PLOS Medicine Submission Process

Stage 1: Initial submission

The initial submission is intentionally lightweight. You upload a complete manuscript text, but detailed formatting, final supplementary materials, and polished reference styling are not required.

This stage exists so you can get editorial feedback without the overhead of full formatting. PLOS Medicine will tell you within 2 weeks whether the work fits the journal. If it does not fit, you have lost minimal preparation time.

To submit, go to the PLOS Medicine submission portal. Create or log into your PLOS account. The corresponding author needs an ORCID.

Include:

• manuscript text with structured abstract (300 to 500 words)
• author list with CRediT contributions
• figures and tables
• cover letter (optional but recommended)

Do NOT include at this stage:

• final supplementary materials (unless they are ready)
• detailed PLOS formatting
• polished reference style

Stage 2: Full submission

If editors want to move forward, they request a full submission. At this point, you need:

• complete manuscript formatted per PLOS Medicine guidelines
• all supplementary materials
• fully completed reporting checklist (CONSORT, STROBE, PRISMA, etc.)
• data deposited in a public repository with accession numbers
• complete ethics declarations and conflict of interest statements
• trial registration number (if applicable)

The full submission goes to peer review.

The initial submission goes to PLOS Medicine's senior editors. They evaluate whether the paper should move to full submission and peer review.

Editors are asking:

• does this work directly inform clinical practice or health policy?
• are the findings relevant beyond one national context?
• is the study design strong enough to support the claims?
• is the topic relevant to PLOS Medicine's international readership?
• does the work represent a substantial advance over what is already known?

About half of all initial submissions are declined at this stage. The decline is typically fast (1 to 2 weeks) and includes brief feedback explaining why the paper does not fit.

If editors are uncertain, they may consult an academic editor with relevant expertise before deciding. This can add a few days to the screening timeline.

Full submissions go to 2 to 3 expert reviewers selected for their expertise in the study's clinical area and methodology. PLOS Medicine uses single-anonymous review by default (reviewers are anonymous, authors are visible). Authors can opt into open peer review where reviewer identities are disclosed and published alongside the article.

Reviewers evaluate:

• significance for clinical practice or health policy
• methodological rigor and study design
• appropriateness of statistical analysis
• completeness of reporting (against the relevant guideline)
• data availability and transparency
• whether the conclusions match the evidence

The review timeline is typically 4 to 6 weeks. First decisions from peer review arrive 6 to 8 weeks after the full submission.

Understanding the decision

• Accept: rare on first round. Usually follows revision.
• Minor revision: specific changes requested. The paper is close to publication.
• Major revision: substantive concerns about methodology, analysis, or interpretation. The revised paper returns to reviewers.
• Reject after review: the paper does not meet the journal's threshold despite passing initial screening. The decision letter will include reviewer feedback.
• Reject at initial submission: the paper does not fit PLOS Medicine's scope or significance standard. Brief editorial feedback is provided.

Published peer review option

PLOS Medicine offers the option to publish peer reviews alongside the accepted article. If authors and reviewers both consent, the reviewer reports are published with the paper. This is optional and does not affect the editorial decision.

Treating the initial submission as a full submission

Some authors spend weeks perfecting formatting before the initial submission. This misses the point of the two-stage system. Get the science right, present it clearly, and let the editors assess fit before you invest in formatting details.

Submitting without the global health angle

PLOS Medicine is not a general clinical journal. It specifically prioritizes work that informs clinical practice or health policy in international settings. A strong clinical trial that is primarily relevant to one health system may be better suited to BMJ or a specialty journal.

Not having data ready when the full submission is requested

If editors request a full submission, you need the data deposited and the availability statement finalized. Do not wait until the full submission request to start the data deposit process. Prepare the data plan alongside the manuscript.

Missing the reporting checklist at full submission

The initial submission does not require a finalized reporting checklist. The full submission does. If the editors request a full submission, have the CONSORT, STROBE, or PRISMA checklist ready to include.