JAMA 'With Editor': What the Tiered Editorial Screen Means

JAMA operates the editor-in-chief + deputy editor + associate editor tiered model, and the "With Editor" stage is where that model does its heaviest work. The editor-in-chief and deputy editors, with input from associate editors who are practicing academic physicians, read the paper and assess methodological rigor, general-medicine relevance, and reporting quality before any referee is invited. A deputy editor at JAMA typically handles 80 to 120 manuscripts per quarter and spends 30 to 90 minutes on the initial read; associate editors provide subspecialty expertise during the triage discussion. The distinctive feature is the in-house statistical review applied at the screen: JAMA's statistical editors read the CONSORT, STROBE, and PRISMA checklists, and roughly 30 percent of papers reviewed have reporting problems significant enough to trigger a desk reject or an immediate request for revision before review even begins.

JAMA editorial culture is decisive at the screen: the tiered triage produces roughly 85 percent desk rejection, one of the highest rates among top general medical journals, and JAMA's fast front-door triage means clearly-out-of-scope work is often returned within 7 to 14 days. Papers that clear the JAMA tiered triage and statistical gate have passed the steepest filter in AMA-tier general-medicine publishing, and the decision then shifts from "does a general-medicine reader care" to "are the clinical findings sound."

"With Editor" is the stage where the ~85-percent desk-reject decision is made, before any referee is involved. The editor-in-chief and deputy editors, with associate-editor input, evaluate whether the general-medicine relevance warrants one of JAMA's selective slots. A desk rejection at this screen most often means the paper is excellent for a subspecialty audience (cardiology, oncology, neurology, infectious disease) but does not explain why the JAMA general-medicine reader should change interpretation, policy, screening, diagnosis, or treatment, or that the in-house statistical editors flagged a reporting-checklist gap. None of this is a referee judgment; it is the editors reading the abstract and first page and asking whether a general clinical audience should care, and whether the statistics and checklist are trustworthy.

Before the paper reaches the deputy editor, the JAMA editorial office confirms the submission package is complete: for clinical trials, the manuscript, figures, supplementary files, CONSORT checklist, trial registration, protocol or statistical analysis plan, conflict-of-interest forms, IRB or ethics approval, data-sharing statement, and author disclosures all need to line up; for observational studies and reviews, the same screen checks STROBE or PRISMA alignment. A missing checklist or registration is a common reason a submission stalls before "With Editor."

This is the core of the "With Editor" stage. The deputy editor reads the paper and evaluates methodological rigor, general-medicine relevance, and reporting quality, consulting the editor-in-chief for high-stakes papers. JAMA's fast triage returns clearly-out-of-scope work within 7 to 14 days; papers the editors want to keep move toward associate-editor input and in-house statistical review.

In parallel with the deputy editor's read, the deputy editor may consult an associate editor (a practicing academic physician) for subspecialty input, and JAMA's in-house statistical editors read the reporting checklists. This runs alongside the triage and adds 3 to 14 days that are invisible in the portal. Roughly 30 percent of papers reviewed have reporting-checklist problems significant enough to trigger a desk reject or an immediate request for revision. If your status sits at "With Editor" near the two-week mark, statistical review or associate-editor input is the most likely reason, not neglect.

Once the triage and statistical gate pass, the associate editor moves to recruit at least 2 reviewers, and that recruitment typically takes 7 to 14 days because reviewers with topic-matched clinical and methodological expertise are scarce. ScholarOne can keep reading "With Editor" during this window because it does not always break out reviewer recruitment as a distinct status, so a status that lingers at "With Editor" past two to three weeks most often reflects this recruitment step rather than an unfinished screen.

The "With Editor" stage ends the moment the editorial team either returns the paper (desk reject), recommends a JAMA Network transfer, or moves it to reviewer assignment. The portal label changing from "With Editor" to a reviewer-assignment or "Under Review" state is the single clearest signal that your paper cleared the tiered triage and the in-house statistical gate.

• Return within 1 to 7 days: Fast EIC + deputy editor triage rejection for general-medicine readership fit.
• Return within 7 to 21 days: Standard associate-editor desk rejection or in-house statistical-reviewer flag per the ~85-percent and 30-percent figures.
• Still With Editor at 2 to 3 weeks: Normal; usually associate-editor input or statistical review. Not a reject signal.
• Still With Editor past 6 weeks: A polite inquiry via the ScholarOne portal is appropriate; the screen may have stalled in statistical review.
• Status moves to Reviewers Assigned / Under Review: Screen passed. Your paper cleared the steepest filter in AMA-tier general-medicine publishing.

This is the most common anxiety we hear from JAMA authors during the editorial-screening window. The honest answer: no, 2 weeks past the fast initial triage usually means your paper cleared the general-medicine-fit filter that drives most desk rejections. The most likely explanation is that the deputy editor sought associate-editor input on subspecialty relevance, or JAMA's in-house statistical editors are reading your CONSORT, STROBE, or PRISMA checklist, neither of which the portal breaks out. That is a sign the editors see clinical value worth keeping, not a sign of a pending desk reject. Most "With Editor" delays at JAMA come from the statistical-review and associate-editor input steps rather than from a slow editor, because JAMA's front-door triage resolves general-medicine-fit cases quickly.

What you should NOT do during the first 6 weeks at "With Editor" is email the editorial office. JAMA associate editors are practicing academic physicians managing 30+ active papers around their own clinical practice; an inquiry mid-screen adds friction without accelerating the decision. If the status still reads "With Editor" past 6 weeks, a single polite one-line inquiry referencing the manuscript ID is reasonable.

• 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 With Editor at JAMA; JAMA has explicit prohibitions on dual submission.
• Confirm the abstract states the general-medicine implication before the specialty-specific nuance, because general-medicine fit is the most common desk-rejection reason.
• Confirm the CONSORT, STROBE, or PRISMA checklist points to specific Methods paragraphs, tables, and figures rather than vague "see Methods" language, since the in-house statistical editors read it at the screen.
• Prepare a JAMA Network fallback plan (JAMA Network Open, JAMA Internal Medicine, a JAMA specialty journal) in case the editor recommends transfer at the screen.

If your JAMA paper is returned at the "With Editor" screen rather than sent to referees, the cascade depends on what the editorial team cited:

JAMA Network Open is the natural JAMA Network open-access cascade for clinical-research papers where the general-medicine readership fit of the flagship is not met but the rigor is high; JAMA Network supports manuscript transfer with reviewer reports preserved (at the screen stage, transfer happens before reports exist, but the editorial assessment travels).

JAMA Internal Medicine is the JAMA Network cascade for internal-medicine-focused clinical-research papers.

JAMA specialty journals (JAMA Cardiology, JAMA Oncology, JAMA Neurology, JAMA Pediatrics) are JAMA Network cascades where the specialty editorial scope fits.

NEJM is the external general-medicine cascade for top-tier evidence-changes-practice clinical research, and The Lancet and BMJ are external general-medicine cascades. These journals operate independently from JAMA Network; assessments do not transfer.

The "With Editor" decision is not a referee evaluation; it is a tiered desk screen against four criteria, including a statistical gate. The table maps each to what you can confirm while you wait.

In our pre-submission review work with JAMA manuscripts, three named patterns generate the most consistent editorial-screen concerns and the most common reasons a paper is returned at the "With Editor" stage before any referee is invited. The practical question during the screen is whether the abstract, introduction, Methods, CONSORT/STROBE/PRISMA checklist, statistical analysis plan, and data-sharing statement already make general-medicine readiness and statistical trustworthiness auditable. JAMA's public guidance explains the tiered process and statistical-review culture; the Manusights layer is the manuscript-level pattern, what a waiting author can strengthen before the editors decide.

JAMA specialty-only framing flagged at the EIC + deputy editor triage. In JAMA manuscripts, the introduction and abstract sometimes frame an excellent cardiology, oncology, neurology, or infectious-disease result without explaining why the JAMA general-medicine reader should change interpretation, policy, screening, diagnosis, or treatment. The clinical question may be strong, yet the manuscript still reads to a subspecialty because the triage does not see general-medicine relevance. During the "With Editor" wait, check whether the abstract and first page state the broader clinical implication. If only the cover letter makes the general-medicine argument, the screen package is fragile because the cover letter is not what the editors weigh most heavily.

Check whether your JAMA framing reaches a general-medicine reader→

JAMA reporting-checklist and statistics gaps that surface at in-house statistical review. In JAMA manuscripts, an incomplete CONSORT, STROBE, PRISMA, or ARRIVE checklist, items that say "see Methods" without actual Methods coverage, unclear prespecified outcomes, missing-data handling, multiplicity adjustment, trial-registration timing, or subgroup-analysis logic often trigger a desk reject or an immediate request for revision before peer review begins. The weak point is rarely an ignored checklist name. It is that the statistical editors cannot trace each checklist entry to a specific Methods paragraph, table, or figure. If the manuscript is With Editor, use the wait to turn the checklist into a precise map so the paper is ready the moment the screen passes.

Check whether your JAMA checklist and statistics package are complete→

JAMA Network transfer logic that ends the screen in a redirect. In JAMA manuscripts, a rigorous paper may receive a transfer recommendation to JAMA Network Open or a JAMA specialty journal if the editors conclude at the screen that the work is sound but the general-medicine readership fit of the flagship is not met. Authors lose time when they treat that as failure instead of mapping the likely route. Before the screen ends, identify whether the issue is audience fit (which cascades well) or methods readiness (which needs repair before transfer), and build a transfer-ready response file. That map helps if the screen ends in reject-with-transfer rather than referee assignment.

Check whether your JAMA Network cascade plan is screen-ready→

This guide tells you what JAMA editors look for while the manuscript is being screened. The review tells you whether YOUR paper passes that tiered screen and statistical gate before the decision arrives. We have reviewed manuscripts targeting JAMA and peer general-medicine venues; the named patterns above are the same ones deputy editors, associate editors, and statistical editors flag during the screen. 60-day money-back guarantee. We do not train AI on your manuscript and delete it within 24 hours.

This page helps JAMA authors turn a static With Editor label into a concrete screening-window plan: check the general-medicine framing, CONSORT/STROBE/PRISMA checklist, statistical-analysis plan, data-sharing statement, and likely JAMA Network fallback before the editorial team finishes the screen.

Of the 86 manuscripts our team reviewed for this JAMA status-page pattern sample, the strongest screening-window signal was whether the abstract and checklist made general-medicine readiness and statistical trustworthiness visible before the senior editorial discussion had to reconstruct them from the Methods.

This page was created from JAMA's public Instructions for Authors at jamanetwork.com/journals/jama/pages/instructions-for-authors, JAMA Network editorial documentation (6,000+ submissions/year, sub-10 percent acceptance, EIC + deputy editor + associate editor tiered triage, fast front-door triage, 30 percent checklist-flagged at in-house statistical review), ScholarOne status-label documentation (literal "With Editor" / "Editorial Assessment" status, "Reviewer Invited" can revert to "With Editor" on declines), a live review of public search results for "jama with editor" queries in June 2026 (where the ranking results were generic cross-journal "with editor" explainers from author-services sites rather than JAMA-specific tiered-triage and statistical-review timing), and Manusights pre-submission review experience with JAMA-targeted manuscripts.

Source limitation: JAMA public materials explain the author requirements and editorial model, but they do not expose deputy-editor notes, statistical-review comments, or reviewer-invitation timing for a specific manuscript. In practical author terms, the useful task during the "With Editor" wait is to connect the screen to general-medicine framing, reporting-checklist completeness, statistical-analysis readiness, and JAMA Network transfer planning you can prepare before the editors decide.

For the JAMA Network landscape beyond the flagship, see JAMA Network Open (open-access cascade), JAMA Internal Medicine (internal-medicine specialty), JAMA specialty journals (JAMA Cardiology, JAMA Oncology, JAMA Neurology, JAMA Pediatrics), and external general-medicine alternatives (NEJM, Lancet, BMJ, Annals of Internal Medicine). Once your paper clears the "With Editor" screen, the next status is reviewer assignment; the JAMA Under Review guide covers what happens once at least 2 reviewers are invited.

Editors screen and triage manuscripts before any external reviewer sees them, with the in-house statistical review providing an additional layer at the screen, and the "With Editor" stage is where that triage happens. Preparing a response template that addresses general-medicine relevance, statistical methodology, and CONSORT/STROBE/PRISMA compliance accelerates revision rounds substantially once the screen passes.

For a pre-upload check of your manuscript against the JAMA general-medicine-relevance-plus-checklist-rigor bar before the editorial screen, our JAMA pre-submission diagnostic flags the framing and checklist-compliance weaknesses most likely to stall a paper at "With Editor."