Should I throw in the towel with my case report?

[VCorp]

I recently wrote up a case report of an unique visual presentation of a giant pituitary adenoma that was trilobed. I unfortunately just got a rejection letter from the journal of Neurology and was pretty disappointed. This is the second journal to turn down my manuscript, with the first being "Clinical Imaging".

I spoke to my attending and he felt the paper was really well put together and flowed well. However, I'm a bit discouraged and feel like a damn loser who can't even get a case report published.

I know there are journals who will accept any and every case report out there, but I really wanted to put my paper in a journal that had a good reputation and didn't accept everything that came through the door. I tried to contact the editor to get his input, but it seems like he's already left the office.

Has anybody ever been in this situation where there work was denied a few times and then eventually submitted, or am I the only ******* out there having this difficulty?

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[SpartanWolverine]

Did you get no feedback as to why it was rejected at either journal? If they both rejected you outright, perhaps such a case report is not in line with what the journals are looking to publish.

 

[SurfingDoctor]

Every article has a home. Keep trying.

 

[deleted343839]

Case reports aren't always easy to publish. Some journals publish few, if any, so make sure you're submitting to journals that publish them regularly. Read case reports that have already been published in the same journal and modify yours to adopt a similar structure and level of detail. Editors are busy so only send a presubmission inquiry if your question can't be answered another way.

My most cited paper (cited about 200 times and in public policy) was rejected from a couple of journals before it found a home. Keep trying.

 

[VCorp]

Case reports aren't always easy to publish. Some journals publish few, if any, so make sure you're submitting to journals that publish them regularly. Read case reports that have already been published in the same journal and modify yours to adopt a similar structure and level of detail. Editors are busy so only send a presubmission inquiry if your question can't be answered another way.

My most cited paper (cited about 200 times and in public policy) was rejected from a couple of journals before it found a home. Keep trying.

@SpartanWolverine @SurfingDoctor

Thank you guys for the encouragement. I'm responding on my phone so I apologize for any errors. Just to give you guys and @MamaPhD an update, my manuscript did get accepted it. The happiness was short lived, till I spoke to the publisher, Elsevier, and there's a $400 fee for the publishing process. The representative said that since the journal is open access and indexed on PubMed the journal doesn't make any money. The journal I submitted to was "Journal of Radiology Case Reports".

You can guys can be honest, but is this bull**** money grabbing journal, and the journal accepts every manuscript they get? I know BMJ does this, with an astronomical fee of $700. I remember seeing another journal where you can pay them $X dollars per year, and they'll accept all manuscripts.

 

[SpartanWolverine]

$400 is not unexpected, and is actually pretty low to publish in an Elsevier journal depending on what is included in your paper. I believe an open access article is typically more pricey due to a loss of subscription revenue.
Yes, unfortunately the publishing business is ridiculous. Is there no funding money available from your institution to cover this cost?

 

[SurfingDoctor]

Agreed, for open access, this is pretty cheap (maybe due to the low number of pages). I remember PLoS One is like $1500.

 

[VCorp]

$400 is not unexpected, and is actually pretty low to publish in an Elsevier journal depending on what is included in your paper. I believe an open access article is typically more pricey due to a loss of subscription revenue.
Yes, unfortunately the publishing business is ridiculous. Is there no funding money available from your institution to cover this cost?

Agreed, for open access, this is pretty cheap (maybe due to the low number of pages). I remember PLoS One is like $1500.

Thank you for the insight from both of you. I greatly appreciate it. So I just looked on Elsevier's website. The price to publish a manuscript can be between $500 - $1,500 depending on the manuscript. When the rep told me $400, I forgot to mention that she said, "not to quote me on this, as it depends on the manuscript".

My manuscript is 7 pages long, 8 counting the reference page which has 13 references, and 9 counting the supplemental page which is basically the figure legends. There's 10 figures/ images. I'm hoping that I'll be able to qualify for the fee waiver which the publisher offers in certain circumstances. I'm going to ask my school if they're willing to cover any publishing expense or the hospital, as per your suggestion spartan. Unfortunately, I'm an IMG, so I very much doubt my school will cover it. I'll ask the IRB of the hospital as well, but I'm certain they'll say no, since it's a bit of a piece of ****.

Also, my brother is big into research. He told me to Google the "impact factor" of the journal. He mentioned that journals are out of 40 points or so, and majority of journals are at a score of 1, 2, or 3. "Nature" has a very high score, and so does "NEJM". He said that would give me a better idea of how reputable my journal is. Doing the search, the journal comes back at a whopping score of 1. :/

 

[SurfingDoctor]

You shouldn't be concerned about Impact Factor regarding case reports. Most high impact journals don't publish case reports. Just be glad you got your name on something (you can PubMed your name now!) and got to contribute and work toward a higher impact in the future.

 

[VCorp]

@MamaPhD @SurfingDoctor @SpartanWolverine

Just wanted to give you guys an update on where things are at the moment. I got an email from the publishing company and received the invoice for publication which ended up being $425. I spoke to the IRB of the hospital which I rotated through. From talking to him, he sounded ecstatic by this and is going to talk to the different department heads to see if they're willing to cover the fees. He felt that since the hospital was small, getting any recognition will certainly benefit them. I wanted to say thank you for helping me hold my hands and walk through this entire process. Couldn't have done it without you guys.

Onto my next issue, and please do tell me if I'm in the wrong here.

I was talking to a resident who wanted to work on a paper together. I explained to him that I'd be more than happy to start the research, write the discussion work, and work on the reference page, as long as he was willing to give me the first authorship. All he'd have left to do is do the introduction, case presentation (which entails copy/pasting stuff from EMR and properly formatting it). He responded back by saying that the attending will be the first author, so he couldn't do that for me. I responded back by saying, shouldn't the attending be in last place - since the attending is essentially the PI? He came back by saying "my bargaining skills need work, and he'll just write the papers up themselves". I was a bit taken back by this.

I found this thread, with a similar situation. Seems like attending = senior author = published last.

http://forums.studentdoctor.net/threads/authorship-question.359842/

This paper also talks about, but became confusing when it says the senior editor should be first, if the student lacks the skills for scientific writing.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010799/

 

[SurfingDoctor]

@MamaPhD @SurfingDoctor @SpartanWolverine

Just wanted to give you guys an update on where things are at the moment. I got an email from the publishing company and received the invoice for publication which ended up being $425. I spoke to the IRB of the hospital which I rotated through. From talking to him, he sounded ecstatic by this and is going to talk to the different department heads to see if they're willing to cover the fees. He felt that since the hospital was small, getting any recognition will certainly benefit them. I wanted to say thank you for helping me hold my hands and walk through this entire process. Couldn't have done it without you guys.

Onto my next issue, and please do tell me if I'm in the wrong here.

I was talking to a resident who wanted to work on a paper together. I explained to him that I'd be more than happy to start the research, write the discussion work, and work on the reference page, as long as he was willing to give me the first authorship. All he'd have left to do is do the introduction, case presentation (which entails copy/pasting stuff from EMR and properly formatting it). He responded back by saying that the attending will be the first author, so he couldn't do that for me. I responded back by saying, shouldn't the attending be in last place - since the attending is essentially the PI? He came back by saying "my bargaining skills need work, and he'll just write the papers up themselves". I was a bit taken back by this.

I found this thread, with a similar situation. Seems like attending = senior author = published last.

http://forums.studentdoctor.net/threads/authorship-question.359842/

This paper also talks about, but became confusing when it says the senior editor should be first, if the student lacks the skills for scientific writing.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010799/

Just so I understand, you, another resident and an attending are going to do some sort of retrospective analysis and it discussing authorship, the attending wants to be first author? Is that right?

First, I would say good for you for establishing the authorship order up front. It will definitely save you some headaches later. Second, an attending can be first author, however in that scenario, there is generally another attending who is just as senior or more senior than the attending who takes the last author or senior author place. This is seen when the attending is junior and needs first author publications and whose work is overseen my senior faculty, like a division or department chair. However, in your case, it sounds like you or the other resident are co-authors behind the attending, but there is no senior author? That is a strange situation, however usually the most senior author who oversees the project ultimately decide authorship order.

The last article you referenced was saying the senior author may choose to be the corresponding author if the first author is inexperienced, like in that case of a student or trainee. The corresponding author is who the journal and readers communicate with regarding the contents of the publication, it can be the first or last author depending on the authors experience.

 

[VCorp]

Just so I understand, you, another resident and an attending are going to do some sort of retrospective analysis and it discussing authorship, the attending wants to be first author? Is that right?

First, I would say good for you for establishing the authorship order up front. It will definitely save you some headaches later. Second, an attending can be first author, however in that scenario, there is generally another attending who is just as senior or more senior than the attending who takes the last author or senior author place. This is seen when the attending is junior and needs first author publications and whose work is overseen my senior faculty, like a division or department chair. However, in your case, it sounds like you or the other resident are co-authors behind the attending, but there is no senior author? That is a strange situation, however usually the most senior author who oversees the project ultimately decide authorship order.

The last article you referenced was saying the senior author may choose to be the corresponding author if the first author is inexperienced, like in that case of a student or trainee. The corresponding author is who the journal and readers communicate with regarding the contents of the publication, it can be the first or last author depending on the authors experience.

Yes, but it's a case report. So it's me (currently applying for residency), a PGY4, and an attending.

So I linked him to a couple of other articles.

http://www.nature.com/nature/journal/v489/n7417/full/nj7417-591a.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677992/?report=classic

He thanked me for providing the details and "not talking out of my ass". He said r was taught at Sloan that an attending gets first authorship, by default. I guess this is a lost cause.

 

[SurfingDoctor]

Yes, but it's a case report. So it's me (currently applying for residency), a PGY4, and an attending.

So I linked him to a couple of other articles.

http://www.nature.com/nature/journal/v489/n7417/full/nj7417-591a.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677992/?report=classic

He thanked me for providing the details and "not talking out of my ass". He said r was taught at Sloan that an attending gets first authorship, by default. I guess this is a lost cause.

So this is a different case report than the one above or the same one? Either way, his interpretation that attending get "first author" is not usually true in the case you described, the attending is usually the last author and the corresponding author and the trainee is the first author. However because he is most senior and overseeing the writing, I'm afraid you are stuck with whatever order he decides.

 

[VCorp]

So this is a different case report than the one above or the same one? Either way, his interpretation that attending get "first author" is not usually true in the case you described, the attending is usually the last author and the corresponding author and the trainee is the first author. However because he is most senior and overseeing the writing, I'm afraid you are stuck with whatever order he decides.

Yes, it's a new case report, I apologize for the confusion. That's unfortunate. I was hoping to work with him as he has a few interesting cases. This is how the convo went, just for clarification. We have a good relationship, so don't mind the urban lingo.

 

[SurfingDoctor]

That is hard to interpret. Sorry I don't have any good advice, other than if you are friends with this person, I would give it a rest for a bit and than ask again how the paper is coming and if there is anything you can do with help. The authorship thing though can be a tricky subject and you can either let it side and get your name on something, though maybe not first, or not help at all and look for a different opportunity.

 

[VCorp]

That is hard to interpret. Sorry I don't have any good advice, other than if you are friends with this person, I would give it a rest for a bit and than ask again how the paper is coming and if there is anything you can do with help. The authorship thing though can be a tricky subject and you can either let it side and get your name on something, though maybe not first, or not help at all and look for a different opportunity.

Makes sense. Thanks again for all of your help. I greatly appreciate it.

 

[IlDestriero]

In general, the person who does most or all of the work gets the first author position, then everyone else, then the big dog at the end. What your other resident suggested is odd. And he sounds like a douche. Good luck.
Here's how I see it going down. They'll dump most of the work on you when they're ready to actually move forward, and you'll still be second author.


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Il Destriero