Behind most medical journals' instructions to authors sits a single document: the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals. Produced by the International Committee of Medical Journal Editors, it is updated periodically and adopted by hundreds of journals. If you publish in medicine, knowing its main requirements saves you from the most common — and most avoidable — submission problems.
1. Authorship: four criteria, all required
The best-known part of the Recommendations. To be listed as an author, a person must meet all four of:
- Substantial contributions to the conception or design, or the acquisition, analysis or interpretation of data;
- Drafting the work or revising it critically for important intellectual content;
- Final approval of the version to be published;
- Agreement to be accountable for all aspects of the work.
People who contributed but do not meet all four — a technician, a funder, a department head — belong in the acknowledgements. This is the standard that makes gift and ghost authorship identifiable rather than a matter of opinion.
2. Trial registration, before enrolment
ICMJE journals require that clinical trials be registered prospectively — in a public registry, before the first participant is enrolled — as a condition of consideration. The reason is publication bias: a registry entry created before the results exist makes it visible when a trial is never reported, or when its outcomes quietly change. Retrospective registration is usually not accepted, so this is a requirement you must meet at the start of the study, not at submission.
3. Disclosure of interests
Authors are expected to disclose all financial and non-financial relationships that could be seen to influence the work — funding, employment, consultancies, patents, and personal or professional relationships. The test is not whether you feel biased; it is whether a reasonable reader would want to know. See our guide to declaring conflicts of interest.
4. Overlapping publication
The Recommendations set out when publishing related work is acceptable and when it is not — covering duplicate submission, secondary publication (for example in another language, with consent and citation), and the reuse of data across papers. Our guide on duplicate and redundant publication covers the practical lines.
5. Everything around the paper
The document also addresses peer review confidentiality, editorial independence, corrections and retractions, protection of research participants, and manuscript preparation — including the "uniform requirements" that shaped the reference style many medical journals still use.
How to use it
You do not need to memorise it. Read the authorship criteria once and apply them honestly; register trials before you enrol; disclose generously; and when a journal's instructions cite the ICMJE, follow the link and check the specific section rather than guessing. The full text is freely available at icmje.org.