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.
What to do next
Already submitted? Interpret the status here.
The useful next step is understanding what the status usually means, how long the wait normally runs, and when a follow-up is actually reasonable.
Last reviewed: 2026-05-16. Quick answer: If your Annals of Internal Medicine submission shows "Under Review," elapsed time is the most reliable signal.
Annals of Internal Medicine has a 2024 JCR Journal Impact Factor of 39.2, accepts 6 to 8 percent of original research submissions, and reports that approximately 68 percent of manuscripts were rejected without external review with the first editorial decision arriving in approximately 5 days on average and the first revision report taking an average of 59 days (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 uses ScholarOne Manuscripts at ScholarOne submission portal. Editorial questions should reference the manuscript ID; annals@acponline.org handles editorial-office inquiries. The Annals of Internal Medicine for-authors portal covers the editorial workflow and status-check guidance.
How does ACP handle an Annals of Internal Medicine submission?
Annals of Internal Medicine operates the ACP handling editor + deputy editor model. The Annals of Internal Medicine editorial team includes professional editors with internal-medicine clinical-research backgrounds; a deputy editor at Annals typically handles 30 to 50 manuscripts per quarter and spends 30 to 60 minutes on the initial read. 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: approximately 68 percent of manuscripts are rejected without external review (within ~5 days on average), and only 31 percent reach external peer review. 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 |
|---|---|---|
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 (5-day average target) |
Editor Discussion | ACP editorial team consultation for ambiguous fit | Days 5 to 7 (parallel; 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 (59-day average to first revision report) | Check email |
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. Approximately 68 percent of manuscripts are rejected without external review, with first editorial decisions arriving in approximately 5 days on average.
A desk rejection most often means the editor concluded that the work would fit better at a sister ACP journal (Annals of Internal Medicine Clinical Cases for case-focused work, 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 (5-day average target)
The Annals handling editor reads the paper and evaluates internal-medicine clinical-research significance, methodological rigor, and ACP family routing. The 5-day average to first editorial decision reflects the fast pace at Annals.
Days 5 to 7: ACP editorial team discussion (parallel for ambiguous cases)
In parallel with the handling editor's primary read, ambiguous-fit papers are discussed across the ACP editorial team where deputy editors and the editor-in-chief weigh in on whether the paper would fit better at Annals flagship or at sister ACP journals. This editorial-team discussion runs alongside the desk-screen and adds 1 to 3 days to the timeline that is invisible to the author in the portal.
Days 7 to 21: External reviewer recruitment
Annals deputy editors typically invite at least 2 external peer reviewers. 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, the typical Annals peer-review cycle lasts 2 to 6 weeks per reviewer. Reviewers are asked to evaluate internal-medicine clinical-research significance, methodological rigor, and reproducibility. Reviewer reports for Annals tend to be thorough; 2000 to 4000 word reports are typical given the clinical-research bar.
Day 56 onward: Editorial synthesis and decision
After reports return, the deputy editor synthesizes them. The 59-day average to first revision report reflects the multi-stage ACP editorial workflow.
When should you worry?
- Rejection within 1 to 3 days: Administrative issue or immediate scope mismatch.
- Rejection within 5 to 7 days: Annals handling editor desk rejection per the 5-day average.
- 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 puts you in the normal middle of Annals's 59-day average to first revision report distribution. 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 1-2 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 | ~68 percent | ~70 to 75 percent | Well above 90 percent | 50 to 60 percent |
Desk-decision speed | 5-day average | 7 to 14 days | Executive Editor 3 to 7 days | 7 to 14 days |
Total review time (post-screen) | 59-day average to first revision | 8 to 12 weeks | 8 to 12 weeks | 6 to 10 weeks |
Reviewer count | ≥2 external peer reviewers | ≥2 + in-house statistical review | ≥2 + in-house statistical review | 2 to 3 |
Peer-review model | Single-blind | 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. The 6 to 8 percent overall acceptance rate 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?
ACP asks reviewers at Annals to evaluate four things specifically. The table below maps each to actionable preparation.
Reviewer focus area | What Annals asks reviewers 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 5-day average 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. 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 within 5 to 7 days 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 the 100-manuscript Manusights sample across internal-medicine and general-medicine targets, Manusights internal analysis identifies 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 editorial documentation (5-day average to first editorial decision, 59-day average to first revision report, 6 to 8 percent acceptance, 68 percent rejected without external review, 31 percent sent for peer review), 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).
Reviewers at Annals typically draw from one internal-medicine clinical specialist and one methodologist. 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 Annals of Internal Medicine ScholarOne admin 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. Approximately 68 percent of manuscripts were rejected without external review, and 31 percent were sent for peer review.
Authors receive the first editorial decision in approximately 5 days on average, and the first revision report takes an average of 59 days. Acceptance rates for original research range from 6 to 8 percent in recent years at Annals of Internal Medicine.
Wait at least 6 weeks before inquiring. Contact via the Annals of Internal Medicine ScholarOne portal at the official submission portal referencing your manuscript ID; annals@acponline.org handles editorial-office inquiries.
No. Annals of Internal Medicine's 59-day average to first revision report means 6 weeks puts you in the normal middle of the active review distribution. 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. Annals of Internal Medicine operates single-blind peer review by default. About 31 percent of submissions reach external peer review.
Yes. The 59-day average to first revision report means about half of papers take more than 60 days for the first decision. Multiple revision rounds are common; total submission-to-acceptance commonly runs 4 to 8 months for successful papers.
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
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Conversion step
Interpret the status and choose the next move.
Guidance first. Use the scan for the next manuscript.