Tag Archives: creative-writing

Crafting Narratives for Publication

Posted on October 27, 2025 by | Leave a comment

By Sara Shields, MD
associate editor,
Family Medicine

You’ve had a defining clinical, teaching, or learning experience in your role as a family physician educator, clinician or student.  Someone suggests that you write about it. Here are some pearls for crafting your reflective piece in hopes of publication in a journal like Family Medicine that accepts such narrative work.

  • What story are you trying to tell? Just as with any written piece, consider first your content. What are your key themes (keeping in mind that any word limit may mean focusing on just one theme)?  Consider the readership of the journal—how would a medical student on a family medicine rotation respond to your story? How would a seasoned family medicine faculty member?
  • Avoid judgment–In general, an effective narrative piece is a personal story that shares a particular learning point, but does so without editorializing or requiring references.  How can your writing avoid judgment even as you elucidate and emphasize what you hope the reader will learn with you in your story?
  • Focus on the writing–In narratives, the “methods” of your writing enrich your themes and help them resonate for your readers.  The term “methods” refers to the craft of the writing—how are you using language to move your meaning along?  While avoiding redundancies or complicated phrasing is important, your writing may “sing” more to your readers with careful use of specific literary devices such as metaphor, alliteration, rhythm, or repetition of key words.  No matter whether you are choosing prose or poetry, remember the adage “show, don’t tell” –how can you describe people or events in ways that invoke the reader’s sensory or emotional response rather than simply stating what happened?
  • Every word matters–Especially for formats with strict word counts such as 6 word stories or 55 word essays, every word needs to move your story along. 
  • Circle back to the meaning—When looking at every word,do not lose sight of the totality of the essay.  Does this piece make sense overall?  Does it still say what you want it to say?
  • Do your homework–If your themes seem like they are common in narrative work (e.g. a physician’s experience of their own illness), you may want to look for similar pieces and think about how your story offers new angles or reflections compared to other similar work.  What can you contribute that may be new or surprising for readers?
  • Ask a friend or colleague to read your story–Consider asking someone to read your work before submitting it, to help assess both the content/themes and your storytelling style.  Do these readers resonate with your language?  Your themes?
  • You may need permission__If you describe a patient or learner scenario with enough detail, you may need to get their permission to submit your story for possible publication.
  • Don’t lose yourself–Be authentic; challenge yourself to dig deeply into both personal and professional lessons from your story.   How can you help the reader to consider multiple perspectives?

Reference: Walling A, Shapiro J, Ast T. What Makes a Good Reflective Paper? Fam Med 2012;45(1):7-12.

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Behind the Curtain: What Really Happens After You Submit a Paper to a Journal

Posted on May 3, 2025 by | 1 comment
By Sarina Schrager, MD, MS, 
Family Medicine editor-in-chief

Many people express confusion about the process of submitting a paper to a journal, receiving peer reviews, and ultimately getting published. This post attempts to answer your questions. Editors do not want their activity to be opaque. We want everyone to know what really happens when you submit a paper. The team at Family Medicine may do things a little differently than other journals, but the major steps will be the same.

You hit “submit”, then what? Once you submit your paper into the electronic portal (we use ScholarOne) the paper will be evaluated by our editorial assistant. S/he will determine if your paper conforms to our author instructions (please read before submitting) for formatting and whether you have IRB approval, if needed. The assistant will unsubmit your paper if it is too long, has too many references, or if the references are not in the proper format.

First review by the editor in chief: At Family Medicine, I read each submitted paper carefully before assigning it to an associate editor. I will occasionally reject a paper at this stage if it is not in scope for our journal (ie, we do not publish clinical papers) or if I think it is in the wrong category. For example, papers describing educational studies in one residency or one medical school fit in our Brief Report category, but probably not in Original Research. I will send those papers back to the authors if they are submitted in the Original Research category and ask the author(s) to shorten them. Another common mistake I often see is papers submitted as a narrative essay when they are really a commentary or an editorial. Narratives are personal stories about an experience you have with patient care, teaching, or your career.

Assigning papers to the associate editors: We have a team of fabulous associate editors at
Family Medicine. Papers that are both in scope and of interest our readers go on to the next step. I assign these papers to one of our associate editors who carefully reads the paper again, and either advises me they don’t think the paper is appropriate for our journal, or, more commonly, sends the paper for peer review.

Requesting peer reviewers: We have hundreds of peer reviewers who volunteer their time and expertise to help us publish the best papers we can. The associate editors aim to get 2-3 reviewers to evaluate each paper before sending it back to me with a recommendation. The associate editor sends requests to 4-6 people. Sometimes these invited reviewers don’t respond, and sometimes they respond but decline the invitation. It will occasionally require upwards of 10 invitations to find the 2-3 reviewers needed for a thorough review of each paper. We give all peer reviewers 3 weeks to return the review. Sometimes a
paper will be caught in this step for a few months. Family Medicine designates 4 potential
outcomes for a paper after peer review: accept (it’s very unusual to accept after initial peer review),
minor revision, major revision, and reject.

Revisions: The vast majority of authors will be asked to revise their paper. This is a good thing.
It means that the editorial team believes that the paper will be an important addition to the literature when revised. We expect authors to respond to every reviewer comment and explain how they addressed each comment. After the revised manuscript is submitted, I will review it again and then send back to the associate editor. In some cases, if there were many revisions, the associate editor will send the revision back to the reviewers to assure that all comments were addressed. After those reviews come back, the associate editor indicates an outcome. It is not unusual for a paper to be revised a second (and occasionally a third) time. It is important for authors to remember at this point that these further reviews are designed to improve your paper.

Recommendations for publication: Even great papers can be improved, and this is always the goal of peer review. Our peer reviewers and our associate editors provide feedback to authors to help make
their papers better. A minor revision decision signifies that a paper needs only small changes before it is appropriate to publish. A major revision decision signifies that the peer reviewers and the associate editor like the paper and think it has potential to be a meaningful addition to the scholarly literature, but has some weaknesses. We do not ask people to revise a paper if we do not think it will be interesting to our readers and contribute to the literature. Those papers are denied further review.

Acceptance: Once the associate editor believes that the authors have addressed all revision
requests, they send it to me with a recommendation for publication: Yay! Our production
team has worked hard to decrease the time from acceptance to online publication. You may expect your paper to be published online about 6 weeks after you get your acceptance notice. It will be available on the journal’s ‘Recently Published’ page before being assigned to a monthly issue. As you can see, there are a lot of steps in the process! However, they all aim to support authors through optimizing their paper’s impact.

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Getting Started With Your Writing: Finding Your Voice

Posted on October 25, 2024 by | Leave a comment
By Sarina Schrager, MD, MS, 
Family Medicine editor-in-chief

I will often talk to groups of junior faculty, fellows, residents, and students about writing. When I say enthusiastically, that writing is fun, I am faced with a sea of skeptical faces.  Is writing fun?  Well, for most people the answer is no. Why not?  Because it is hard and for many of us no one has taught us how to do it. One of my favorite quotes about writing is by Ernest Hemingway. He said, “We are all apprentices in a craft where no one ever becomes a master.”  Well, that’s frustrating you may say. If I can’t become a master, why bother?  My answer is that seeing your work in print is worth the effort. The process of writing and editing and developing a strong final product is very satisfying. You have something to say and writing is an excellent way to share your ideas with a broader public. So, how do we get started?  

  1. Just start writing.  No one is born a great writer and the only way to get better is to practice.  Think about what you want to write and start writing. You can practice when writing for work (craft well worded e-mails for example) or in your every-day life.
  2. Try writing short academic pieces like case reports or book reviews or letters to the editor. These forms of writing are less intimidating because they are short and very structured.  Family Medicine has a new article type called Family Medicine Focus. This infographic is less than 500 words and covers a narrow, specific topic on education or professional development. (Family Medicine (stfm.org))
  3. Think about how you want to structure your work. People have different techniques for planning out a writing project.  Many people use outlines. Some people will use bulleted lists of headings or topics to cover.  Some people start writing at the end and then go back and craft the beginning of their writing. Others will start with the section that is easiest for them—just to get something down on paper.
  4. Give up perfectionism. This may sound simple, but it is hard to be a good writer if you get lost in trying to find the perfect words.  Start off by just writing. If you want to dictate and then transcribe, that can help you put your ideas down on paper. Then, you can edit, craft your argument, and look for clear ways of communicating. Pulling out the thesaurus does not come until you are a couple of revisions into the process.
  5. Ask for help. Yikes, this is a hard thing to do.  But, asking a friend, colleague or family member to read your work before sending it into a journal can get you honest feedback that will improve your writing. It may be painful, but better to address weaknesses in your writing first rather than getting rejected from a journal.
  6. Find your voice. Writing takes a lot of time and can be frustrating if you are not writing about a topic that you care about. Look around you and explore writing about your teaching, your patient care, your work experiences, or your research. You have a story to tell!
  7. Finding a time to write.  For many of us, clinical duties, teaching responsibilities, and administrative tasks take precedence and writing and scholarship quickly fall down the “to do” list. The most prolific writers have one thing in common and that is that they designate time to write. It may not be daily, or even weekly, but if you talk to someone who writes a lot, they will tell you that they block off their calendar to write. Evaluate how, where, and when you work best and take advantage of that. I often recommend a 2009 article in the Emergency Medicine literature entitled, “Tuesdays to Write”.   The author talks about designating Tuesdays for academic time and blocking off the entire day to write.  Obviously, that is not possible for many of us, but the concept is alluring. Look ahead at your calendar. Are there mornings or afternoons that you can block off to write?  
  8. Keep practicing. Maya Angelou said, “Do the best you can until you know better. Then when you know better, do better.”  Start writing for yourself and as you get better at it, share it with your colleagues and the broader family medicine community.  

Reference:

  1. Lowenstein SR. Tuesdays to write … A guide to time management in academic emergency medicine. Acad Emerg Med. 2009 Feb;16(2):165-7. doi: 10.1111/j.1553-2712.2008.00337.x. Epub 2008 Dec 30.

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