For young investigators, gaining insights into the peer-review process and a better understanding of what editors and reviewers look for in manuscripts can greatly enhance their success in publishing. On July 17, 2023, past and current Editors-in-chief (EIC) of the Journal of Nuclear Cardiology (JNC) sought to engage young investigators by sharing their thoughts on the “Ins and Outs of Publishing in a Medical Journal” to the American Society of Nuclear Cardiology Leadership Development Program. Their presentations provided tips for investigators and discussed guiding principles that have driven JNC’s preeminence in nuclear cardiology.

Dr Ami Iskandrian (JNC EIC 2013–2023) opened the session by describing philosophical tenets that have guided the review process at JNC. He pointed out that journals have critical educational roles and that during his time as EIC, he sought for JNC to serve as a “teaching and learning module.” To that end, he discussed the important roles that original manuscripts, reviews, and editorials play, as well as the educational value and popularity of “Images that Teach.” Moreover, he noted that the manuscript review process is a period filled with new insights, where reviewers learn from authors, and in turn, authors learn from reviewers. He adds that this bi-directional-learning process supports a culture of mutual respect, resulting in a review process that is fair to authors, timely, and driven to improve the field of nuclear cardiology.

Dr. George Beller (JNC EIC 2004–2013) discussed “What a Reviewer and Associate Editor Look for in Accepting a Manuscript,” citing an excellent review on the topic by Aga et al.1 He began by noting that the Abstract should succinctly convey the entire message of the paper. It should identify the novel observations yielded by the study, how those new findings extend what is already known, and how the knowledge gained may prompt additional changes and innovations.1 The manuscript’s Introduction should clearly delineate the reasoning and motivations for conducting the study while describing critical knowledge gaps that exist and how the current study provides important insights to bridge those gaps. The Methods should provide a clear description of how the study was performed. He noted that both the reviewers and editors carefully evaluate methods to understand the study’s implications, strengths, and limitations. The Results, he added, is the core feature of the manuscript. The presented findings should relate to the study’s objectives and should address the questions posed in the Introduction. He suggested not to repeat data already represented in tables and figures and cautioned against discussing, interpreting, or contextualizing the results within the Results section. The Discussion should interpret the study's findings and delineate how those findings fill the critical knowledge gaps. The first paragraph should highlight the study’s most important findings, provide an interpretation of those findings, and highlight their novel aspects. Additional paragraphs should further address how the new findings advance the field (while avoiding bias or excluding important citations). He cautioned against including data that were not previously presented in the manuscript. In addition, a sub-section within the discussion is needed to discuss the study’s strengths and limitations. The Conclusion represents one of the most important components of the manuscript and has the potential to have an enduring effect on the reader. It should succinctly highlight the most important findings of the study, state how those findings add to the existing literature, and describe how the novel insights gained may lead to future innovations. He identified pitfalls to avoid: overstating what the data reveals, making recommendations not supported by data, or failing to provide a take-home message or future perspectives.

Dr. Marcelo DiCarli (JNC EIC 2023- current) discussed “Guiding Principles of the Peer Review Process.” He noted that peer review is not perfect, but it is the best system we have to evaluate the quality and validity of scientific publications. He describes reviewers as “consultants” to the editors since manuscript decisions reside entirely with the editorial team, which considers expert advice from reviewers but may occasionally differ from reviewers’ opinions. Mixed or conflicting reviews are resolved by the editors; rarely is there a need to seek an additional review. In deciding on whether to accept a manuscript, the key question for the editorial staff is: Are the findings new, valid, and important? Thus, editorial decisions are generally based on the quality of the science rather than on measures of popularity, such as citations and downloads. Accordingly, papers that fulfill this primary objective often get published even if they may not be expected to be highly cited.

Further, Dr. DiCarli provided tips to help authors select the optimal journal for their manuscript. He suggested that authors begin by clearly understanding the scope, strengths, and limitations of their data. This helps them better identify the most appropriate audience for their paper. He suggested that, based on the above understanding, authors should rank journals that would be the best home for their research. He cautioned against submitting manuscripts to journals where the manuscript is highly unlikely to be accepted. He warns that such a practice could add to authors’ frustrations and create the feeling that one's research is not appreciated or is somehow less valuable.

What was evident from the presentations, as well as from the discussion that followed, is that the JNC's past and current EICs believe that young investigators represent the future of nuclear cardiology. Not only has the editorial team provided tips and advice to strengthen the position of young investigators, but it is also creating new programs for them as well. With that in mind, the JNC, with its “JNC Early Career Editorial Board” is expanding programs for young investigators with the goals of enhancing critical thinking, investigative and communication skills, and leadership abilities. Further, the journal is growing its social media presence to help amplify its global reach in nuclear cardiology, especially among younger investigators. In addition, the journal has a new mentorship program wherein early career authors receive dedicated editorial support to help shepherd their first manuscript as a lead author from submission to publication.

Together, the JNC’s past and current EICs provided a wealth of information and advice on publishing in a medical journal that would be informative and applicable for investigators at all career stages. Moreover, they demonstrated a commitment to invest in the success of nuclear cardiology’s early investigators and provided insights into the reasons underscoring JNC’s position as a pillar within the field.