BMJ Open Time to First Decision: 8-16 Weeks From Submission

BMJ Open routes submissions through the BMJ Manuscript Tracking System. The labels you see depend on the stage:

• "Awaiting PRM Assignment" is a queue status. Your paper is waiting to be assigned to a Production and Review Manager who will then route it to an academic editor and recruit reviewers.
• "With Editor" means the academic editor is conducting the initial assessment: scope check, methodology screen, and reporting-guideline compliance.
• "Under Review" means the paper has passed editorial assessment and is with 2-3 independent reviewers. Most of the wait time falls here.
• "Awaiting Decision" means the reviewer reports are in and the editor is weighing them.

If your paper sits at "Awaiting PRM Assignment" or "With Editor" for more than 4 weeks, that is normal during high-volume months but worth a polite inquiry after 6 weeks.

BMJ Open is a broad-scope, soundness-first medical journal that covers all areas of clinical medicine, public health, health services research, and medical education. Three structural factors drive the timeline:

Open peer review logistics. BMJ Open operates fully open peer review: reviewers are told who the authors are, sign their names, and have their reports published alongside the final article. Reviewers who agree to open review are committing to a public record of their judgment. Some potential reviewers decline open-review invitations, which extends recruitment time, particularly for sensitive or contested clinical topics.

Submission volume. BMJ Open is one of the largest open-access medical journals by submission count. The editorial office cannot triage every paper at the same speed; periods immediately after major conference cycles see longer queues.

Reporting-guideline checks. Editors check CONSORT, STROBE, PRISMA, and ARRIVE checklist compliance before reviewer assignment. Papers that complete checklists with "see Methods" or "N/A" generate editorial returns at this stage, adding 1-2 weeks before the paper moves to peer review.

If your paper has been at "Under Review" for 8-12 weeks, the most likely explanation is reviewer recruitment difficulty, not a negative signal about the manuscript. The more useful calibration:

• Under Review for less than 4 weeks: Probably in reviewer recruitment. No read on quality.
• Under Review for 4-8 weeks: Reviewers may be writing their reports. Normal.
• Under Review for 8-12 weeks: Approaching first decision. Still within normal range.
• Under Review for 12+ weeks: Longer than typical. A polite inquiry is appropriate.

BMJ Open reviewers focus on methodological soundness, not novelty or significance. The editorial criteria do not require a paper to demonstrate high-impact findings. Reviewers check:

• Study design and methods: are they appropriate for the research question?
• Reporting completeness: does the paper follow the relevant reporting guideline?
• Statistical analysis: are the methods correct and the conclusions supported?
• Ethical approvals and data availability
• Whether the abstract accurately reflects the content

A paper with solid methods, appropriate reporting, and supported conclusions passes BMJ Open's bar regardless of whether the findings are unexpected or the sample is large.

Wait at least 10-12 weeks from submission before contacting the editorial office. When you do:

• Use the BMJ Open contact form or the email listed in your acceptance confirmation
• Reference your manuscript ID
• Keep the message brief: request a status update, note when you submitted

One follow-up per 4-week interval after the 12-week mark is reasonable. BMJ Open is a high-volume journal and cannot provide individualized timelines, but the editorial office will usually acknowledge and escalate genuinely delayed cases.

• Reject: Usually with reviewer comments explaining why. The methodology problems identified are genuine and worth addressing before submitting elsewhere.
• Major revision: Common at BMJ Open. Expect requests to clarify methods, add limitations, update the reporting checklist, or address specific reviewer questions.
• Minor revision: Usually quick to resolve (2-4 weeks turnaround).
• Accept subject to revision: Less common as a first response, but possible for well-prepared manuscripts.

Before submitting a revision with significant methodological changes, a BMJ Open submission readiness check can assess whether your response addresses the reviewers' core concerns.

In our pre-submission review work with manuscripts targeting BMJ Open, three failure patterns generate the most consistent desk returns and extended review timelines. We find these across manuscripts we've reviewed through our BMJ Open submission readiness check.

The reporting checklist completed with "see Methods" instead of specific page citations. BMJ Open uses mandatory reporting guidelines as part of its editorial assessment. We observe that papers completing CONSORT, STROBE, PRISMA, or ARRIVE checklists with generic references generate desk returns or reviewer revision requests. BMJ Open editors check checklist compliance before assigning reviewers. Papers that map each checklist item to a specific page number and section heading clear this screen; papers that complete checklists perfunctorily are flagged before external review begins. The item most commonly completed incorrectly: allocation concealment for RCTs and selection of participants for observational studies.

The open peer review response letter that would not survive public scrutiny. BMJ Open publishes reviewer reports and author responses publicly alongside the final article. We observe that authors who write responses appropriate for private exchange but not for public reading create problems during editorial review. BMJ Open's editorial office explicitly reviews response letters for tone before accepting revisions. The standard: write the response letter as if 500 researchers in your field will read it alongside the paper. Concede valid points clearly, explain your reasoning for defended decisions, and avoid language that reads as dismissive. Papers whose revision letters meet this standard move through the editorial cycle faster.

The statistical reporting that omits confidence intervals required by BMJ's guidelines. BMJ Open follows BMJ Group statistical reporting standards, which require confidence intervals alongside or instead of p-values for all primary outcomes. We find that roughly 30% of manuscripts we review for BMJ family journals report only p-values for primary and secondary endpoints. SciRev community data for BMJ Open consistently shows "statistical reporting" as a top revision request. Papers that pre-empt this by reporting effect sizes and 95% CIs throughout the results section move through the revision cycle without this specific request.