How to Handle a Manuscript Rejection? : International Journal of Advanced Medical and Health Research

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Research Series Article

How to Handle a Manuscript Rejection?

Kalayarasan, Raja; Murugesan, Chandrasekar

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International Journal of Advanced Medical and Health Research 9(2):p 120-123, Jul–Dec 2022. | DOI: 10.4103/ijamr.ijamr_241_22
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Researchers who work on developing scientific evidence through trials strive hard to inscribe and publish their work in a peer-reviewed journal with a good impact factor for it to reach the global audience and have recognition of their work. However, it is easier said than done, as more than 60% of submitted manuscripts undergo rejection. Journal editors and reviewers also endeavor to bring the best of scientific research papers to the readers and follow a vigilant framework to choose the finest research work from available submissions for publication. Hence, manuscript rejection is inevitable even for leading authors. Scientific journals have a rejection rate of 31%–89% depending on the journals' reputation and impact factor.[1] However, an analysis of the rejected manuscripts revealed that nearly 70% were published in different journals.[23] Therefore, researchers and authors can be assured that their well-deserved scientific work will eventually find its journal home if appropriate corrective measures are taken. A pragmatic approach to dealing with manuscript rejection is discussed in this review.


When an author submits a scientific article to a peer-reviewed journal, the editor's office scrutinizes the manuscript for technical compliance, including images, tables, consent, conflict of interest, Declaration of Helsinki, and plagiarism. Then, the editor assesses whether the manuscript fits within the journal's scope. For manuscripts not meeting the above criteria, the editor rejects or sends back the article to make necessary changes. When the journal's standards are met, the manuscript is forwarded to two to four independent reviewers in the related field to assess the research article's merit for publication. The reviewers would be given an appropriate time and a checklist of items they must go through for their review. When the reviewers' inferences are discordant, the editor may obtain additional reviewers' opinions. Based on the reviewer's comments and the editor's purview, the journal may accept or reject the manuscript. The editor's decision is communicated to the author alongside the reviewers' comments.[45] Some high-impact factor journals have a more complicated review process that includes a separate team to review the statistical analysis and ask for complete data of all the included patients in an anonymous format for review. Thus, the researchers can be assured that their manuscript is assessed appropriately at multiple stages before publication in peer-reviewed journals [Figure 1].

Figure 1:
Flowchart depicting the process of evaluation of the manuscript

In case of rejection, the journal editor may outright reject the manuscript with or without peer review due to unsuitability or major technical flaw in the study. Sometimes, the editor feels the manuscript is interesting but cannot be accepted in the present format, hence may reject it conditionally. In conditional rejection, the editor will suggest the authors to resubmit as a research letter or letter to editor so that the manuscript can be reconsidered.


About 20%–30% of the submitted manuscripts are rejected without peer review.[6] The most common reasons and probable discreet solutions for desk rejections are enumerated below.

Failed technical check

The technical team in the editor's office will send the manuscript back to the authors if it fails the initial technical evaluation. Hence, the researcher should check the author's guidelines properly before submission to any journal. The authors must conform to the guidelines regarding the title, abstract structure, manuscript alignment, word limit, format for figures and tables, and referencing style. The manuscript will often be processed further if the authors make necessary changes, draft the manuscript according to the journal's guidelines, and resubmit. Otherwise, it may be rejected for technical noncompliance.

Outside the aim and scope of the journal

A typical example is submitting a case report to a journal that does not accept a case report or case series. The author must carefully analyze a journal's aim and scope, including the target audience, whether broad or narrow specialty. Some journals that do not accept case reports or case series, at times, suggest the authors resubmit their manuscript to the associated network journals which might be interested in this work. Furthermore, the editorial team would not be interested if a similar article was earlier published, particularly in the same journal. Hence, the authors must be aware of recent publications in their research area and choose appropriate journals that match their field of research.

Poor language

Even novel and innovative research manuscripts may face rejection if not expressed comprehensively in the language of publication. In a survey, about 60%–80% of the authors from non-English speaking nations face a difficulty writing manuscripts for English international journals.[7] The authors should restrict using technical jargon and colloquial terms in their manuscript. They can take online assistance or editorial services for revision if poor language is the sole reason for manuscript rejection.

Ethical issue

Biomedical researchers and authors are obliged to follow the Declaration of Helsinki, which states, “While the primary purpose of medical research is to generate new knowledge, this goal can never take precedence over the rights and interests of individual research subjects.”[8] The authors must include the Institutional Ethical Committee approval, ensure that safety is followed through interim analysis, and report any adverse impact as per guidelines. The trial participant's anonymity should be maintained, and all supporting images and data should be reported with informed consent.


The author can use the ideas of previous literature with its due accreditation in the citation. If using the exact words, then it should be used within quotation marks. Data falsification and fabrication to support study objectives and derive desired conclusions are disreputable practices; these can result in upfront denial. Further, the author could face delisting from the journal for further submissions. To avoid such an unpleasant situation, the authors must be vigilant and prudent in their research. Furthermore, authors can use available online plagiarism-checking software such as iThenticate and Turnitin to ensure the originality of the work before submission.


Peer reviewers do the crucial assessment of the research, such as research objective, methodology, data analysis, interpretation, and conclusion.[910] Peer reviewers are usually researchers with expertise in the related topic and voluntarily do the critical assessment of the manuscript to improve research.[11] The common causes for rejection after peer review are enumerated below.[12]

Lack of novelty

Biomedical research requires unique hypotheses and findings to gain the interest of the reviewers. The researcher must identify a lacuna in the field of study with an extensive literature search and demonstrate it in the manuscript with appropriate citations. Research manuscripts about a topic that has been well established and extensively studied over the years will be considered repetitive and fail to gain adequate traction from the reviewers. A well-identified research gap, an innovative approach toward the research problem, or novelty in methodology could add originality to the research work.

Flaws in study design or methodology

No clear definition of the study method, inclusion and exclusion criteria, sample size calculation, data collection, and analysis can affect the reproducibility of the study and raise questions about the validity of study methodology. A clear definition of the variables and measurements clarifies any possible bias. Confounders and biases should be identified apriori to increase the study's validity. These days, academic journals follow standard reporting guidelines for different types of studies. Researchers need to be mindful of this and incorporate it in their manuscript. Examples of reporting checklists include Preferred Reporting Items for Systematic Reviews and Meta-Analyses for meta-analysis and systemic review, Consolidated Standards of Reporting Trials for clinical trials, Strengthening the Reporting of Observational Studies in Epidemiology criteria for observational studies, and CAse REport (CARE) guidelines. The researchers can use the checklist in these guidelines before submission to the journals.

Poor interpretation of the findings

Analytical and experimental studies are most desired for publication as they are high in hierarchy of evidence and more likely to get cited.[13] The significance of the results should be analyzed with comparable variables using an appropriate statistical test. The opinions in the discussion and conclusion should be derived from the study's results; personal speculations or conclusions not supported by the data should be avoided. In case of insignificant results, it is encouraged to report the research finding with necessary justification rather than a falsely modified result.

Failed compliance with the journal

When a reviewer asks for a major or minor revision, they are more likely to be accepted for publication, provided the author makes necessary corrections within the stipulated time. Failure to address the issues in the manuscript within the specified time frame may lead to rejection. The authors must be conscious of the timeline process and abide by the journal instructions. Authors can request for extension of submission deadline, if necessary, by writing to the editor; reasonable requests are usually accepted.


As rejection after peer review is a common phenomenon, the researcher should approach it with a positive attitude and follow a pragmatic process.

Appeal the rejection and resubmit it to the same journal

Some journals allow authors to appeal the rejection. However, it is often not recommended as it is bound to fail. Rarely, peer reviewers' comments are not favorable, but the editor may be interested in the manuscript. In that case, the journal's editor often asks the authors to resubmit after major revision. If the rejection is due to a fatal flaw in the study design or lack of novelty, the appeal is unlikely to succeed.[14] However, rejection due to a misunderstanding of the findings by the peer reviewers can potentially succeed. A typical example is when a manuscript on surgical technique is submitted with two to three supplementary videos, but the reviewer fails to see one of the videos and comments that the description of the surgical procedure is unclear. In such a scenario, the author can appeal the rejection. Whenever an appeal is made, your comments must be polite and humble and not belittle the reviewers.

Submit it to a different journal

The most prudent option is to accept the denial, analyze the cause for rejection, make appropriate modifications in the manuscript, and submit it to a different journal. It is easier to submit it to another journal without making any change to the original manuscript. However, it is generally not recommended as there is a good chance the editor of a different journal might send the manuscript to the same set of reviewers; the manuscript would then face a similar fate. Even if the manuscript is sent to a diverse group of reviewers, they may identify the same mistakes. Authors should consider the reviewer's comments as an opportunity to improve the quality of the manuscript. Before resubmission to a different journal, ensure that the manuscript is formatted as per the new journal's instructions.

Filing the manuscript without resubmission

If the article is rejected in more than two journals, it is natural to get frustrated and feel that your paper is not worthy of publication. Authors would do well to carefully analyze the reviewers' comments and strive to improve the quality of their manuscript. If the reviewers' comments are not related to significant flaws in the study design, then there is a definite scope to publish your manuscript elsewhere. Not publishing the findings of your study is equivalent to dumping your scientific research, which is a waste of resources and a significant loss to the scientific community. Your study results might provide the missing link to a research question or preclude other researchers from doing a similar study. Broad-scope journals that emphasize study methodology rather than research novelty are an excellent option. If there are no financial constraints, open-access journals are another option or else authors can file the manuscript in online digital repository sites like Figshare, which are citable and freely accessible.


Manuscript rejection is a common phenomenon in a researcher's career, and the authors should constructively use the reviewers' comments to improve the quality of the manuscript. When one faces rejection in a peer-reviewed journal, the emotions should be set apart and follow a pragmatic approach for the work to gain recognition.

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Conflicts of interest

There are no conflicts of interest.


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Editorial process; manuscript rejection; manuscript resubmission; manuscript revision; peer review

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