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8 reasons why journals may reject your manuscripts

Before a medical manuscript even reaches a journal’s Editor-in-Chief or is selected for peer review, it is subjected to intense scrutiny, which, more often than not, results in rejection. ​​Rejection rates of top-tier journals typically vary between 80-85%, but for some journals, rejection has been reported to be as high as 90-95%. (1)

Example acceptance rates of high-ranking scientific journals:

Stats on journal publication rates

Rejection rates of top-tier journals typically vary between 80-85%, but for some journals, rejection has been reported to be as high as 90-95%

Naturally, medical research must meet a set of standards to be deemed worthy of publishing. For example, research must be supported by a strong hypothesis, flawless methodology and accurate, complete data. However, even those papers whose research and data meet these standards may still be rejected following editorial review. 

So, what are the key reasons a manuscript may be rejected? (2-4)

  1. It does not comply with the target journal’s requirements and instructions to authors or lacks the necessary supporting documents. 

  2. It contains information that is suspected to be plagiarised or under review by another journal. 

  3. It is incomplete - for example, it may lack key elements such as title, keywords, references, tables and figures etc.

  4. The tables or figures are unreadable - for example, figures are of low resolution or tables are too complex.

  5. References are incomplete, out-of-date, or not presented as per the journal style.

  6. It is poorly written 

    • The spelling or grammar is sub-standard.

    • There is an absence of clarity, structure, or content organisation.

    • Arguments are illogical, unstructured or invalid.

    • The conclusions fail to acknowledge the published literature. 

    • The results do not provide an answer to the question(s) posed in the aims and objectives.

  7. It is out of scope for the journal and its readership - i.e., it does not fall within a target journal’s aims and scope (the objective or purpose of what the journal is trying to achieve and how the journal aims to accomplish it).

  8. It does not contribute any new or interesting knowledge to the area concerned.

Medical writers reduce the risk and impact of inexperience regarding publications practise

To avoid the many pitfalls that can lead to a manuscript being rejected, medical writers provide invaluable support in developing well-organised, well-written, high-quality manuscripts. As well as providing an unbiased scientific perspective, medical writers improve the quality of an author’s writing, minimise the time, cost and frustration required to deliver manuscripts, and reduce the risk and impact of inexperience regarding publications practise. 

At Synthesis, we offer specialised manuscript writing support, working with authors to effectively organise and communicate their research or recommendations and ensure the article presents new and interesting information that attracts and holds the attention of its readership. Moreover, we work with clients to develop publication plans and identify appropriate target journals or congresses to ensure the paper’s messages are suitable for the intended audience. 

Whether you’re looking for ad-hoc or long-term publications support, contact us to learn more about how we can work together to maximise the reach and clarity of your content.


  1. Khadilkar SS. Rejection Blues: Why Do Research Papers Get Rejected? J Obstet Gynaecol India. 2018;68(4):239–241. doi:10.1007/s13224-018-1153-1

  2. Thrower P. Eight reasons I rejected your article. Elsevier Connect. 2012

  3. Dantas-Torres F. Top 10 reasons your manuscript may be rejected without review. Parasit Vectors. 2022;15(418).

  4. Pierson D. J. The top 10 reasons why manuscripts are not accepted for publication. Respir Care. 2004;49(10):1246–1252