Medical

Publish or Perish: Getting Started on Your First Manuscript

Publications are the holy grail for the budding student researcher. These days, competitive specialties all but require one for serious consideration of your ERAS application. Posters and abstracts were enough to show research productivity during the undergraduate years, but as a soon-to-be doctor you’re now in the big leagues. A laundry list of posters on your CV—while impressive in their own right—will eventually paint you as one who can’t finish a project if a publication is conspicuously absent. Like it or not, the old mantra of “publish or perish” is beginning to apply to you.

Writing a manuscript and getting it published can be a daunting task, especially if it’s your first time doing so. However, with the right approach and a solid mentor to guide you things become much less stressful. You may even have some fun along the way! This article—the first in a short series on writing your first manuscript—will build the foundation and serve as a jumping-off point for your writing journey. Today we’ll discuss the basics of scientific writing, how to select a journal, tips for getting started, and how to stay productive while working on your first publication. 

Intro to Scientific Writing

Writing in the scientific style that permeates most research papers is an acquired skill. This alone is often the most intimidating factor for those just getting started, skilled creatives and the writing-challenged alike. Luckily, much of this intimidation is self-imposed. Learning to write scientifically may seem a terrifying task, but the reality is that you probably already know how.

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Scientific writing is about doing less, not doing more; simplicity reigns supreme in this arena. While creative writing leans heavily on style and flair, writing for research is all about keeping things clear and concise. Remember, many of your readers might not be native English speakers. Thus, the more accessible you can make your writing, the wider your paper’s potential reach and impact will be. 

At its core, simple and understandable scientific writing relies on a foundation of concise subject-verb-object sentences. Think back to the days before you tried to write “well,” and lean heavily on that uncomplicated style. There’s no shame in writing short, declarative sentences if they are clear and easy to understand. Practice makes perfect here, so be sure to critically analyze your efforts and seek feedback at regular intervals. For a more detailed walkthrough of this style of writing, consider browsing through Strunk and White’s classic reference The Elements of Style. Two other works I’d strongly recommend as a starting point include Paul Silva’s delightful book How to Write a Lot and George Gopen’s masterful paper The Science of Scientific Writing.

Once you have a basic grasp on scientific writing in general, decide on what type of paper you’ll ultimately write and draft a basic outline. If you already have a project up and running this is likely already known, but if you are just venturing into research you’ll want to consider the project types out there and plan accordingly. There’s a big difference between writing up a single case report and summarizing two years of bench research. Keeping this in mind will allow you to better prepare for the writing process and avoid excessive revisions and wasted time. 

Lastly, avoid future conflicts by discussing the authorship credit with your team ahead of time. First author is most sought-after position and goes to the primary contributor, while last author is reserved for the PI, mentor, or whoever’s funding supported the project. Middle authors should be listed in order of contribution from most to least, with equal contributors listed alphabetically. In general, it is unethical to tack on extra authors who didn’t contribute substantially, so be sure to review the ICMJE recommendations on authorship prior to submitting your manuscript. 

Picking the Perfect Journal

Selecting a target journal before you begin writing is a great way to focus your efforts and avoid extra work later on. While your preferred journal won’t always accept your paper, picking one to shoot for still comes with numerous advantages. Be realistic about the caliber of journal you target. If you’re not reporting something groundbreaking, don’t fool yourself into thinking Nature will jump all over it. Ideally, find the sweet spot between reputable and realistic and tailor your initial draft to the specifications listed on that journal’s website. 

Writing for a target audience is one of the most effective ways to increase the impact of your paper and picking a target journal is the first step in doing this. Your selection will immediately narrow your focus. For example, if you target a niche basic science journal your writing can be appropriately granular, while aiming for a health policy journal may require you to appeal to a wider audience. Whatever you choose, always write with your intended reader in mind. 

Selecting a target journal is also useful as it allows you to mold your draft to the word and figure limits, which often vary depending on where you submit. Other criteria to keep an eye on are the number of references allowed and any stylistic suggestions made in the author instructions. Treat any suggestions as outright requirements, as a paper that conforms exactly to these specifications will be much easier for reviewers to review and accept than one that does not. 

When it comes to deciding on a journal target, lean heavily on your mentor. If they’ve published a lot of work in one or two places, your barrier to entry there is likely much lower. Another shortcut is to look for a “call for papers” on a specific topic; if your project fits the designated theme this can be a fast track to publication. In a similar vein, many large conferences will do an expedited review of manuscripts related to abstracts accepted for oral presentation. If you find yourself with such luck, sending your paper to that society’s journal is a no brainer. 

Keep the journal’s impact factor in the back of your mind but don’t define your choice by it. Plenty of great journals have an average impact factor, and—just like an applicant’s test scores—this should not be the only criteria you base your selection on. Pick the journal that fits your work best, not the one with the highest impact factor. In the end, any publication during medical school is a big deal regardless of where it appears in print. 

Finally, take every precaution to avoid predatory journals. These fraudulent journals practice highly unethical publishing and often take advantage of eager and naïve authors. When in doubt, ask your mentor for advice and attempt to vet the journal with a thorough online investigation. 

Strategies to Start Writing

The best way to start writing is to do so early. Many students wait until all the data is in and the experiments are finished before opening up that Word doc, neglecting the fact that some sections of the paper can be written well in advance. Before you begin the writing itself though, be sure you’ve outlined your paper in detail to guide your future efforts. 

The easiest section to write early is the methods; while you might not be done with your experiments, you likely have them planned out in detail already. Thus, write this section up while the project is ongoing and make small tweaks later if your plans change at all. The introduction, while more challenging to draft, can also be started early if you’re feeling brave. Doing so will alleviate the writer’s block of staring at a blank page when you do sit down later to tackle the remaining sections. 

Once your data collection wraps up, decide if you’d like to tackle the easiest or hardest remaining section first. The jury is out on this one, so try it both ways and pick whichever is best for your productivity. The methods are often the easiest to draft, hence my suggestion to get them on paper while the project is still ongoing. Many prefer to leave the introduction for last, citing it as one of the hardest sections to get right. Others, however, tackle it first in order to frame the remainder of their paper. As you can see, much of this depends on personal preference. A common game plan is to write the methods, introduction, results, and discussion in that order. 

When it comes to the actual words you put on paper, always attempt to craft and tell a story. Just as we discussed in my article on writing abstracts, doing so will make your manuscript much more interesting and compelling than merely listing out your findings. We’ll delve deeper into the art of storytelling in a future entry in this series, so for now just have this goal in mind. Try to think about the journey you want to take your reader on before beginning the first draft, ideally before outlining the paper, and tie as much as you can back to this common thread as you write. 

Stay organized by using a reference manager to keep your citations neat from the start. Doing so will save you numerous headaches later on, especially if the list is long. Most authors use EndNote to cite, but alternatives exist and you’ll likely end up using whichever platform your institution pays for. Regardless, get familiar with the software before you begin writing and use it according to the citation preferences of your target journal as you proceed.

Preserving Your Productivity

The major challenge of writing for most authors is simply getting started, but how do you stay productive once you fight past that initial barrier? First and foremost, figure out your own bad habits and tackle these head on. Are you a procrastinator, a perfectionist, or something else equally sinister? Both can strangle your productivity, and the first step to fighting these tendencies is identifying and admitting to them. 

The golden rule of manuscript writing is to start early and write regularly. Stick to a firm writing schedule if you can, as a few hours each day is much better for productivity than trying to fit in marathon writing binges every couple of weeks. Put this schedule on your physical calendar and treat it like any other meeting, with tardiness and cancellations strictly forbidden. If you have a hard time with staying accountable, form or join a writing group with your peers. Paul Silva waxes poetic on the importance of a writing schedule in his aptly titled book How to Write a Lot, which is a must read for any newly minted author. 

Set yourself up for successful writing by avoiding overcommitment. I personally struggle with this evil, so take my word for how detrimental it can be. Before you take on additional projects or roles, ask yourself what you will gain from them. If the answer isn’t substantial, say no and move on without a second thought. It’s much more efficient to focus your effort on one project at a time than to split your attention between multiple works that never get finished. 

Furthermore, when assessing your ability to juggle projects, always overestimate how much time each will take. We are awful predictors of our own productivity, and incorrectly assuming that new projects will entail minimal work is the fastest way to weigh yourself down and burn out. Above all else, keep your priorities straight and don’t let side projects steal time and effort away from those that should be most important to you. 


Few things in a young scientist’s life are capable of instilling as much fear as writing the first manuscript. That fear is born out of a lack of guidance and the assumed complexity with which scientific writing is frequently construed. Fear not though! With this framework, you should be well on your way to knocking your first publication out of the park. Keep these tips in mind as you finish your project and begin writing, and look out for future column entries containing a deep dive into the anatomy of a research paper and more specifics on how to write a great one. Together, we’ll take the madness out of manuscript writing so you can publish rather than perish!

Welcome to “Research for the Rest of Us”, a column about navigating the complex intricacies of life in the lab. These articles aren’t for the superhuman Nature-publishing, Nobel Prize-winning MD/PhDs out there, but rather for the rest of us: the Average Joes simply trying to get our feet wet in research. Join us as we journey through this complex world of academic adventures, from picking a project to matching into your dream residency and everything in between. 

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