Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
My young colleague recently received the following note from the editors of a well known primary care medical journal:
Thank you for submitting your manuscript, [ Title here], manuscript number XYZ-601-14 Version 1, for consideration by the Most Important Journal of Family Medicine. The editors have completed their evaluation and we regret that we are unable to accept the paper for publication. This decision reflects a variety of factors, including the large number of manuscripts competing for limited space and the paper’s priority relative to others we are considering.
She was especially disappointed because the paper was summarily dismissed. Her submission was a painstaking review of the literature that demonstrates the equivocal evidence for the successful management of obesity in general practice. The paper was co-authored by two senior colleagues and she had been encouraged to submit it as a quality piece of writing. I could show her my collection of similar letters. I have kept them all. It seems, ‘space’ is lacking rather than the value of this young researchers offering. A researcher who will one day become a leader in her profession. Her paper will be published of that there is no doubt but not in that journal. An experience that is all too common for those trying to make an impression in the early part of their career.
Five years ago a team of us decided we’d like to make a small difference to people in this position and so, in 2008, the AMJ was launched. We administered the journal on a shoe string budget and brought it to the attention of medical students via face book. In the early days it was hard work. In fact it was an expensive and time consuming hobby. Today the AMJ is an established and recognised peer reviewed medical journal, it is listed on most of the major databases and is entirely self sustaining. Some of the papers the AMJ has published have made an enormous impact. It makes a small but reasonable contribution to the work of people who often find themselves sidelined because editors of the ‘far too important’ journals can’t see the value of their ideas or care how their dismissive and impersonal tone can crush their junior colleagues. And so we say to our colleagues, there is no point cursing the darkness because today with global access a mouse click away, with a little tenacity, it is possible to reach out to many. If only a few like minded people respond what started as a small candle in the gloom may one day become a beacon. At a time when primary care in so many parts of the world seems to be undervalued we need to do a small thing to assist our cause rather than whinging about how unfair it all is.
Picture by Justin McMurray