BMJ Pre-Submission Checklist: Clinical Practice Readiness

Clinical practice impact

1. Will this finding change how clinicians manage patients?

BMJ's threshold is the same as NEJM's: practice-changing evidence. But BMJ has a specific advantage for research that is international in scope. If your study draws on non-US populations, addresses global health questions, or comes from a non-US institution, BMJ is meaningfully more receptive than NEJM or JAMA.

2. Is the clinical question relevant to BMJ's general medical readership?

BMJ publishes across all of clinical medicine. A study that matters only within one narrow specialty (interventional cardiology, neuro-oncology) may be better suited to a specialty journal. The question is whether a general internist, family physician, or public health professional would find the result directly relevant to their practice.

3. Does the abstract make the practice implication concrete?

BMJ editors scan abstracts quickly. If the practice-changing finding is buried after two paragraphs of methods description, the first impression is weaker. Lead with the clinical question and the answer.

Study design and evidence

4. Is the study design appropriate for the clinical claims?

BMJ favors randomized trials, large cohort studies, systematic reviews, and health services research. Observational studies are published but face higher scrutiny. The key question: is the design strong enough that a clinician would change their practice based on these results?

5. Are the statistical methods rigorous enough for independent review?

BMJ sends papers to independent statistical reviewers. Like NEJM and JAMA, the statistical review evaluates sample size justification, analytical methods, missing data handling, and multiplicity corrections. Prepare for questions your clinical reviewers would not ask.

International relevance

6. Does the paper have international applicability?

This is where BMJ differs most from NEJM and JAMA. BMJ has a genuinely international editorial perspective. Research relevant to healthcare systems in multiple countries, studies from low- and middle-income settings, and work addressing global health challenges receive priority consideration. If your study is US-only, you need to explain why the findings apply internationally.

7. Is the paper framed for an international clinical audience?

Drug names, clinical pathways, and healthcare system references that are specific to one country should be contextualized. US brand names should include generic names. UK-specific NHS terminology should be explained for international readers.

Reporting and compliance

8. Is the reporting checklist complete?

CONSORT for trials (2025 update if applicable), STROBE for observational, PRISMA for systematic reviews. BMJ published the CONSORT 2025 statement alongside NEJM, Lancet, and Nature Medicine. Complete the checklist with specific page references.

9. Are ethics approvals, trial registration, and data sharing documented?

Trial registration is required before enrollment. Ethics approval must be stated with institution and approval number. BMJ requires a data sharing statement. The journal offers a subscription track with no APC (articles free after 6 months, immediate free access in low-income countries), which satisfies many funder open access mandates.

Cover letter and timing

10. Does the cover letter explain clinical impact concisely?

BMJ editors may reject within the first hour of submission if they are convinced the journal is not the right fit. The cover letter is the first thing they read. Keep it short: state the finding, the clinical implication, and why BMJ specifically is the right journal. Do not spend a paragraph on background.

If the paper addresses an ongoing public health emergency or has immediate policy implications, flag this explicitly in the cover letter. BMJ has a fast-track process for time-sensitive public health research.