The Long, Arduous Journey to Publication: It Doesn’t Have to be That Way

I recently co-authored an article submitted to Nature Urology, a subdomain of the Nature publishing group. It took roughly eight weeks of review before we received feedback from the editorial office. In December 2016 we were finally presented with several reviewer questions that had to be answered before a final decision could be made. After all outstanding questions and reviewer requests had been answered the article was finally, mercifully “accepted in principle” on February 3rd. That was far from the end of it, however, as another round of editing requests arrived on May 11th.

This time the requests came directly from the Nature editorial office. The majority of the requests concerned tightening up the narrative flow and bringing the article in line with their in-house style. At this time, we discovered that the edits already made by the editorial office were so extreme that the editors had to check with us to make sure the meaning of our words (and indeed the entire article itself) had not been altered by their editing process. All of this for arbitrary language and formatting issues.

On May 15th, with the article still unpublished, we were yet again asked to check affiliations and other minor aspects of the article. The article was finally published yesterday, May 23rd, roughly eight months after submission. (And it could have been worse!)

How does this kind of perfectionism serve the scientific community? Why does the editorial office of the Nature publishing group change the text of professional scientific authors in a way that even they are not sure if the scientific information is still correct? The editorial work of so-called high-end and high-ranking journals has reached a level where their interaction is beyond thoroughness. It is absurd to edit every paragraph, every sentence, and even every word. This does not serve the scientific community. Instead it unnecessarily prolongs the publication process to guarantee the house style of a specific journal. The scientific message does not change with this heavy editing, but an article may look better and therefore may be better sold by the publisher based on the work of scientific authors.

The process (and underlying philosophy) are different with Cureus. In short, we rely on the individual capabilities of our authors, who also retain their copyright. We want to make the publishing process fast and efficient, so while we provide a certain level of support to our authors, we do not intend to alter their scientific message. Instead, we appeal to their own sense of pride and responsibility for adequate language and general accuracy.

In the end it is the scientific community that will evaluate if the article is scientifically sound, informative and correct. If it is not, the article will be met with heavy criticism, both via a low SIQ score and negative comments attached to the article. This system is not only much faster but also unbiased and transparent. We want to keep the focus of scientific publishing on what we feel is most important – the fast, fair and uncomplicated dissemination of interesting findings around the world.


In the Name of Truth and Reconciliation: A Plagiarist’s Mea Culpa

Dr. John Adler, Founder and Editor-in-Chief of Cureus: Speaking as a physician-scholar and an editor-in-chief, damn do I hate plagiarists! The entire idea of plagiarism sucks the life out of something that I believe to be almost sacred. Idealism aside, fraudulent behavior among authors is all too common, and maybe even rampant, within the world of scientific journals. To combat such fraud, Cureus, like most credible journals, has made it a formal policy to aggressively police plagiarism when we encounter it, as stated explicitly in our guidelines for authors’ section:

“Cureus pledges to rigorously enforce all standards, and promptly follow up on any transgressions. In extreme cases, this may call for article retraction and the reporting of individuals to their employer, institution or some appropriate body for further investigation.”

To date, Cureus’ policy appears to have ended the careers (sadly) of some young ambitious physicians; it is the aspiring younger academic who in my experience appears most tempted to cheat, especially given Cureus’ liberal willingness to publish credible science. In response to the cheaters, Cureus’ editorial team has always sought to be ruthlessly punitive, believing it to be the best defense against future plagiarism. Once exposed to the leadership of their medical institution, a plagiarist’s career tends to end in the quiet of the night, which unfortunately does little to communicate the seriousness of such cheating to others.

Therefore, I recently made a decision (for better or worse and somewhat capriciously I might add) to not report a plagiarist to his senior leadership. In the name of “truth and reconciliation” I instead demanded that the attempted-plagiarist explain their underlying motivations so as to serve as a warning to future authors who might be similarly tempted. That is the impetus for the below anonymous blog post. It is my hope and prayer that future potential plagiarists might read this post and come to their senses before very possibly destroying their own medical careers.

My decision for leniency under the current situation was done with great hesitancy. I can rightfully be criticized as undermining our journal’s clear warning to authors. Therefore, I wish for the record to say that as long as I am Editor-in-Chief of Cureus I intend to never ever repeat such leniency towards a fraudulent submission. Any author who might be tempted otherwise, consider yourself to be hereby forewarned.

Anonymous Cureus user: Most residents desire to do research and get published in a journal, for both the academic benefits and to develop one’s resume when applying for future fellowship training. Being such a young ambitious physician, but also having no significant experience in publishing research, I recently made the biggest mistake of my professional life, and this error has haunted me every day since.

A couple of months ago I decided to publish a case report on an interesting patient I had just seen in the clinic. I decided to submit the report to Cureus. As I began to write I realized my research writing skills were seriously wanting. By chance I found a similar case and heavily “borrowed” portions of text; my only focus was on getting my first publication and I turned a blind eye to the consequences of such actions. In fact, I hardly changed any words or sentences and simply submitted this report to Cureus thinking that in this particular case the objective was the same.

Why did I do it? Regretfully I now have only stupid explanations to fall back upon. Nevertheless, it is worth saying that in the country where I was raised, the topic of plagiarism is never discussed or seriously acknowledged. Plagiarism just isn’t such a big deal.

Soon after submitting my manuscript I received an email from Cureus’ editor who told me that I plagiarized and he sent me a link to the original source. I was humiliated, and even more so now very scared. By all rights the editor could and maybe should have reported me to my program director. If that were to happen, I realized that it could very well end my career in medicine. So many years of hard work was potentially destroyed by a single incredibly stupid decision! I pleaded and begged the editor for mercy, and the consequence of that plea is the confessional blog you are now reading.

Once again I ask myself why did I do such a stupid thing? Thinking back now I realize I had been blinded by ambition and was totally dishonest to myself. It disappoints me to know my poor decisions mostly reflect my greedy nature and a willingness to get ahead without hard work; I was largely jealous of my friends and colleagues who were publishing. Blinded by such emotions, I failed to ask myself how dangerous such actions would be for my character, my occupation, my career and my family. In hindsight, had I thought deeply about the potential consequences of my careless act, I would have never done it, and that mistake taught me a very tough lesson.

As a resident, I already knew that laziness can make the difference between the life or death of a patient. However I failed to consider that laziness towards publishing medical research is potentially even more dangerous, as it can put many other lives at risk. My actions can only be described as utterly immoral and unethical; my behavior is completely inexcusable. Although it is the ethical right and privilege of the editor to report me to my departmental chair and residency director, I am sincerely grateful for the career-saving opportunity I have been afforded. I am determined that this painful lesson will lead to my honest behavior in the future, as God is my witness.

Cureus Peer Review Just Got a Heck of a Lot Easier

We’re pleased to announce the launch of our brand new, built-from-the-ground-up peer review tool! Any article submission started today will utilize the new system while in peer review.

Previously, we had used a third-party software tool called Crocodoc for article peer review. Our team has been hard at work creating our own proprietary system that makes reviewing an easier, more intuitive experience.

Similar to Google Docs or Microsoft Word, this new system enables reviewers to highlight text and leave comments. Each reviewer’s comments will be displayed via a unique highlighted color, while also allowing for overlapping comments.

Adding a comment
Adding a comment

Only articles created and submitted after the release will utilize this new system. All articles created before the release will still use our original peer review system. As such, please don’t be alarmed if your review experience changes from article to article!

Viewing a comment
Viewing a comment

Between the peer review and submission systems, we have now overhauled the entire publishing process in the past five months. We’re confident that submitting and reviewing articles with Cureus is easier than it has ever been, but we won’t stop working to make your experience better. Stay tuned for more exciting updates as we continue to tweak and enhance the Cureus Journal of Medical Science. Thanks for your support!

– The Cureus Team

Questions about the new peer review system? Drop us a note at and we’ll get back to you ASAP.

The Gross Inefficiencies & Politics of Peer Review

A junior colleague described to me a review he was recently asked to perform for one of the leading journals in neurosurgery.  After a careful review he reported that the paper “sucked” and he recommended that it not be published. A few months later a revised paper was sent back to him, despite his rejection, leading him to again recommend that the paper be rejected. The next communication was a letter from the editor-in-chief asking my colleague to write a commentary of the paper in question which was to be published alongside the now twice-rejected article. Eschewing a discussion of whether this paper merited ultimate publication or not, I do question the entire peer-review charade that this vignette exposes. The reality is that too often reviewers have little say in whether a paper gets published or not. Instead journal politics and the discretion of the editor-in-chief is transcendent throughout the peer-review process. My lament is that if the editor-in-chief is intent on publishing a paper from the start, why not say so and at least ensure that the process is efficient; this is of course the Cureus process of peer review!

What the above story calls into question is  just what exactly constitutes peer review? What is its function? The stalwart champions of peer review argue that it alone uniquely enforces scientific quality. The “acceptance” of one’s scientific work by potential critics and academic rivals, represents the highest measure of personal and scientific integrity. It is hard to argue with such a high-minded proposition, but is it grounded in reality?

In my own, and many of my colleague’s considerable experience, the realities of peer review are nothing like the above idealistic notions bandied about by proponents. Gross inefficiency is often embraced in the name of scientific integrity by rivals who are in no rush to see the accomplishments of scholarly competitors lauded. Many reviews are little more than cursory reads by time-harried reviewers resulting in a thumbs up or down. Ironically when all is said and done this may not be the worst outcome!

Too frequently reviews become meaningless intellectual battles, which at their core are little more than exercises in power and ego. These many skirmishes are often expressed in the to-and-fro volleys between reviewers and authors centering around secondary or even tertiary measures of paper quality. Time-wasting reviewer obsessions with incautious conclusions, inadequate words of self-criticism (at times almost Marxist in nature), failure to reference important (reviewer?) publications, by the letter ethical processes, inconsequential statistical measures, etc. often mask the importance, and strip away the beauty, of science. Given human nature and a subjective system that deliberately selects reviewers from the pool of intellectual competitors, is it not too surprising that baser self-interested emotions too often trump fairness, or at least efficiency? There has to be a better way! Because we at Cureus believe there is, we invite you to learn more about our peer review process.

Lessons Learned From Winning a Poster Competition

Lessons Learned From Winning a Poster Competition

Competing For Eyeballs of Those Passing By

    1. You are competing with everyone for the attention of a few (1 minute of their time – MAX)
    2. Catchy titles! Lure in the reader with a title that stands out from the crowd
      • E.g., One title I used was “The Panic Disorder Patient who Cried Wolf.” Clearly, this is not the title for the manuscript I eventually published (which was about information-processing biases and auditory perception in anxious individuals), but, it certainly piqued the curiosity of convention-goers.
    4. Bullet-pointed text (similar to a talk). A few points of interest or “talking points,” but let the quality of your tables and graphs/images speak to the quality of your data!
      • No one has the time to read tiny text boxes (if the reader has to squint…you lose)!
      • Consider leaving out the abstract (so many words, and these words are redundant with what your poster will convey LOUDLY AND CLEARLY, also the abstract will be published in the Conference Proceedings anyway. On Cur?us, the title of your poster will be directly linked to your published abstract.  In essence, your poster IS the abstract plus some cool graphic design effort!
    5. What to include?
      • Background and Rationale
      • Specific Aims and Hypotheses
      • Methods/Design
      • Results
      • Graphs/Tables
        • Summarize results in bullet pointed text
        • Don’t add a single bullet under a point. What’s the point in the bullet if the bullet IS the point?
      • Conclusions/Discussion
      • Implications/Future Directions

Most of all, have fun with your work, have confidence in it, and BE CREATIVE!

Poster Sample (above): Spinal Chordoma by Stefan Norbert Zausinger

Fall 2012 International Poster Competition is Now Open

Fall 2012 International Poster Competition is Now Open

Several months ago we started a revolution in medical publishing by offering tools for physician authors unlike any in the industry.  Today we expand the revolution to include medical and graduate students, residents, fellows and anyone who has or will publish a medical poster.  There are thousands of posters discarded after conferences every year and yet they represent hard work, creative thinking and many will lead to the next full academic papers.

Dust off those posters sitting on your hard drive and upload them to Cureus where they can receive new life.

To have some fun we are introducing our Fall 2012 International Poster Competition which includes a $1,000 Grand Prize and $100 prizes for each of our 40 categories.  Each category will have a winner for a total of 40 First Place prizes.  We are honored to have Varian Medical Systems participate as the sponsor of the competition.  They are a company that values innovation and are strong supporters of physician authors who are pushing to advance medical science and discourse.

As authors you may submit any poster you have created over time and as many as you like.  Once you upload your poster, its time to promote….get friends, family, professors etc. to come vote for your poster.  The top 10 vote recipients in each category will make it to the final round where our esteemed Editorial Board members will select the Top 3 Winners in each category.  Top 3 winners will get noted in their profile and can add this distinction to their CV…plus bragging rights.

Go to to get started.…the sooner your poster is submitted, the sooner you can begin getting votes and head toward victory.

Let the games begin.


Download the official Fall 2012 Poster Competition Press Release.


Cureus People – Rod Oskouian, M.D.

Cureus People – Rod Oskouian, M.D.

Cureus met with Rod Oskouian, M.D., a neurosurgeon at Swedish Neuroscience Institute who specializes in the diagnosis and treatment of complex spinal disorders. He talked to us about the sometimes lengthy process of peer-reviewed medical publishing.

“One of the reasons why I got involved in Cureus and why I’m on the editorial board is pretty simple – I want to have open access to journals, be able to publish journals and review journals in a timely fashion so it doesn’t take two years to get a paper out.” – Dr. Rod Oskouian, told Cureus.


“I think the younger generation we’re all using mobile applications, going online a lot – the traditional journals where you have to subscribe to some obscure article that costs the institution thousands of dollars in some corner of the library that you have to go look up is not happening.” – Dr. Oskouian added.