Medical Writing Basics: Cringe-Worthy Errors and How to Avoid Them

Oncology Fellows, June 2012, Volume 4, Issue 2

Are physicians really expected to be effective writers? The answer to this question is both "yes" and "no."

As an oncology fellow, you are among the best educated individuals in the country. From basic science to applied clinical technique, what you didn’t learn in the classroom you will continue to learn, every day you spend in the office, the clinic, the lab, and the operating room, as long as you practice.

Over the course of what you hope will be a long and illustrious career, you will likely be expected to share the benefits of your research, education, and experience with your colleagues, primarily by writing articles for publication in reputable peer-reviewed journals and trade publications. If you are among the vast majority of physicians, however, you may not be properly prepared for this leg of your career journey. Your medical school curriculum likely didn’t include a single course on clinical writing.

This reality notwithstanding, are physicians really expected to be effective writers? The answer to this question is both “yes” and “no.” You might ask, “Isn’t that what editors are for?” Certainly every medical publication has an editor (or a staff of editors) whose job it is to ensure that all accepted articles conform to the publication’s standards and read as clearly, concisely, and error-free as possible. But the responsibility for producing accurate and effective articles remains with the author(s). In fact, the “cleaner” and more publication-ready the manuscript is as written, the less editorial work it will need. Less extra editing reduces the chance that your intended meaning could be changed inadvertently or that your article will read as if it’s been written by the copy editor and not by you.

Because a complete medical writing primer is far beyond the scope of this brief article, the following tips are intended to help you recognize and avoid a few of the most common writing errors. These are the key pitfalls to avoid since they make copy editors cringe when they catch them and, if they should happen to miss them, reflect poorly on you when they appear in print. When you avoid these errors in your writing, you ensure that your articles will retain your voice and effectively reflect and communicate your expertise.

One-size-fits-all Writing

The content and tone of your article, the amount of detail and background information you provide, and the explanations of medical terminology you include will differ substantially depending upon your intended readers. After all, an article describing a technique used specifically by those in your subspecialty will be written differently if it is intended to provide an overview for primary care physicians than if it is detailing the specifics of how to perform the technique for an audience of medical oncologists, surgical oncologists, those in your subspecialty, etc. This is why knowing your readers should be the “first commandment” for any type of writing, including medical writing. If you don’t reach your audience appropriately, you run the risk of alienating, confusing, or even insulting at least some of your readers. If you’re not sure who reads the journal you want to submit your article to, visit the journal’s website for a description of the scope of the journal and its target audience. Many journals’ editorial information also identifies their readers.

Failure to Look Beyond the Guidelines

It can be argued that knowing your journal is as important as knowing your readers. Every peer-reviewed publication has a clear set of author guidelines (or “information for authors”). This information is usually available on the journal’s or publisher’s website and may be periodically published in the journal itself. These guidelines list essential details about how to submit an article for publication and how to prepare it for review. These requirements often list everything from article length and types of articles accepted, to the specifics of preferred font size and acceptable table and figure formatting. Different journals may also have distinct specifications for clinical art or diagrams, rules for how to reference drugs and devices, and instructions on how to format references. To increase the chances of your article being accepted for publication, all of these requirements must be followed to the letter. In addition, read several different articles already published in the journal to get a sense of how the guidelines are applied, and to get a sense of valuable information that isn’t typically found in the guidelines, such as the tone and style (eg, formal versus informal) expected by the readers. Find 2 or more articles similar to the type of article you want to submit (case study, research-based, review, etc) and use those articles as guides through the writing process.

Trading Clear and Concise for Confusing and Wordy

Run-on sentences, unnecessary adjectives, and flowery descriptions have no place in a description of a minimally invasive technique for tumor resection. In fact, a rule of thumb for any type of writing is to communicate clearly and concisely, using only the words needed to convey the information. Anything more is distracting.

Poor Choice of Words

As the author of an article, your readers and colleagues must accept you as an authoritative expert on the topic at hand or, at the very least, as someone with knowledge and experience that might be useful to them. You will have a hard time keeping your credibility if you misuse medical or even lay terminology, or simply choose the wrong words to convey your message. For example, the word data is plural, not singular (“these data were analyzed” is correct; “this data was analyzed” is not) and patients don’t fail therapy; instead, they undergo a failed course of treatment. Also, remember to target your word choice to your intended audience. Avoid the use of subspecialty jargon in an article for a general physician audience.

Sloppy Work

There’s no need to raise your hand and ask; yes, spelling counts (as do grammar, punctuation, and sentence structure). A misplaced comma or sloppy sentence structure can change your intended meaning, and can easily slip past even the most careful copy editor or proofreader, since they can’t read your mind to know what you intended to say. Do not rely on “Spell Check,” which will accept anything that’s an actual word, even if that word was not the one you intended to use. A non-medical but real-life (and amusing) example from a classified lost and found ad makes the point quite effectively: “Found. Large white rabbi hopping down Route 80.” How can you avoid such snafus? Long before submitting your article, read it and reread it. It can often help to read it slowly, even reading it aloud. Perhaps most importantly, ask someone else to read it. The more familiar you become with your article, the easier it is to miss such errors, and a fresh pair of eyes is frequently the best safety net.

The Bottom Line

Writing of any kind is about communicating. To ensure that you are, indeed, communicating effectively, share your manuscript with a colleague and invite (and be open to) constructive criticism. Your ability to clearly communicate your findings, experience, or ideas to an appropriate audience reflects on your credibility as a medical professional. In turn, your contributions to the published literature will help to advance cancer prevention and treatment by providing the clear and concise sharing of knowledge.