Suggester, or Jane (Journal/Author Name Estimator).
Consider where similar studies have been published—if your research focuses on a rare disease, it fits better in a specialized journal than in a general medical one.
Review the impact factor, indexing, and readership—not just prestige. A journal with a lower impact but a better fit is often a smarter choice than a top-tier journal that isn’t quite right.
Example: A client submitted an oncology manuscript to a general internal medicine journal, which was rejected in two days. After revising the scope and resubmitting it to a specialized oncology journal, it was accepted with minor revisions.
2. Lack of Writing Clarity: When Good Research Gets Lost in Poor Writing
Many researchers underestimate the importance of clear writing. A poorly structured, jargon-heavy manuscript can obscure even groundbreaking findings. Reviewers don’t have time to decipher confusing writing—and I’ve seen papers rejected simply because reviewers had difficulty understanding how the research findings were presented.
How to Fix It:
Employ the IMRAD structure (Introduction, Methods, Results, and Discussion) to maintain logical organization.
Eliminate unnecessary words and jargon—concise, direct language always prevails.
Seek feedback before submission—ask a colleague or a professional medical writer to review your manuscript.
Example: A neurologist I collaborated with had strong data but unclear results in the discussion section. We restructured it to highlight key findings, limitations, and clinical impact. The revised version was accepted in a Q1 journal.
3. Lack of Novelty: “This study does not contribute anything new"
What I’ve Seen Happen:
Journals prioritize research that brings new insights to the field. If reviewers believe a study offers nothing beyond the current literature, it is rejected.
How to Fix It:
Clearly articulate the research gap in the introduction.
Compare the findings with earlier studies to emphasize their novelty.
If your study validates existing results, highlight its clinical significance.
Example: A researcher submitted a pain management study that was rejected due to a lack of novelty. We revised the introduction to clarify the research gap, reanalyzed subgroup data for distinct insights and reframed the discussion. It was subsequently accepted in a specialized pain medicine journal.
4. Ethical Concerns: The Quickest Way to Get Rejected (or Blacklisted!)
Ethical issues—whether intentional or not—can instantly derail a submission. Journals regard plagiarism, data manipulation, and lack of ethical approvals with the utmost seriousness.
How to Fix It:
Obtain IRB approval prior to initiating human or animal research.
Ensure strict patient confidentiality
Disclose conflicts of interest and funding sources; transparency is crucial.
Consider using plagiarism checkers such as iThenticate prior to submission.
Adhere to authorship guidelines—never include “honorary” authors who did not contribute.
Example: A physician I worked for included identifying information about patients, such as initials, age, specific diagnoses, and treatment details, without proper anonymization. This constituted a violation of patient privacy and led to immediate rejection.
5. Statistical Errors and Poor Data Analysis: When Reviewers Question Your Numbers
Even well-designed studies can be rejected if the statistical analysis isn’t robust. I’ve encountered papers where sample sizes were too small, p-values were inaccurately reported, or statistical tests were mismatched with the study design.
How to Fix It:
Collaborate with a statistician if you’re uncertain about data analysis.
Justify your sample size and utilize power calculations if necessary.
Clearly outline your statistical methods—ambiguity raises concerns.
Double-check figures, tables, and graphs for errors.
Example: A cardiology researcher received critical feedback from reviewers regarding inconsistencies in statistical methods. After reanalyzing the data with a biostatistician and fixing errors, the paper was accepted in the second round of peer review.
Medical journal rejections can be disheartening, but understanding common pitfalls can greatly improve a manuscript’s chances of acceptance. From selecting the wrong journal to unclear writing, lack of novelty, ethical concerns, and statistical errors, these challenges often stand between researchers and publication success. However, each issue has a solution—whether it’s refining journal selection, enhancing writing clarity, emphasizing research significance, ensuring ethical compliance, or strengthening data analysis. By proactively addressing these factors, researchers can navigate the submission process more effectively, increasing the likelihood of their work making a meaningful contribution to the medical community.
