Rejected from BMJ Open? The 7 Best Journals to Submit Next

About 30-40% of BMJ Open rejections happen at the editorial desk, before peer review. Common triggers include missing ethical approval, protocol deviations in trials, inadequate reporting (not following CONSORT, STROBE, or PRISMA guidelines), and manuscripts that fall outside the journal's clinical scope. If you received a desk rejection, the editors didn't see enough methodological rigor to justify sending the paper out for review.

BMJ Open's reviewers are trained to evaluate study design, and the journal is known for catching issues that other mid-tier journals might overlook. Underpowered studies, inappropriate statistical tests, missing confounders, and poor control selection are the most frequent reviewer criticisms. If your paper received detailed methodological criticism, those issues will follow you to any clinical journal.

Clinical journals are increasingly strict about conclusions matching the evidence. If your observational study uses causal language, or your pilot trial claims generalizable efficacy, BMJ Open's reviewers will flag it. This is one of the most fixable rejection reasons, and addressing it can make your paper competitive at the same tier.

BMJ Open requires adherence to reporting guidelines (CONSORT for trials, STROBE for observational studies, PRISMA for reviews). If your paper doesn't include the relevant checklist, the editors may reject it without review. This is entirely preventable.

Before choosing your next journal, a BMJ Open manuscript fit check can tell you whether the issue was scope or something more fundamental to address first.

1. PLOS ONE

PLOS ONE is the most straightforward alternative after a BMJ Open rejection. The journal evaluates scientific validity rather than perceived significance, which means your well-designed study that BMJ Open considered insufficiently impactful can find a home here. PLOS ONE's acceptance rate (~50%) is significantly higher, and the APC ($2,477) is lower. The review process is typically faster too. If your paper is methodologically sound but the results weren't exciting enough for BMJ Open, PLOS ONE is the natural next step.

Best for: Methodologically sound papers with incremental or confirmatory results, any clinical discipline.

2. BMC Public Health

For public health and epidemiology papers, BMC Public Health is a direct competitor to BMJ Open in scope but with a higher acceptance rate (~40%). The journal publishes observational studies, intervention evaluations, and health policy research. It's part of the Springer Nature family and indexed across all major databases. If BMJ Open rejected your public health paper on borderline grounds, BMC Public Health's editors may view it more favorably.

Best for: Public health research, community interventions, health policy, epidemiological studies.

3. BMC Medicine

This is a step up, not a step down. BMC Medicine has an impact factor around 9, much higher than BMJ Open, and publishes strong clinical research across all medical specialties. If BMJ Open rejected your paper on scope grounds but the methodology is solid and the results are clinically meaningful, BMC Medicine is worth the attempt. The acceptance rate is around 10%, so this isn't a safety option. It's a targeted play for papers that were too strong for BMJ Open's scope but not quite right for the flagship BMJ.

Best for: Strong clinical trials, high-quality systematic reviews, and practice-changing research.

4. JMIR (Journal of Medical Internet Research)

If your BMJ Open submission involved digital health, telemedicine, mobile health, or health informatics, JMIR is likely a better fit. The journal's impact factor (~7) is higher than BMJ Open's, and its readership is specifically interested in technology-mediated health interventions. The JMIR family also includes specialty journals (JMIR Public Health, JMIR Mental Health, JMIR Formative Research) that cover narrower scopes with faster turnaround.

Best for: Digital health interventions, telemedicine, health apps, wearable technology in clinical care.

5. International Journal of Environmental Research and Public Health

IJERPH publishes across environmental health and public health, with a broad acceptance of study designs and methodological approaches. The journal's acceptance rate (~45%) and relatively fast review timeline (4-6 weeks) make it a practical choice when you need to get a paper published efficiently. For environmental epidemiology and occupational health papers that BMJ Open rejected, IJERPH reaches the right audience.

Best for: Environmental epidemiology, occupational health, global public health, health disparities.

6. Medicine (Lippincott Williams & Wilkins)

Medicine publishes clinical research across all specialties with an emphasis on case reports, clinical observations, and systematic reviews. The acceptance rate is around 50%, and the APC ($1,750) is one of the lowest for indexed open-access journals. If your paper is a case series or small observational study that BMJ Open considered underpowered, Medicine may accept it on the basis of clinical interest alone.

Best for: Case reports, case series, small observational studies, narrative reviews.

7. BMJ Open Quality

If your BMJ Open submission focused on quality improvement, patient safety, or healthcare delivery, BMJ Open Quality is a specialized sister journal that covers exactly that territory. The journal publishes QI projects, audit reports, and implementation studies that BMJ Open itself often redirects. If the rejection letter mentioned that a sister journal might be a better fit, this is likely what the editors had in mind.

Best for: Quality improvement projects, patient safety studies, healthcare process evaluations.

Desk rejected for missing reporting checklist? Complete the CONSORT, STROBE, or PRISMA checklist, attach it, and resubmit to PLOS ONE or BMC Public Health. This is a mechanical fix that should take less than a day.

Rejected for "insufficient novelty"? PLOS ONE evaluates validity, not novelty. Submit there. Alternatively, if the clinical question is important within a specific specialty, look for the specialty's mid-tier journal.

Rejected for underpowered study? If you can't collect more data, be honest about the limitation and frame the paper as a pilot study. JMIR Formative Research and Medicine are more receptive to pilot and feasibility studies.

Rejected for methodology after full review? Fix every issue the reviewers identified before going anywhere. Methodological problems won't disappear at a different journal. If the statistical analysis needs reworking, get a biostatistician involved.

Rejected for scope ("not clinical enough")? BMC Public Health or IJERPH may be better fits for population-level or environmental health research that doesn't center on clinical outcomes.

Complete your reporting checklist. Download the appropriate checklist (EQUATOR Network has all of them) and fill it out before submitting anywhere. Many rejections from BMJ Open and similar journals are entirely preventable with proper reporting.

Tone down your conclusions. If the reviewers said you overstated your findings, rewrite your conclusions to match the study design. Observational studies can't prove causation. Pilot trials can't demonstrate efficacy. Saying what the study actually shows, rather than what you wish it showed, makes the paper stronger at every journal.

Address every reviewer comment. Even if you're submitting to a different journal, the BMJ Open reviewers gave you a free consultation. Their feedback is probably similar to what the next journal's reviewers will say. Fix everything they flagged.

Consider a biostatistician. If statistical analysis was cited as a weakness, invest in a formal statistical review. Many institutions offer free biostatistics consultation for faculty, and the improvement in manuscript quality is substantial.

Don't just change the cover letter and send the same paper to the next journal. Run your revised manuscript through a manuscript scope and readiness check to catch formatting gaps, reporting compliance issues, and scope mismatches before reviewers see them. The fastest path to acceptance starts with fixing the problems, not just finding a different set of reviewers.

Resubmit to the same tier if:

• Reviewers praised the science but identified fixable issues
• The rejection letter mentioned "consider resubmission after revision"
• You can address every concern within 2-3 months
• No competing paper has appeared since your submission

Move to a different journal if:

• The rejection cited scope mismatch, not quality
• Multiple reviewers questioned novelty or significance
• Your timeline needs a decision within 2-3 months
• A specialist journal's readership would value the work more

Reframe before resubmitting anywhere if:

• Reviewers found fundamental methodology concerns
• The narrative needs restructuring, not just polishing
• New experiments or analyses are needed
• The rejection exposed a gap between claims and evidence

In our pre-submission review work with manuscripts targeting BMJ Open, four patterns generate the most consistent desk rejections worth knowing before resubmission.

Methodological reporting gaps that prevent evaluation of scientific validity. BMJ Open's peer review specifically assesses whether the study design and reporting allow readers to evaluate the validity of the findings. We see this failure as the most common pattern in BMJ Open desk rejections we review: observational studies missing STROBE checklists, clinical trials without CONSORT flow diagrams, or systematic reviews without PRISMA documentation. In our review of BMJ Open submissions, we find that editors consistently require completed reporting checklists as a condition of entering peer review, not just as supplementary compliance.

Sample sizes that are not justified by a power calculation. BMJ Open requires pre-specified or post-hoc power justification for study size. We see this pattern in BMJ Open submissions we review present clinical studies where the sample size is not explained relative to a primary outcome, or where the study is clearly underpowered for the conclusions drawn. Editors return these for statistical methodology concerns before assigning peer reviewers.

Ethical approval documentation missing or inadequate. BMJ Open requires full ethics committee documentation and participant consent statements. We see this failure regularly in manuscripts we review: studies from settings where IRB or ethics approval was not obtained or not documented, or where participant consent procedures are not described clearly enough to assess. These gaps trigger desk returns independently of the scientific quality.

Conclusions overreaching the observational or pilot study design. BMJ Open publishes preliminary, pilot, and observational studies but requires that conclusions match the study design. We see this pattern in BMJ Open submissions we review draw causal or definitive conclusions from cross-sectional or single-center pilot data. Editors consistently flag this mismatch between the study's evidential level and the language of the conclusions.

SciRev community data for BMJ Open confirms desk rejections typically arrive within days, with post-review first decisions within 6-10 weeks, consistent with the editorial cadence the BMJ Publishing Group maintains for its open-access titles.