Common Reasons Manuscripts Get Rejected by Medical Journals (and How to Avoid Them)

Rejection is one of the most common — and most misunderstood — experiences in academic publishing. Even strong research is regularly turned away, not because the science is flawed, but because of avoidable issues in how the manuscript was prepared or targeted. Understanding the most frequent reasons for rejection can meaningfully improve your odds the next time you submit.

1. The Paper Doesn’t Match the Journal’s Scope

This is, by a wide margin, the most common reason for an early desk rejection. Every journal defines the disciplines and types of research it publishes, and editors screen for fit before a manuscript ever reaches a reviewer. Before submitting anywhere, read the journal’s stated scope carefully. IJMS, for example, explicitly covers Medicine, Surgery, Nursing Science, Obstetrics/Gynaecology, Mental Health, and Public Health — research well outside these areas is unlikely to move forward regardless of quality.

2. A Weak or Vague Abstract

Editors frequently form a first impression from the abstract alone. An abstract that fails to clearly state the research question, methodology, key findings, and significance of the work gives reviewers little reason to engage seriously with the full manuscript. A strong abstract should be able to stand entirely on its own.

3. Poor Study Design or Methodology

No amount of polished writing can compensate for a flawed methodology. Common issues include inadequate sample sizes, missing control groups, unclear inclusion/exclusion criteria, or statistical methods that don’t match the data type. Reviewers are trained to catch these issues quickly, and they are among the hardest to fix after the fact.

4. Ignoring Formatting and Submission Guidelines

It sounds minor, but failing to follow a journal’s formatting checklist — file type, font size, spacing, placement of figures and tables — signals carelessness and can result in a submission being returned before review even begins. Most journals, including IJMS, provide an official article template specifically to prevent this.

5. Insufficient Novelty or Contribution

A well-executed study that simply replicates existing, well-established findings without adding new insight, population, or methodology may be rejected on the grounds of limited contribution to the field. Clearly articulating what is new about your work — in the introduction and again in the discussion — helps reviewers see its value.

6. Overstated Conclusions

Claiming more than your data supports is a fast path to rejection. Reviewers are specifically trained to check whether conclusions follow logically from the results. Be precise about the limitations of your study and avoid extrapolating beyond your sample or study design.

7. Ethical or Disclosure Gaps

Missing ethics committee approval, absent informed consent documentation, or undisclosed conflicts of interest are serious red flags. Reputable journals require these disclosures as standard practice, and gaps here can result in rejection regardless of the strength of the science.

8. Simultaneous Submission

Submitting the same manuscript to multiple journals at once is considered a serious breach of academic publishing ethics and is grounds for immediate rejection if discovered. Wait for a decision — or a formal withdrawal — before submitting elsewhere.

9. Poor Language and Clarity

Even technically sound research can be rejected if it is difficult to read. Long, convoluted sentences, inconsistent terminology, and unclear figures all place an unnecessary burden on reviewers and editors.

How to Reduce Your Risk of Rejection

  • Confirm your topic fits the journal’s scope before you write a single line
  • Use the journal’s official template and follow the submission checklist exactly
  • Have a colleague outside your immediate field read the abstract — if they can’t summarize your study back to you, revise it
  • Be explicit about what is novel about your contribution
  • Address limitations honestly rather than omitting them
  • Secure all necessary ethics approvals and disclosures before submission

Rejection Isn’t Always Final

A rejection from one journal doesn’t mean your research lacks value — it often means a mismatch in scope, presentation, or timing. Many well-cited papers were rejected at least once before finding the right home. If your manuscript falls within Medicine, Surgery, Nursing Science, Public Health, Obstetrics/Gynaecology, or Mental Health, review the IJMS Scope and consider submitting through the Paper Submission page.

For a deeper look at research and publication integrity standards recognized internationally, see the guidelines published by the Committee on Publication Ethics (COPE).