The Process Behind the Pages: A Year with the New England Journal of Medicine

The New England Journal of Medicine (NEJM) is a well-respected and world-renown medical journal both inside and outside the medical establishment. The research published in the Journal is quoted on ward rounds, in clinics, and on news throughout the world. As doctors-in-training and clinicians, we were both familiar with the pages of the Journal but were unaware of what was behind the name. When we each independently chose to pursue the editorial fellowship at NEJM, our colleagues gave us similar perplexed looks and asked, “Are you a writer?” or “You’re leaving clinical medicine to pursue medical journalism?” Our experience working at NEJM this year was more than just a chance to learn about medical publishing; it was a unique opportunity to learn how to appraise, interpret, and relay medical research, and contribute in our own small way to help disseminate research findings with the goal of advancing health.

The NEJM fellowship was started in 2000, and the role of the editorial fellows has evolved substantially since then. However, the editorial meetings have remained at the core of the educational experience. Prior fellows have described the meetings as the "ultimate journal club." As editorial fellows, we have a front-row seat to observe and participate in discussions on emerging medical research, ranging from basic science and clinical trials to health policy. At these meetings, NEJM editors present key findings and comments from peer reviewers about a research paper under consideration, including careful attention to details ranging from statistics to the clinical trial protocol and trial registration. The discussion that follows reveals how and why NEJM continues to publish high-quality manuscripts, as the editors with decades of experience in clinical medicine and medical research debate the scientific accuracy, merit, novelty, and impact of each study.

The portfolio of the editorial fellows has evolved to include projects that help deliver and translate NEJM content for its readers. For example, every week we select one original research article to be featured as a two-minute animated video summary (Quick Take).  We then write the scripts and work with the phenomenal medical illustrators to help bring each video to life. We also write for the From Pages to Practice blog to gain experience putting NEJM research into context for practicing physicians and physicians-in-training.

A picture is worth a thousand words, especially in medicine. The NEJM Images in Clinical Medicine (ICM) is one of the most selective and viewed sections of the Journal. As editorial fellows, we have the privilege of viewing the hundreds of images submitted each week and selecting those that we think should undergo further review. We subsequently work with authors to edit image legends to maximize accuracy and learning objectives.

Keeping up with the medical literature is challenging, especially as trainees rotate through clinical posts every few months. In 2016, the NEJM group launched NEJM Resident360, a website for residents and doctors-in-training in the United States and around the world. Editorial fellows curate and create content for the NEJM Resident 360 Rotation Prep guides, identifying high-yield research, reviews, and facts to help students and residents prepare for training in internal medicine. The editorial fellows also help to foster an online community of young clinicians by organizing discussions on issues ranging from wellness and career advice to journal club discussions on recently published research. 

Although the projects are challenging, educational, and interesting, the most powerful part of the experience is working with the NEJM staff. The deputy and associate editors, at the top of their fields with decades of experience and a critical eye for research, are remarkable resources for learning. Many of them continue to treat patients and remain engaged with clinical medicine alongside their work for NEJM. It is important to note that the expertise and excellence of the final NEJM content requires more than physician and scientist editors. This process requires the commitment of skillful manuscript editors, medical illustrators, and graphic artists who carefully collaborate to bring the highest quality research to readers around the world. The NEJM editorial office is a dynamic, inspirational, and energizing environment filled with ideas from individuals with varying backgrounds and interests.

The editorial fellowship, like any educational opportunity, is what you make of it. Although the experience may seem like a departure from the standard or clinical research training pathway, it is an unparalleled opportunity to learn about the research process, contribute to the translation and communication of research findings, and will undoubtedly shape the way you will approach the rest of your career in medicine.

For more information on being a NEJM Editorial Fellow and how to apply, click here

Rebecca is a 2016-2017 NEJM Editorial Fellow and a hospitalist at Massachusetts General Hospital. She graduated from Columbia University College of Physicians and Surgeons in 2013 and completed internal medicine residency at Massachusetts General Hospital in 2016. Her interests include medical education, quality improvement, patient safety, health care delivery innovation, and teaching value in health care.


Ramya Ramaswami is a 2016-2017 NEJM editorial fellow. She is a medical oncologist within the National Health Services of the United Kingdom. Ramya received her medical degree, postgraduate medical and oncology training from Imperial College London, and a masters in public health from Columbia University, Mailman School of Public Health. Her clinical and research interests include cancer prevention, viral driven cancers, as well as disparities and access issues in global oncology.