Annals of Internal Medicine 'Under Review': What Each Status Means
If your Annals of Internal Medicine submission shows Under Review, here is what the ACP editors are doing during each stage and when to follow up.
While you wait
Waiting on a decision? Get your next move ready.
The wait is out of your hands; the next move isn't. Scan your next manuscript free, or run this paper through the scan to see what reviewers typically push back on, so the revision response is ready when the decision lands.
Last reviewed: 2026-10-10. Quick answer: If your Annals of Internal Medicine submission shows "Under Review," elapsed time is the most reliable signal.
Annals of Internal Medicine lists a 2025 Impact Factor of 17.3, says that in recent years 8 percent of all unsolicited submissions and under 5 percent of original research articles were accepted, sends about 45 percent of submitted papers for external peer review, and notifies authors within 1 to 2 weeks of receipt when a paper is rejected without external review. ACP publishes no average time to a first revision report (per Annals of Internal Medicine Information for Authors).
Annals of Internal Medicine publishes new articles online every Tuesday, with print issues on the third Tuesday of each month.
For a second opinion before reviewers see your manuscript, run a Annals of Internal Medicine submission readiness check.
Submission portal and editorial contact: Annals of Internal Medicine accepts submissions only through its online manuscript submission system at Annals online submission site, not by e-mail or regular mail. Editorial questions should reference the manuscript ID. The Annals of Internal Medicine for-authors portal covers the editorial workflow and status-check guidance.
If you have not submitted yet, use the Annals of Internal Medicine submission guide for journal-fit and upload-readiness checks; this page owns the post-submission status question after ScholarOne has created a manuscript record.
How does ACP handle an Annals of Internal Medicine submission?
At Annals of Internal Medicine, ACP says at least 1 editor and 1 associate editor read each manuscript and together decide whether to send it to outside reviewers. Editorial decisions consider the scientific strength and appropriateness for readers of the information in submitted manuscripts; Annals of Internal Medicine's editorial process involves review of submitted work by editors and external peer reviewers.
Annals editorial culture is decisive: ACP says about 45 percent of submitted papers are sent for external peer review, and authors of papers rejected without external review are notified within 1 to 2 weeks of receipt. Papers that pass the Annals editor desk screen have cleared the steepest filter in ACP internal-medicine publishing.
What is Annals of Internal Medicine's review pipeline?
Status | What is happening | Typical duration (unofficial estimate) |
|---|---|---|
Submitted | Administrative processing at Annals editorial office | Day 0 to 3 |
With Editor | Annals handling editor + deputy editor evaluating desk-screen fit | Days 3 to 7 |
Editor Discussion | ACP editors and associate editors discuss many peer-reviewed papers at a weekly manuscript conference | Weekly (invisible to author) |
Under Review | External reviewers invited or actively reviewing | Days 7 to 56 |
Required Reviews Complete | Deputy editor synthesizing reports | 7 to 21 days |
Decision Pending | Senior editorial team finalizing recommendation | 7 to 14 days |
Decision Sent | Reject, R&R, or accept | Check email |
ACP publishes no status labels and no stage timings for Annals, so the status names and durations in this table are unofficial Manusights planning estimates, not ACP figures.
What happens at the Annals editor desk screen?
Before the paper reaches external reviewers, an Annals handling editor evaluates whether the internal-medicine clinical-research significance warrants Annals's selective editorial slots. ACP says about 45 percent of submitted papers are sent for external peer review, and authors of papers rejected without external review are notified within 1 to 2 weeks of receipt.
A desk rejection most often means the editor concluded that the work would fit better at Annals of Internal Medicine: Clinical Cases for case-focused work, or at another journal such as JGIM for general internal medicine research, or that the internal-medicine readership relevance bar is not met.
Day 0 to 3: Administrative processing
The Annals editorial office checks whether the package is reviewable: manuscript file, figures, supporting information, trial registration where applicable, ethics approvals, competing-interest statements, data-sharing language, and reporting checklists such as CONSORT, STROBE, or PRISMA. The practical risk is not only missing files; it is a methods section or data-sharing statement that cannot support the internal-medicine claim in the abstract.
Days 3 to 7: Annals editor desk screen
The Annals handling editor reads the paper and evaluates internal-medicine clinical-research significance, methodological rigor, and ACP family routing. ACP says authors of papers rejected without external review are notified within 1 to 2 weeks of receipt.
ACP editorial team discussion
ACP says editors and associate editors discuss many of the papers that are peer reviewed at a weekly manuscript conference, and that quantitative or methods-focused papers that pass initial review are usually also reviewed by methods editors at a weekly methods conference. These discussions are invisible to the author in the portal.
Days 7 to 21: External reviewer recruitment
ACP says papers go to external peer review usually with at least 2 reviewers, chosen from an electronic database of approximately 18,000 reviewers. In our planning estimate the recruitment window can take 7 to 14 days because reviewers with topic-matched internal-medicine clinical-research expertise are scarce.
Days 14 to 56: Active peer review
Once reviewers agree to review, a peer-review cycle of 2 to 6 weeks per reviewer is a reasonable planning estimate, since ACP publishes no reviewer deadline. Reviewers are likely to focus on internal-medicine clinical-research significance, methodological rigor, and reproducibility. Reviewer reports for Annals tend to be thorough.
Day 56 onward: Editorial synthesis and decision
After reports return, the deputy editor synthesizes them. ACP publishes no average time to a first revision report, and the multi-stage ACP editorial workflow means timing varies.
When should you worry?
- Rejection within 1 to 3 days: Administrative issue or immediate scope mismatch.
- Rejection within 1 to 2 weeks: Annals handling editor desk rejection; ACP says authors are notified within 1 to 2 weeks of receipt when a paper is rejected without external review.
- Still Under Review after 2 weeks: Strong signal. Paper passed the Annals editor filter.
- Still Under Review after 10 weeks: Reviewer-recruitment or reviewer-report delay. A polite inquiry via the ScholarOne portal is appropriate.
- Status changes to "Decision Pending": Reports are in; expect a decision within 1 to 2 weeks.
"My paper has been Under Review for 6 weeks. Is that bad?"
This is the most common anxiety we hear from Annals of Internal Medicine authors during the active editorial window. The honest answer: no, 6 weeks at Under Review falls inside the unofficial planning window on this page (ACP publishes no average time to a first revision report). Reports may already be in editorial synthesis with the deputy editor preparing the recommendation.
Most reviewer-driven delays come from reviewer-recruitment timing rather than slow reviews because Annals recruits topic-matched internal-medicine clinical-research reviewers who are scarce. If the portal still says Under Review at the 9-week mark, the most likely explanation is that one of the assigned reviewers asked for an extension and the deputy editor granted it. This is normal practice at ACP.
The better use of the 6-to-9-week window is to audit the revision package reviewers are likely to request: abstract clinical-practice claim, first table and figure logic, statistical-methods detail, data-sharing statement, reporting checklist, and the response-letter skeleton. A status note at 6 weeks rarely changes reviewer behavior, but a prepared response file can shorten a later revision by several days.
What to do while waiting
- Do not email the editorial office during the first 6 weeks unless an urgent ethics issue surfaces.
- Do not submit the paper anywhere else while it is Under Review at Annals of Internal Medicine. Annals has explicit prohibitions on dual submission.
- Prepare a point-by-point response template for likely reviewer concerns: internal-medicine clinical-research significance, methodological rigor, CONSORT compliance, reproducibility.
- If you have related work submitted elsewhere or recently published, prepare disclosure language for when revisions are requested.
- Read recent Annals research articles in your subfield to calibrate the current editorial bar.
Readiness check
While you wait, scan your next manuscript.
The scan takes about 2 to 3 minutes. Use the result to decide whether to revise before the decision comes back.
Status inquiry checklist
Send an inquiry only when the elapsed time is outside Annals of Internal Medicine's normal window or when a material fact has changed. A useful message includes the manuscript ID, submission date, current portal status, article type, and one sentence asking whether any action is needed from the authors. Do not ask for a prediction of the decision, do not attach a revised manuscript unless requested, and do not send the same note separately to multiple editors.
Before writing, check whether the status has changed from "Under Review" to "Required Reviews Complete" or "Decision Pending." If it has, wait for the deputy editor or senior editorial-team synthesis because reviewer reports are already moving toward a decision letter.
If Annals of Internal Medicine rejects, what cascade makes sense?
If your Annals paper is rejected after review, the natural cascade depends on what the reviewers and editor cited:
Annals of Internal Medicine Clinical Cases is the natural ACP cascade for case-focused work where the original-research framing of Annals flagship is not the central contribution.
JGIM (Journal of General Internal Medicine) is the SGIM cascade for general internal medicine research papers.
JAMA Internal Medicine is the JAMA Network internal-medicine cascade. JAMA Internal Medicine uses ScholarOne at ScholarOne submission portal; editorial contact jamainternalmedicine@jamanetwork.org.
NEJM is the external top-tier general-medicine cascade. NEJM uses ScholarOne at ScholarOne submission portal; editorial contact nejm@nejm.org.
The Lancet is the external general-medicine cascade for global-clinical-impact work. The Lancet uses Editorial Manager at Editorial Manager submission portal; editorial contact editorial@lancet.com.
BMJ is the British general-medicine cascade for general-medicine open-access work.
How does Annals of Internal Medicine compare to nearby alternatives?
Feature | Annals of Internal Medicine | JAMA Internal Medicine | NEJM | JGIM |
|---|---|---|---|---|
Desk-rejection rate | Not published (about 45 percent of submitted papers go to external review) | ~70 to 75 percent | Well above 90 percent | 50 to 60 percent |
Desk-decision speed | Authors notified within 1 to 2 weeks of receipt when rejected without external review | 7 to 14 days | Executive Editor 3 to 7 days | 7 to 14 days |
Total review time (post-screen) | Not published | 8 to 12 weeks | 8 to 12 weeks | 6 to 10 weeks |
Reviewer count | Usually at least 2 external peer reviewers | ≥2 + in-house statistical review | ≥2 + in-house statistical review | 2 to 3 |
Peer-review model | Reviewer identities not disclosed to authors unless a reviewer signs | Single-blind + in-house statistical review | Single-blind + in-house statistical review | Single-blind |
Editorial bar | Top-tier ACP internal-medicine clinical-research | Top-tier AMA internal-medicine | Top-tier evidence-changes-practice clinical-impact | General internal medicine research |
Submit If
If your Annals of Internal Medicine paper is Under Review past 2 weeks, you have cleared the ACP editor desk-screen filter. Use the waiting window to prepare a thorough revision response template.
Annals of Internal Medicine submission readiness check takes about 5 minutes.
Think Twice If
- The abstract claims internal-medicine practice relevance, but the first table and discussion still read like a narrow subspecialty report.
- The methods section names CONSORT, STROBE, PRISMA, or data sharing, but the protocol, statistical code, sample exclusions, or checklist items are not traceable.
Annals deputy editors retain discretion to reject after partial review if reviewer reports surface methodological or internal-medicine-relevance concerns the desk screen did not catch. ACP's reported acceptance of 8 percent of all unsolicited submissions and under 5 percent of original research articles means most post-desk-screen papers still receive a reject or substantial-revision decision.
For a pre-upload diagnostic of internal-medicine-relevance framing and CONSORT compliance, run a Annals of Internal Medicine pre-submission diagnostic before reviewer reports surface those concerns.
Last verified: Annals of Internal Medicine Information for Authors at Acpjournals author instructions and ACP editorial documentation.
What do Annals of Internal Medicine reviewers evaluate?
Reviewers at Annals are likely to focus on four things. ACP does not publish a reviewer checklist, so the table below is Manusights interpretation, mapping each to actionable preparation.
Reviewer focus area | What reviewers are likely to evaluate | How to prepare for it |
|---|---|---|
Internal-medicine clinical-research significance | Does the work matter for internal-medicine clinical readers beyond a specialty audience? | Frame the introduction around the internal-medicine clinical relevance. The desk screen selects for papers with clear internal-medicine clinical relevance. |
Methodological rigor | Are the experimental methods appropriate, properly conducted, and ethically robust? | Include detailed methods documentation. Pre-registration for clinical trials, sample-size justification, multiple-testing adjustments, and missing-data handling are evaluated by reviewers. |
CONSORT compliance | Does the manuscript comply with CONSORT reporting standards for clinical trials? | Complete the CONSORT checklist fully before submission. Reviewers consistently flag CONSORT gaps. |
Reproducibility | Could the central clinical analyses be reproduced by another team with the methods as written? | Use detailed methods documentation. Annals requires data-sharing statements for manuscripts that report clinical trial results and asks all authors to state their willingness to share the protocol, code and data. Pre-registration documentation strengthens reproducibility framing. |
What patterns miss the Annals bar?
In our pre-submission work with Annals of Internal Medicine-targeted manuscripts, three named patterns generate the most consistent reviewer concerns and the most common reasons papers miss the editorial bar or fail the desk screen.
Subspecialty-only framing flagged at Annals editor desk screen. When the introduction frames the work too narrowly without internal-medicine clinical readership relevance, Annals editor desk rejection is common. The strongest manuscripts frame the introduction around an implication for internal-medicine practice that would matter to the broad ACP readership.
Check whether your Annals framing reaches internal-medicine readers →
Reporting checklist gaps surface as reviewer requests. When the CONSORT, STROBE, or PRISMA checklist is incomplete or items say "see Methods" without actual Methods coverage, reviewers consistently request expanded reporting-compliant sections. The strongest manuscripts complete the relevant reporting checklist fully before submission.
Check your reporting checklist traceability before review →
Sister-ACP cascade offers from deputy editor. When the deputy editor concludes the work is rigorous but the internal-medicine readership fit of Annals flagship is not met, transfer offers to Annals of Internal Medicine Clinical Cases (case-focused work) or sister ACP journals are common. ACP editors take these transfers seriously.
Check whether Annals or an adjacent internal-medicine venue is the better fit →
We have reviewed 50+ manuscripts targeting Annals of Internal Medicine, JAMA Internal Medicine, NEJM, The Lancet, BMJ, and adjacent clinical-research venues. Full Manusights reviews include a 60-day money-back guarantee, and we do not train models on your manuscript.
In our pre-submission review work across internal-medicine and general-medicine targets, we see five recurring preventable risks before peer review: subspecialty-only framing, unsupported practice implications, under-specified statistical methods, data-sharing statements that are not operational, and reporting checklists that do not map cleanly to the manuscript. Source limitation: Official guidance explains the process, portal route, and historical screening outcomes, but it cannot diagnose whether your specific abstract, tables, methods, and reporting package will satisfy the Annals reviewer mix.
Methodology note
This page was created from ACP's public Information for Authors at Acpjournals author instructions, Annals of Internal Medicine author information (authors notified within 1 to 2 weeks of receipt when a paper is rejected without external review, about 45 percent of submitted papers sent for external peer review, 8 percent of all unsolicited submissions and under 5 percent of original research articles accepted), SciRev community-reported transit data on Annals of Internal Medicine, and Manusights pre-submission review experience with Annals-targeted manuscripts.
What to read next
For the ACP and AMA internal-medicine landscape beyond Annals of Internal Medicine, see Annals of Internal Medicine Clinical Cases (case-focused work), JGIM (SGIM general internal medicine research), JAMA Internal Medicine (AMA internal-medicine specialty), and external general-medicine alternatives (NEJM, Lancet, JAMA, BMJ).
The choice across these titles depends on whether the central contribution is top-tier ACP internal-medicine clinical-research (Annals of Internal Medicine), case-focused work (Annals of Internal Medicine Clinical Cases), general internal medicine research (JGIM), AMA internal-medicine specialty (JAMA Internal Medicine), or external general-medicine (NEJM, Lancet, JAMA, BMJ).
ACP says quantitative or methods-focused papers that pass initial review are usually also reviewed by its methods editors at a weekly methods conference. Editors screen and triage manuscripts before any external reviewer sees them, and preparing a response template that addresses both internal-medicine clinical-research significance and methodology accelerates revision rounds substantially.
For a pre-upload check of your manuscript against the Annals internal-medicine-clinical-research bar before submission, our Annals of Internal Medicine pre-submission diagnostic flags the framing and reporting-checklist weaknesses most likely to surface in reviewer reports.
Frequently asked questions
Your manuscript has cleared the journal's administrative checks and is being evaluated. Annals of Internal Medicine's editorial process involves review of submitted work by editors and external peer reviewers, and editorial decisions consider the scientific strength and appropriateness for readers of the information in submitted manuscripts. ACP says about 45 percent of submitted papers are sent for external peer review.
ACP says authors of papers rejected without external review are notified within 1 to 2 weeks of receipt, and it publishes no average time to a first revision report. In recent years, ACP reports, 8 percent of all unsolicited submissions and under 5 percent of original research articles were accepted.
Wait at least 6 weeks before inquiring. Contact the editorial office through the Annals of Internal Medicine online manuscript submission system at the official submission portal, referencing your manuscript ID.
Not by itself. ACP publishes no average review time, and 6 weeks falls inside the unofficial planning window on this page. Reports may already be in editorial synthesis.
Your paper passed the editor desk screen and at least 2 external peer reviewers have agreed to review. ACP does not disclose reviewer identities to authors unless a reviewer chooses to sign the review. About 45 percent of submitted papers are sent for external peer review, per ACP.
Yes. ACP publishes no average review time, and papers sent to external review commonly take more than 60 days to a first decision (an unofficial estimate). Multiple revision rounds are common; total submission-to-acceptance commonly runs 4 to 8 months for successful papers (also an unofficial estimate).
Past 10 weeks is the right moment for a polite inquiry. Past 14 weeks suggests a reviewer dropped out and the editor needs a replacement. Silence in the first 6 weeks is normal at Annals of Internal Medicine given the multi-stage ACP editorial workflow.
Sources
Free guide
Waiting is not the same as being ignored, and there is a way to tell.
Reviewers usually get ten days. When it has been months, an appeal and a complaint are different instruments with different addresses, and only one of them fits a delay. This is which to use, and the wording that gets an answer.
Final step
Done interpreting the status? Put the wait to work.
The decision will arrive on the journal's clock. What you control is what's next: scan your next manuscript free, or run this paper through the scan so the likely reviewer pushback is mapped before the revision request lands.
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Use the practical response workflow when a manuscript needs revision, or the process guide when you need to understand what the editorial status means.