BMJ Open APC and Open Access: The Clinical Megajournal With Published Peer Reviews

Here's what sets BMJ Open apart from nearly every other medical journal: when your paper is published, the peer review history goes with it.

This means:

1. Reviewer reports are published as supplementary material alongside your article.
2. Your point-by-point responses to reviewer comments are also published.
3. Reviewer names are disclosed by default (though reviewers can opt out of being named).
4. The handling editor's decision letters are included.

This is genuine transparency, not a half-measure. Readers can see exactly what concerns reviewers raised, how you addressed them, and whether the editor required additional experiments or analyses.

For some authors, this is uncomfortable. Your early draft's weaknesses are on permanent display. For others, it's a selling point. Published reviews add credibility to the final paper. They show that the work was properly scrutinized. And they make it harder for anyone to claim the peer review was superficial.

In clinical medicine, where reproducibility and methodological rigor are under intense scrutiny, published peer reviews are a meaningful signal of quality. This is one reason why BMJ Open has steadily gained ground in clinical research communities that value transparency over prestige.

BMJ operates several institutional programs that reduce or eliminate the APC:

The UK Jisc agreement is the most generous. UK-based corresponding authors at Jisc member institutions can publish in BMJ Open with the APC fully covered. Given that BMJ is a UK-based publisher and many clinical researchers work within the NHS/university system, this deal covers a large share of BMJ Open's UK submissions.

For researchers outside the UK, the situation varies. Check whether your institution has a BMJ OA membership or fellowship. Many medical schools and teaching hospitals subscribe to BMJ products, and some of those subscriptions include APC discounts.

In the United States, there's no national-level BMJ deal. Individual universities may have agreements, and most academic medical centers maintain OA funds that can cover the $2,850 APC. It falls well within typical fund limits.

BMJ's waiver policy follows industry norms with some additional flexibility:

Automatic waivers: Corresponding authors in Research4Life Group A countries (low-income nations) receive a full APC waiver.

Automatic discounts: Authors in Group B countries (lower-middle-income) receive a 50% discount.

Hardship waivers: Available on request for authors who can't cover the fee through grants, institutional funds, or personal resources. BMJ states that inability to pay won't affect editorial decisions.

Discretionary editorial waivers: In rare cases, editors may offer reduced fees for papers they consider particularly important to public health. This isn't something you can apply for, but it happens.

The $2,850 APC is modest enough that waiver requests from well-funded institutions are unlikely to succeed. BMJ targets waivers at researchers who genuinely lack access to publication funding.

1. It's one of the largest medical journals in the world. BMJ Open publishes over 3,000 articles per year, making it comparable in volume to PLOS ONE's medical content. The acceptance rate is approximately 45-50%, which is higher than specialty medical journals but reflects the megajournal model: if the methodology is sound and the research question is valid, the paper gets published regardless of perceived impact.

2. Study protocols are a major article type. BMJ Open is one of the best-known venues for publishing study protocols, particularly for clinical trials and systematic reviews. Publishing your protocol prospectively creates a citable record of your planned methodology before results are known. This is increasingly expected by funders, ethics committees, and trial registries.

3. BMJ Open is indexed everywhere that matters. PubMed, MEDLINE, Scopus, Web of Science, PMC. For clinical researchers, MEDLINE indexing is the critical factor, and BMJ Open has had it since launch. Every paper is discoverable through PubMed, which is the primary search tool in medicine.

BMJ Open is fully gold OA, so compliance is automatic for all major mandates. Papers are deposited in PubMed Central and available from publication day. No embargo, no repository deposit required by the author.

The journal supports CC BY licensing, which satisfies Plan S. It also offers CC BY-NC for authors whose funders allow it. As with all journals, make sure you select the correct license during production. The wrong choice can create compliance problems that are difficult to fix after publication.

BMJ Open has clear strengths in certain article types:

• Clinical trials: Particularly pragmatic trials, pilot studies, and feasibility studies. The journal doesn't require that your trial changed clinical practice. It requires that the methodology was sound.
• Observational studies: Cohort studies, cross-sectional surveys, case-control studies. BMJ Open follows STROBE guidelines strictly and expects transparent reporting.
• Systematic reviews and meta-analyses: PRISMA compliance is required. The journal publishes both quantitative meta-analyses and qualitative evidence syntheses.
• Study protocols: One of the top venues globally. Publishing here creates a citable DOI for your planned study design.
• Health services research: Quality improvement studies, health economics analyses, implementation science.
• Qualitative research: BMJ Open is one of the few high-visibility journals that consistently publishes qualitative health research.

Papers that don't fit: basic science without clinical relevance, laboratory studies, animal models (unless directly linked to a clinical question), and purely computational work.

BMJ Open is clean on fees, but a few things to track:

• No page charges or length surcharges. The APC covers articles of any length.
• No color figure fees. Everything is digital-first.
• Reporting guidelines are mandatory. CONSORT for trials, STROBE for observational studies, PRISMA for reviews. If your paper doesn't include the appropriate checklist, it will be returned before review. This isn't a cost in money, but it's a cost in time if you're not prepared.
• Data sharing requirements. BMJ Open expects data sharing wherever possible. For clinical trials, individual patient data should be available on reasonable request. For observational studies, aggregate data should be in the paper or a repository.
• Open peer review exposure. Your reviewer reports will be public. If a reviewer was critical of a specific methodological choice, that criticism is permanently visible. Make sure your revisions thoroughly address every point.
• Rapid rejection for low-priority topics. Despite being a megajournal, BMJ Open does screen for relevance to clinical medicine. Papers outside the journal's scope are desk-rejected quickly.

BMJ Open occupies a specific niche: it's the best-value gold OA option for clinical researchers who want transparency and MEDLINE visibility without paying $4,000+ for a specialty journal.

If your work is a well-designed clinical study that doesn't quite reach the bar for BMJ, The Lancet, or JAMA, BMJ Open is the logical next step. The APC is reasonable, the brand is recognized, and the published peer reviews add credibility that other megajournals can't match.

The main alternative decision is BMJ Open vs PLOS ONE. If your paper is clinical, choose BMJ Open. The extra $1,150 buys you a medical-specific editorial process, published reviewer reports, and stronger recognition among clinical audiences. If your paper spans multiple disciplines or isn't primarily clinical, PLOS ONE's broader scope and lower cost may be the better fit.

For a broader perspective on multidisciplinary journal fees, see our PNAS cost breakdown. For more details on BMJ Open's editorial policies, visit the BMJ Open journal page.

Before submitting to BMJ Open, remember that the journal publishes your peer reviews. You want your manuscript to be as strong as possible before it enters that transparent process. Run a free readiness scan to catch reporting guideline gaps, statistical issues, and formatting problems before reviewers see them.