Medical Publishing in Canada
Perspective From a Small National
Radiology JournalPeter L Munk MDCM, FRCPC, FSIR
Editor-in-Chief CARJ
Professor of Radiology and Orthopedics UBC
Section Head Musculoskeletal Radiology
Vancouver General HospitalOverview• Country of 34 million bordering USA with~350 million• 70,000 physicians in Canada• International journals widely accessed andused for publication

Overview• Numerous Canadian Medical Publications….
Canadian Journal of Respiratory Therapy
Journal of Obstetrics and Gynecology Canada
University of Toronto Medical Journal
Perspectives in Cardiology
Canadian Journal of Neurological Sciences
Canadian Journal of Surgery
Canadian Family Physician
World Journal of Nephrology and Urology
Cancer and Clinical Oncology
Journal of Medical Cases
Canadian Academy of Child and Adolescent Psychiatry
Experimental and Clinical Cardiology
Journal of the Canadian Medical Association
Canadian Association of Radiologists Journal
Gastroenterology Research
Journal of Mind-Body Regulation
Journal of Medical Internet Research
Canadian Journal of Geriatrics
Current oncology
Canadian Journal of Rural Medicine…………………………………………………………

Overview• 128 publications• Some in publication since 1911
• CMAJ largest circulation ~80,000 andhighest impact factor 8.22
• Most have much smaller circulation often
artificially boosted by drug company
promotional subscriptions

Overview• Most Canadians prefer publishing in widely
circulated American and otherinternational journals• Canadian journals often viewed as suitablefor “national” or “local” issues• Often treated as “journal of last resort”

Overview• Subspecialty journals– Small staff– Small budget– Frequently heavily subsidized by sponsoringorganization

So Why be an Editor of a Canadian(Radiology) Journal?
• Challenge• Share your experience and expertise• Use your knowledge and contacts in theradiology community• Influence the direction of radiology locally,nationally (- and beyond?)

What Should an Editor Have?
• Publication experience– Author & reviewer• Enough stature in the radiology community– Network of contacts / people ( author, reviewer,other editors, institutions….)• Organizational experience / leadership– Obsessive / compulsive (anal personality…..)– Timeline conscious
Adams PC Can J Gastroenterol 2009;23:157.

And Why Me?
• Challenge– Full Professor– Section Head– Experienced Authors, Conference Participant /Organizer– What next?
• ? Chairmanship• ? Administration• ……….. or what else?

Editor? And Why Me?
• Published• Reviewer– AJR– Radiology– CARJ– Skeletal Radiology– CMAJ– Singapore Medical Journal– Hong Kong Journal of Radiology– European Journal of Radiology

What is the Role of Radiology Journals?
• Disseminate new information– New techniques, validation of accepted orcontroversial practices• Provide forum for discussion– Airing of controversies, provision of opinions• Promote education– Trainees, CME

What is the Role of Radiology Journals?
• Role of any given journal defined byintended readership– Specialists? Generalists? Both?
– Research? Education? Policy/Politics? Other?

•••••••••••••••••••••••••••••

Korean Journal of RadiologyRadiology
Journal of Computer Assisted Tomography
Clinical Radiology
World Journal of Radiology
Japanese Journal of Radiology
Journal of Vascular and Interventional Radiology
Acta Radiologica
Hellenic Journal of Nuclear Medicine
Seminars in Musculoskeletal Radiology
Administrative Radiology Journal
Emergency Radiology
Academic Radiology
Abdominal Radiology
Skeletal Radiology
Klinische Neuroradiologie
Oral Radiology
Indian Journal of Radiology and Imaging
Ceskoslovenka Rentgenologie
Clinical neuroradiology
Journal of cardiovascular computed tomography
Seminars in musculoskeletal radiology
JBR-BTR : organe de la Société royale belge de radiologie
Critical reviews in computed tomography
Journal of radiology case reports
The open neuroimaging journal
Journal of the American College of Radiology
Journal de radiologie diagnostique et interventionnelle
Journal de Radiologie ………………….

Radiology Journals• PubMed– Indexes ~263 imaging journals ….. And there
are MANY others they will not index• Do we need this many journals?
• Do we need a Canadian journal (CanadianAssociation of Radiologists Journal)?

Role of the CARJ
• Journal of the CAR– Allows transmission of CAR ideas, values,initiatives etc….

• Vehicle for Canadians to publish– Uniquely Canadian issues or wider issues fromour perspective• CMEState of the CARJ 2009
• 1804 CAR subscriptions (315 electroniconly - residents)• 46 institutions (1 electronic only)Specific Problems – June 2009
• Very few manuscripts– Less than 2/3rds of an issue• Chaotic review process & Publisher Change(Canadian Psychiatric Association to Elsevier)– No tracking records or status data
– Angry authors• Office Problems– Records withheld– No handover process

Specific Problems – June 2009
• Shortage of Manuscripts– Canvassed radiologists across Canada and theworld– Attempted to track down manuscripts inreview and accelerate review

Specific Problems – June 2009
• Review Process Change– Review process stream lined by conversion tonew publisher and electronic platform– Almost impossible to retrieve old processmanuscript without any records– …… waited for angry emails and then
expedite reviews

Specific Problems – June 2009
• Editorial Office Revamped– Deputy editors appointed– New Editorial assistant– Quarterly editorial meetings– Annual meetings with CAR staff

Dr Savvas Nicolaou – Associate Professor UBC and ER/Trauma Imaging Director

Dr Kieran Murphy Professor and Vice-Chairman Universityof Toronto

Mr Michael Mudri - Editorial Assistant CARJ ( & JrAssociate)Changes made in the CARJ
• Format• Frequency• Themed issues• Removal of case reports• Alteration of CME format

Format• “The CARJ looks like a throw away……”• Frequency reduced from five per year tofour to allow sufficient thickness forbindingArticle Type• Case Reports– Rarely cited with strongly negative effect on
IF– Trainees directed to EuroRad– Don’t try to fool the Editor with a “Letter”• Reviews– Very popular– Ideal for CME– Greater citation rate

Themed Issue• Once a year
• Allows comprehensive focus on one topic• Emphasis on Reviews and Pictorial Essays• Facilitates CME

CME• CME changed to electronic only
– More efficient and less labor intensive– Improved record keeping– Frees up pages for papers• Articles with CME questions (all thingsbeing equal) prioritized for publication

CIRA Collaboration• Joint issue with Canadian Interventional
Radiology Association– “Canadian IR Journal”– Economies of scale– Shift some IR content from CARJ - increases
total pages

And have I Got Anything Out of This?
• Satisfaction(?)• Community of Editors• Conceptualizing ideas and realizing them
– Themed issues– CIRA collaboration– Electronic CME• Having my opinion heard…..

Editorials• Bring up contemporary issues• Deliberately create controversy anddiscussion• Leave personal stampCARJ 2012
• 1804 CAR subscriptions (315 electroniconly - residents)– 2010 2038 (498)– 2011 2135 (541)• 46 institutions (1 electronic only)– 2010 47 (36)– 2011 65 (35)Article Submissions• 73 2009• 298 2012
• 103 (june 15 2013)

Acceptance Rate
• 82% 2008
• 30% 2012

Ongoing Concerns• Reviewers– Never enough– Turnover of manuscripts• Financial– Limited money leads to limited space– Flexibility / creativity constrained

Research Gate
• Researchers’ Social Networking System• Dramatic expansion in the last 18 months• Increased the profile of Impact Factor• ?increased push to publish in high impactpublications• ? Drive away from lower impact journals

Ongoing Concerns• National and International profile &Impact factor are influenced by – Article type– Publisher bundling with other publications• Increase utility and relevance to CanadianRadiology• Expansion of page count and decrease inpublication delay