Preparing your manuscript

All material submitted is assumed to be submitted exclusively to the journal unless otherwise stated. Submissions may be returned to the author for amendment if presented in the incorrect format.

Manuscript documents are deleted from our systems 6 months after completion of the peer review process.

Cover letter

Your cover letter should inform the Editor of any special considerations regarding your submission, including but not limited to:

  • Details of related papers by the same author(s) already published or under consideration for publication.
  • Details of previous reviews of the submitted article.

Copies of related papers, previous Editors’ and reviewers' comments, and responses to those comments can be submitted using the File Designation "Supplementary file for Editors only". Editors encourage authors to submit previous communications as doing so is likely to expedite the review process.

NIH Employees

Manuscripts authored or co-authored by one or more NIH employees must be submitted with a completed and signed NIH Publishing Agreement and Manuscript Cover Sheet according to NIH’s Employee Procedures.

Title page

This excludes the journal BMJ Quality and Safety which has triple-blind peer review.

The title page must contain the following information:

  • Title of the article.
  • Full name, postal address, e-mail and telephone number of the corresponding author.
  • Full name, department, institution, city and country of all co-authors.
  • Word count, excluding title page, abstract, references, figures and tables.


Authors can usually opt to (or are required to) choose keywords relevant to the content of the manuscript during the submission process. This assists in the identification of the most suitable reviewers for the manuscript. Keywords should also be included in the abstract itself.

Manuscript format

The manuscript must be submitted as a Word document. PDF is not accepted.

The manuscript should be presented in the following order:

  • Title page.
  • Abstract, or a summary for case reports (Note: references should not be included in abstracts or summaries).
  • Main text separated under appropriate headings and subheadings using the following hierarchy: BOLD CAPS, bold lower case, Plain text, Italics.
  • Tables should be in Word format and placed in the main text where the table is first cited.
  • Tables must be cited in the main text in numerical order.
  • Acknowledgments, Competing Interests, Funding and all other required statements. Reference list.

Images must be uploaded as separate files (view further details under the Figures/illustrations section). All images must be cited within the main text in numerical order and legends should be provided at the end of the manuscript.

Appendices should be uploaded using the File Designation "Supplementary File" and cited in the main text.

Please remove any hidden text headers or footers from your file before submission.


Abbreviations and symbols must be standard. SI units should be used throughout, except for blood pressure values which should be reported in mm Hg.

Whenever possible, drugs should be given their approved generic name. Where a proprietary (brand) name is used, it should begin with a capital letter.

Acronyms should be used sparingly and fully explained when first used.


Images must be uploaded as separate files. All images must be cited within the main text in numerical order and legends must be provided (ideally at the end of the manuscript).

Video: How to improve your graphs and tables >>

Colour images and charges

For certain journals, authors of unsolicited manuscripts that wish to publish colour figures in print will be charged a fee to cover the cost of printing. Refer to the specific journal’s instructions for authors for more information.

Alternatively, authors are encouraged to supply colour illustrations for online publication and black and white versions for print publication. Colour publication online is offered at no charge, but the figure legend must not refer to the use of colours.

Detailed guidance on figure preparation >>

File types

Figures should be submitted in TIFF or EPS format. JPEG files are acceptable in some cases. A minimum resolution of 300 dpi is required, except for line art which should be 1200 dpi. Histograms should be presented in a simple, two-dimensional format, with no background grid.

During submission, ensure that the figure files are labelled with the correct File Designation of “Mono Image” for black and white figures and “Colour Image” for colour figures.

Figures are checked using automated quality control and if they are below the minimum standard you will be alerted and asked to resupply them.

Please ensure that any specific patient/hospital details are removed or blacked out (e.g. X-rays, MRI scans, etc). Figures that use a black bar to obscure a patient’s identity are NOT accepted.


Tables should be in Word format and placed in the main text where the table is first cited. Tables must be cited in the main text in numerical order. Please note that tables embedded as Excel files within the manuscript are NOT accepted. Tables in Excel should be copied and pasted into the manuscript Word file.

Tables should be self-explanatory and the data they contain must not be duplicated in the text or figures. Any tables submitted that are longer/larger than 2 pages will be published as online only supplementary material.

Video: How to improve your graphs and tables >>

Multimedia files

You may submit multimedia files to enhance your article. Video files are preferred in .WMF or .AVI formats, but can also be supplied as .FLV, .Mov, and .MP4. When submitting, please ensure you upload them using the File Designation "Supplementary File - Video".


Authors are responsible for the accuracy of cited references and these should be checked before the manuscript is submitted.

Citing in the text

References must be numbered sequentially as they appear in the text. References cited in figures or tables (or in their legends and footnotes) should be numbered according to the place in the text where that table or figure is first cited. Reference numbers in the text should be inserted immediately after punctuation (with no word spacing)—for example,[6] not [6].

Where more than one reference is cited, these should be separated by a comma, for example,[1, 4, 39]. For sequences of consecutive numbers, give the first and last number of the sequence separated by a hyphen, for example,[22-25]. References provided in this format are translated during the production process to superscript type, and act as hyperlinks from the text to the quoted references in electronic forms of the article.

Please note that if references are not cited in order the manuscript may be returned for amendment before it is passed on to the Editor for review.

Preparing the reference list

References must be numbered consecutively in the order in which they are mentioned in the text.

Only papers published or in press should be included in the reference list. Personal communications or unpublished data must be cited in parentheses in the text with the name(s) of the source(s) and the year. Authors should request permission from the source to cite unpublished data.

Journals from BMJ use a slightly modified version of Vancouver referencing style (see example below). The style template is available via Endnote. Note that The BMJ uses a different style.

BMJ reference style

List the names and initials of all authors if there are 3 or fewer; otherwise list the first 3 and add ‘et al.’ (The exception is the Journal of Medical Genetics, which lists all authors). Use one space only between words up to the year and then no spaces. The journal title should be in italic and abbreviated according to the style of Medline. If the journal is not listed in Medline then it should be written out in full.

Check journal abbreviations using PubMed >>

Check citation information using PubMed >>

Example references

Journal article

13 Koziol-Mclain J, Brand D, Morgan D, et al. Measuring injury risk factors: question reliability in a statewide sample. Inj Prev 2000;6:148–50.

Chapter in book

14 Nagin D. General deterrence: a review of the empirical evidence. In: Blumstein A, Cohen J, Nagin D, eds. Deterrence and Incapacitation: Estimating the Effects of Criminal Sanctions on Crime Rates. Washington, DC: National Academy of Sciences 1978:95–139.


15 Howland J. Preventing Automobile Injury: New Findings From Evaluative Research. Dover, MA: Auburn House Publishing Company 1988:163–96.


16 Roxburgh J, Cooke RA, Deverall P, et al. Haemodynamic function of the carbomedics bileaflet prosthesis [abstract]. Br Heart J 1995;73(Suppl 2):P37.

Electronic citations

Websites are referenced with their URL and access date, and as much other information as is available. Access date is important as websites can be updated and URLs change. The "date accessed" can be later than the acceptance date of the paper, and it can be just the month accessed.

Electronic journal articles

Morse SS. Factors in the emergency of infectious diseases. Emerg Infect Dis 1995 Jan-Mar;1(1). (accessed 5 Jun 1998).

Electronic letters

Bloggs J. Title of letter. Journal name Online [eLetter] Date of publication. url eg: Krishnamoorthy KM, Dash PK. Novel approach to transseptal puncture. Heart Online [eLetter] 18 September 2001.

Digital Object Identifier (DOI)

A DOI is a unique string created to identify a piece of intellectual property in an online environment and is particularly useful for articles that are published online before appearing in print (and therefore have not yet been assigned the traditional volume, issue and page number references). The DOI is a permanent identifier of all versions of an article, whether raw manuscript or edited proof, online or in print. Thus the DOI should ideally be included in the citation even if you want to cite a print version of an article.

Find a DOI >>

How to cite articles with a DOI before they have appeared in print

1. Alwick K, Vronken M, de Mos T, et al. Cardiac risk factors: prospective cohort study. Ann Rheum Dis Published Online First: 5 February 2004. doi:10.1136/ard.2003.001234

How to cite articles with a DOI once they have appeared in print

1. Vole P, Smith H, Brown N, et al. Treatments for malaria: randomised controlled trial. Ann Rheum Dis 2003;327:765–8 doi:10.1136/ard.2003.001234 [published Online First: 5 February 2002].



If you are using any material e.g. figures, tables or videos that have already been published elsewhere, you must obtain permission to reuse them from the copyright holder (this may be the publisher rather than the author) and include any required permission statements in the figure legends. This includes your own previously published material, if you are not the copyright holder.

It is the author’s responsibility to secure all permissions prior to publication.

Online only supplementary material

Additional figures and tables, methodology,  raw data, etc may be published online only as supplementary material. If your paper exceeds the word count you should consider if any parts of the article could be published online only. Please note that these files will not be copyedited or typeset and will be published as supplied, therefore PDF files are preferred.

All supplementary files should be uploaded using the File Designation "Supplementary File". Please ensure that any supplementary files are cited within the main text of the article.

Some journals also encourage authors to submit translated versions of their abstracts in their local language, which are published online only alongside the English version. These should be uploaded using the File Designation “Abstract in local language”.


Statistical analyses must explain the methods used.

Guidelines on presenting statistics >>

Research reporting guidelines

Authors are encouraged to use the relevant research reporting guidelines for the study type provided by the EQUATOR Network. This will ensure that you provide enough information for editors, peer reviewers and readers to understand how the research was performed and to judge whether the findings are likely to be reliable.

The key reporting guidelines are:

Research checklists should be uploaded using the File Designation “Research Checklist”.

Pre-submission checklist

In order to reduce the chance of your manuscript being returned to you, please check:

  • Author information: Have you provided details of all of your co-authors? Is the information that you have entered into ScholarOne the same as the information on the manuscript title page?
  • Manuscript length and formatting: Have you checked that your manuscript doesn’t exceed the requirements for word count, number of tables and/or figures, and number of references? Have you provided your abstract in the correct format? Have you supplied any required additional information for your article type, such as key messages?
  • Tables: Have you embedded any tables into the main text? Have they been cited in the text? Have you provided appropriate table legends? Have you uploaded any lengthy tables as supplementary files for online publication?
  • Figures: Have you uploaded any figures separately from the text? Have they been supplied in an acceptable format and are they of sufficient quality? Are they suitable for black and white reproduction (unless you intend to pay any required fees for colour printing)? Have the files been labelled appropriately? Have the figures been cited in the text? Have you provided appropriate figure legends?
  • References: Have all of the references been cited in the text?
  • Supplementary files and appendices: Have you supplied these in an acceptable format? Have they been cited in the main text?
  • Statements: Have you included the necessary statements relating to contributorship, competing interests, data sharing and ethical approval?
  • Research reporting checklists: Have you either provided the appropriate statement for your study type, or explained why a checklist isn’t required?
  • Permissions: Have you obtained from the copyright holder to re-use any previously published material? Has the source been acknowledged?
  • Reviewers: Have you provided the names of any preferred and non-preferred reviewers?
  • Revised manuscripts: Have you supplied both a marked copy and a clean copy of your manuscript? Have you provided a point by point response to the reviewer and editor comments?

Information required for all authors submitting a manuscript to any BMJ journal:

  • Manuscript files in the appropriate format, including a cover letter and title page
  • Details of any co-authors (name, institution, city, country and email address)
  • Details of preferred reviewers (name and email address)
  • Word count, number of figures, number of tables, number of references and number of supplementary files for online only publication
  • Competing interest statement
  • Contributorship statement

Additional information that can be provided or may be required when submitting certain article types to certain journals:

  • Name of the research funder(s)
  • ORCID number(s) for all authors
  • Names of any collaborators
  • Details of non-preferred reviewers (name and email address)
  • Clinical trial registration number
  • Patient consent form
  • Details of ethical approval
  • Research reporting checklist (or a reason why one has not been provided)
  • Data sharing statement
  • Permission from the copyright holder to re-use previously published material
  • Title of an alternate BMJ journal to which your manuscript can be automatically submitted if rejected from your first choice journal

Please check the specific journal’s instructions for authors prior to submitting your manuscript.