After a two-year study, a cardiology fellow completes research on hospital readmissions. There’s no time for the manuscript in her busy clinical schedule, and the data is clean, but the results are important. It remains in a folder for 1 ½ years and a rival group publishes first.

There are lots of such stories in academic medicine. The science is completed, the writing awaits. This is why medical writing services are now used by more medical schools, nursing programs as well as teaching hospitals to complete what was started by the faculty.

How to Use the Writing Load Nobody Budgets For to Support Student Learning.

There are over 150 medical schools in the United States that award the degree of Doctor of Medicine and more than 30 that award the degree of Doctor of Osteopathy, and there are several hundred nursing schools. At these schools, faculty members are expected to treat patients, instruct students and conduct research – sometimes all within a single week. The fourth job is writing; it is often not protected.

The drive to produce is very real. Academic Medical Center promotion committees place great importance on peer-reviewed publications. The National Institutes of Health, which allocates approximately $47 billion each year for research, also requires results to be shared. The new NIH public access policy calls for papers from NIH-funded research to be freely available in PubMed Central upon publication.

Writing which never makes the CV

The tip of the iceberg—the journal article—is all that is visible. Medical schools also generate accreditation self-studies for the Liaison Committee on Medical Education, curriculum documents, continuing education modules, simulation scenarios and patient handouts. They follow their own format, and have their own reviewers.

There are also grant applications. The NIH proposal has strict page limits, sections and reviewers who read dozens of proposals in a cycle. An unclear specific aims page can detract from a strong idea.

If you’re still having trouble with writing as a strong clinician, here’s why.

Precision is taught in clinical training but not craft of structuring paper. Trials are required to report according to CONSORT, systematic reviews and STROBE for observational studies, and systematic reviews are required to report according to PRISMA. If the manuscript does not meet those standards, it may be returned, without anyone assessing the science.

A simple capacity issue is also there. Many faculty members report that they have more data than time, and results to be published accumulate. There is a cost associated with delay because the information that arrives late will be of an outdated nature.

So what exactly does a medical writing service entail? So what does a medical writing service really include?

The good medical writer is not a generalist who has a thesaurus. Many are endowed with advanced life science or clinical qualifications, and the cream of the crop can read a results table as easily as they can write a discussion one. If you intend to learn about the scope of the provider, you could get an idea by reading through a page about medical writing services.

The projects typically go into a couple of categories

Manuscripts: Writing from study data, protocols and the author’s input, formatting for a specific journal, and managing references and figures.
Grant applications: improving the aims, significance and approach sections; maintaining the story flow throughout the entire application.
Educational content: course materials, case based learning scenarios and patient education written at an appropriate reading level.
Institutional documents: IRB submissions, informed consent forms and quality improvement reports.

One word of note on plain language: It has long been known that a large percentage of American adults perform poorly on health literacy tasks. Technically correct but difficult to understand consent forms/discharge handouts can fail the patient.

The investigators never provide the science, the interpretation is always provided by them. The writer provides structure, clarity and discipline to the writing to create a draft submission ready. Keeping the work honest is this division of labor.

Authoring on the « Right Side » of the Rules

Medical publishing is a field with more regulations than others, and anyone who is hiring assistance should be aware of them before signing on to anything!

Most major journals adopt authorship criteria from the International Committee of Medical Journal Editors. An author is required to substantially contribute to the work, participate in its drafting or revision, approve the final version and be accountable for it. A writer who just writes it from the authors’ data doesn’t fit those boxes, and so professional support with writing is usually listed in the acknowledgments rather than in the byline.

Disclosure is the norm. Numerous journals require identification of writing assistance and payment of writing assistance. Guidance on transparent practice is published by the American Medical Writers Association and the International Society for Medical Publication Professionals, and the Good Publication Practice guidelines are applicable to work sponsored by the industry.

There are a couple of lines that should never be crossed:

Never fabricate, modify or select data in a manner that is not original to the writer.
Conclusions should be based on the authors’ preferences rather than a sponsor’s.
All claims are the responsibility of the student author(s) prior to submission.

Student work is an exception. No well-known provider will write a thesis for students and present it as their own work. No good provider will do so if the students ask them to write theses to give as their own work.

Safeguarding patient and student information

Patient information is subject to HIPAA, Student records are subject to FERPA. De-identified data is the standard to use when there is an outside writer. The contract should spell out how files are stored, who can access them and when they are deleted.

Learning how to select a provider and collaborate with them. Selecting and working with a provider.

Begin with the subject fit. Some of the questions a writer will have, who is familiar with oncology, and who is familiar with the education of nurses, or surgical training, will be more pointed and less corrected in your time. Request samples and credentials of the person putting the project together.

Test to see that they are aware of the reporting standards before asking them. The writer should be able to introduce your section (the relevant guideline) and know how to follow a journal’s author instructions, line by line.

Before the job begins, agree the practicalities in writing:

The scope of the project and how many rounds of revisions will be done
A timeline providing authors real-time for review.
The right to submit it under your authors’ names and ownership of the final text.
How the writer’s contribution will be cited

Then protect your time. Authors must read each sentence and check each number. It is a liability, not a shortcut, to write a manuscript that wasn’t really reviewed by the signing authors.

Shop around for a clearly specified project rather than a no-bid contract. There are a range of rates depending on the length, complexity and the writer’s expertise and a clear brief saves cost and misunderstandings.

To bring the Work out of the Folder

There are abundant findings in academic medicine for readers to sink their teeth into, and teaching ideas to take on board. It is not the science that proves to be the barrier. It is the hours spent in writing clearly, achieving all standards and meeting all deadlines.

With good management, the outside writing support fills it in without sacrificing authority or integrity. Use someone who has experience in your field, ensure authors maintain control over the science and be transparent about the assistance provided like journals want. The fellow whose data is admitted reads her paper on time and the research gets to the clinicians who can use it.

Mots Clés : Ghostwriting