What is the impact factor of New England Journal of Medicine?

New England Journal of Medicine has an impact factor of 78.5 (2024). This places it among the top-tier journals in its field with NEJM publishes clinical research that directly changes medical practice.

How long does NEJM take to review?

New England Journal of Medicine typically takes 21 days median to first decision. The full review process involves 6 main stages: presubmission inquiry (rarely needed), full submission, and peer review.

Is New England Journal of Medicine peer reviewed?

Yes, New England Journal of Medicine is fully peer reviewed. All submissions undergo rigorous peer review by Rapid triage by editors. High desk rejection rate (~80%). Focus on clinical significance and impact..

All Journal Guides

Journal Guide

New England Journal of Medicine Impact Factor 78.5: Publishing Guide

Q: What is the acceptance rate of New England Journal of Medicine?

New England Journal of Medicine has an acceptance rate of <5%. A common reason for rejection is submitting pilot studies as original articles. NEJM wants definitive answers. A 50-patient study showing a promising trend belongs in a specialty journal. Come back when you have the full trial.

Q: What does NEJM look for in submissions?

Practice-changing clinical impact: Will physicians change how they treat patients on Monday morning after reading your paper? If the answer isn't clearly yes, NEJM probably isn't the right venue.

Q: What should I know before submitting to NEJM?

NEJM wants definitive answers, not promising signals. If your trial is Phase 2 with exciting results, resist the urge to submit to NEJM. Complete the Phase 3 first. NEJM is where you publish the answer, not the question.

The world's leading clinical journal: where practice-changing research gets published

78.5

Impact Factor (2024)

<5%

Acceptance Rate

21 days median to first decision

Time to First Decision

What NEJM Publishes

NEJM publishes clinical research that directly changes medical practice. They want studies that every physician needs to know about, work that will be discussed at grand rounds worldwide the week it publishes. The bar isn't statistical significance; it's clinical significance.

Large-scale clinical trials with definitive answers to treatment questions
Studies that will immediately change clinical practice guidelines
Research with clear implications for patient care decisions
Public health findings of urgent importance
Novel therapeutics with practice-changing efficacy data

Editor Insight

“NEJM exists to change clinical practice. Every paper should answer the question: 'Should I treat patients differently now?' If your study is scientifically interesting but doesn't directly affect patient care, it belongs in a specialty journal.”

What NEJM Editors Look For

Practice-changing clinical impact

Will physicians change how they treat patients on Monday morning after reading your paper? If the answer isn't clearly yes, NEJM probably isn't the right venue.

Hard clinical endpoints

Mortality, major cardiovascular events, disease-free survival. Surrogate endpoints (biomarkers, imaging findings) are less compelling unless clearly tied to outcomes that matter to patients.

Large, well-powered studies

NEJM rarely publishes underpowered pilot studies. If you have promising Phase 2 data, they want the Phase 3. Adequate sample size isn't optional.

Rigorous methodology

Randomization, blinding, intention-to-treat analysis, pre-registration. NEJM has zero tolerance for methodological shortcuts. Your trial design must be bulletproof.

Global relevance

Findings applicable across healthcare systems, not just in well-resourced settings. NEJM has an international readership and values work with broad applicability.

Independence from sponsor interests

Industry-sponsored trials must have clear independence safeguards. Data access, publication rights, and author control must be explicitly addressed.

Why Papers Get Rejected

These patterns appear repeatedly in manuscripts that don't make it past NEJM's editorial review:

Submitting pilot studies as Original Articles

NEJM wants definitive answers. A 50-patient study showing a promising trend belongs in a specialty journal. Come back when you have the full trial.

Focusing on surrogate endpoints

Showing that a drug improves a biomarker is less compelling than showing it prevents heart attacks or extends survival. NEJM prioritizes patient-centered outcomes.

Burying clinical implications

Your abstract should make the practice implications crystal clear. Physicians reading NEJM are busy; they need to know immediately what this means for their patients.

Single-center studies without validation path

Findings from one institution raise generalizability concerns. Multi-center designs or clear plans for external validation strengthen submissions.

Protocol deviations without justification

NEJM scrutinizes adherence to registered protocols. Any deviation needs clear, documented justification. Post-hoc analyses should be labeled as exploratory.

Inadequate safety reporting

thorough adverse event reporting isn't optional. Selective reporting of harms undermines credibility and raises ethical concerns.

Does your manuscript avoid these patterns?

The quick diagnostic reads your full manuscript against NEJM's criteria and flags the specific issues most likely to cause rejection.

Run Free Readiness Scan →

Insider Tips from NEJM Authors

NEJM wants definitive answers, not promising signals

If your trial is Phase 2 with exciting results, resist the urge to submit to NEJM. Complete the Phase 3 first. NEJM is where you publish the answer, not the question.

The 'Monday morning' test is real

When evaluating your paper, editors ask: will a physician change practice after reading this? If the change is 'consider this option' rather than 'do this now,' impact is diluted.

NEJM has the fastest editorial process among top journals

They understand that clinical findings can be time-sensitive. If you have urgent results (pandemic, safety signal), communicate this clearly.

Editorials and perspectives are commissioned

You can't submit an opinion piece. These are invited by editors. Focus on Original Articles unless you've been contacted.

Pre-registration is scrutinized intensely

Your submitted paper must align with your registered protocol and outcomes. Any changes need explanation. Fishing expeditions are detected.

Patient-reported outcomes increasingly valued

Quality of life, functional status, patient experience: these complement hard endpoints. A drug that extends survival but destroys quality of life isn't a clear win.

The editorial process is thorough but efficient

Expect detailed statistical review. NEJM employs dedicated statisticians who will scrutinize your analysis plan and execution.

Negative trials can be published if well-designed

NEJM values well-conducted trials that definitively show a treatment doesn't work. These change practice too. They prevent use of ineffective therapies.

The NEJM Submission Process

Presubmission inquiry (rarely needed)

Response within 1 week if submitted

NEJM prefers full submissions. Inquiries mainly useful for highly unusual study types.

Full submission

Decision within 21 days

Complete manuscript with structured abstract, trial registration, CONSORT checklist (for trials), data sharing statement.

Editorial review

~10 days

Rapid triage by editors. High desk rejection rate (~80%). Focus on clinical significance and impact.

Statistical review

Concurrent with editorial review

Papers advancing to peer review undergo preliminary statistical assessment.

Peer review

3-4 weeks

Clinical experts and methodologists. Emphasis on validity, clinical relevance, and practice impact.

Decision

21 days median to first decision

Accept, reject, or revise. Revision requests typically focused and achievable.

NEJM by the Numbers

2024 Impact Factor(Clarivate JCR, 2nd in Medicine, General & Internal)	78.5
Submissions per year	~5,000 Original Articles
Acceptance rate	<5%
Desk rejection rate	~80%
Post-review acceptance	~25% of reviewed
Median to first decision	21 days
Weekly publication	52 issues/year
Readership	600,000+ physicians worldwide

Before you submit

NEJM accepts a small fraction of submissions. Make your attempt count.

The pre-submission diagnostic runs a live literature search, scores your manuscript section by section, and gives you a prioritized fix list calibrated to NEJM. ~30 minutes.

Run Free Readiness Scan See a sample report

Article Types

Original Article

2,700 words, 4-5 tables/figures

Full reports of clinical research, typically randomized trials

Special Article

Variable

Important topics that don't fit standard research format

Brief Report

1,200 words

Concise reports of important findings

Case Records of MGH

Case-based format

Clinical problem-solving cases (by invitation)

Landmark NEJM Papers

Papers that defined fields and changed science:

First use of ether anesthesia (1846)
SPRINT trial: intensive vs. standard blood-pressure control (2015)
Framingham Heart Study foundational papers (1961-)
Imatinib (Gleevec) for chronic myeloid leukemia - Druker et al. (2001)
Efficacy of COVID-19 vaccines (2020)

Preparing a NEJM Submission?

Get pre-submission feedback from reviewers who've published in NEJM and know exactly what editors look for.

Run Free Readiness Scan

Need expert depth? Human review from $1,000

NDA-protected

Confidential

Primary Fields

Clinical TrialsInternal MedicineCardiologyOncologyInfectious DiseasePublic HealthHealth Policy

Ready to submit to NEJM?

A desk rejection costs months. Get expert feedback before you submit, from scientists who know exactly what NEJM editors look for.

Need field-expert depth? Human review from $1,000