Journal of Internal Medicine and the new century (2000)

The shift of a century has always in history been associated with expectations and fear. In our enlightened time, concerns are perhaps more focused on concrete matters such as the insecurity of computer systems and of possible applications of scientific achievements within high technologies to human beings. Also in clinical science, we are facing a rapid development of new diagnostic and therapeutic tools based on scientific progress [1]. The understanding of aetiologies and mechanisms of diseases within internal medicine is increasing at an astonishingly accelerating speed. Thus, the need for rapid communication of high-quality information is greater than ever Our Journal was founded in 1863 and has passed through several changes including language, content and name. The latest important step was taken in 1989 when the Journal became truly international, allowing articles not only from Scandinavian countries but from the whole world. Its name was changed from Acta Medica Scandinavica to Journal of Internal Medicine[2]. This change was rewarded by an increased inflow of high-quality manuscripts [3]. The revolution of information technology is timely associated with the shift of millenium. The ongoing development of high-technology communication may confer, for good and bad, dramatic impacts on the documentation of scientific progress. A first step has already been taken by most scientific journals, including our own, by making them readily available on the net. The consequences for high-quality information offered by these new options are intensely debated. The extreme standpoints range from those who claim that ‘like it or not, the days of ink on paper are numbered’[4] to those who believe that the printed journal will not disappear within a foreseeable future [5]. Recently, Harold Varmus, leaving director of the National Institutes of Health (NIH) advocated free presentation of original scientific information on the net [6]. However, this way of publication is associated with a clear risk of decline in quality because no peer review evaluation is involved. Other methods of electronic publication are under discussion. Thus, the Proceedings of the National Academy of Science may appear on the NIH new research archive, PubMed Central, from January this year for a trial period of one year [7]. The articles will be released six weeks after they become available for subscribers of the electronic version. A prerequisite is that only peer-reviewed articles will be accepted on this site. A number of factors are important to attract scientists to publish high-quality papers. Amongst those are the general standard of the journal, the time of publication and the availability of the journal for the readers. During the last few years, Journal of Internal Medicine has increased its rejection rate for scientific articles. Today only approximately 30% of scientific manuscripts received can be accepted. The Journal is now also available in an electronic version, which we hope will serve our readers as an important complement to the traditional paper issues. The future development of the Journal of Internal Medicine on the net is difficult to prophesy. This is partly up to our readers to decide. However, we believe that the greater availability of the on-line version, in particular when combined with a rapid publication, will attract our readers and contributors. Our goal is that manuscripts should be published within two months after acceptance. We are planning an opinion poll about the Journal in general, and on how electronic publication should be designed to attract scientists and readers. The routines for submission of manuscripts for publication in the Journal of Internal Medicine will be changed. Thus, beginning this spring, we will also welcome a transfer of manuscripts by e-mail. Communication with referees and authors by e-mail (in addition to fax) will be used to further speed up handling of manuscripts. We foresee the reorganization of the editorial handling of manuscripts to be completed by June 2000. Full information about the changes will appear in due time in ‘Instructions to authors’. In order to summarize the progress we have enjoyed during recent years, and to foresee development in important fields within internal medicine, we have asked Professor Sir David J. Weatherall to edit a number of articles which will be published during the year 2000 under the heading ‘Internal Medicine in the 21st Century’. His introductory comments and the first article appear in this issue [8, 9]. We plan to have 1–2 papers on the subject presented in each issue. We agree with Professor Weatherall about the need for a reappraisal of internists as generalists who serve the patients by integrating knowledge from the various branch specialities [8]. Now, even more than before, the Journal has an important function to serve this goal [1]. We welcome our previous as well as our new contributors and readers to help us to support the scientific development of internal medicine as one of the mainstays of modern health care. We wish you all A Happy New Year. Received 12 November 1999; accepted 12 November 1999.