Tag Archives: scientific manuscript

What I do

I have been meaning to do this post for a while, but finally got down to it after reading an excellent post describing substantive editing, and another post on the importance of building off your unique set of skills and background. For some reason, I’ve often struggled to describe exactly what I do, beyond saying I am a biomedical editor. There’s nothing wrong with that, it just fails to capture the nuance. I could get really philosophical about what it means to be an editor, but Rich Adin over at An American Editor has done a far better job at this than I ever could, so I will direct you to his excellent posts here and here. His characterization of the twin pillars of editing–mechanics and thinking–really struck me.

So back to my purpose. How do I describe what I do? Of course, what I do differs based on my client, so I will focus on what I feel I do best – scientific grant and manuscript editing. There are really several different levels of editing going on here.

1) Basic editing: Checking spelling and grammar, fixing awkward sentence structures, simplifying the language, and checking verb tenses and parallelism. This is a part of the “mechanics” pillar of editing.

2) Substantive editing: checking the flow and logic. How is the story being told? Is it clear what has been done and what needs to be done? It is clear what hypothesis is being tested and why? Are the right headers being used to help the reader through the document? Obviously this is part of the “thinking” pillar.

My goal here is to make the paper or grant proposal something that the reader wants to read, that the reader actually enjoys reading, rather than just skimming the abstract and figure legends. As a graduate student, I read many, many, many papers, but there were only a few that sucked me in because they were just written so well. There was a clear explanation up front about why the research was being done, each experiment in the results section flowed logically into the next, and the discussion put all the data in perspective, in the context of what is already known. I almost felt like I could see the authors at the bench, working through the data, designing the next experiment. Those are the papers I want my clients to publish. The same thing goes for grants – if anything is confusing or convoluted, the grant reviewer is going to pass it over. I edit grant proposals so that they are as clear and logical as possible, so that the reviewer immediately understands and appreciates the problem that needs to be solved, sees that the proposed aims will answer a clear set of relevant questions, and agrees that the methods used and people involved are up to the challenge.

3) Content editing: Another one for the “thinking” pillar. This is where my unique background fits in, where I can look at the experiments and the results and think about what conclusions are being drawn and whether they are being communicated accurately. Is the experimental design sound? What are the caveats? Are the statistics appropriate? Are the proposed experiments going to test the stated hypothesis? Have the data proven or disproven the stated hypothesis?  How do the data compare to what’s been done before? What are the implications for future basic or translational research? For research grants, I also draw on my background in promotional writing – will the science as presented convince the reviewer that this is a worthy problem (or gap in knowledge) to tackle and that the proposed experiments will provide the data needed to solve the problem?

4) Formatting: This also falls under mechanics – it’s making sure that the manuscript follows the journal’s editorial rules, and that the grant proposal follows the structure stipulated in the funding announcement. There are a ton of rules and regulations for preparing federal grants, and even more embedded in specific funding announcements.

So that is what I do…and now I can just direct friends and family here when they ask (hi mom!).

Descriptive vs. Experimental Research

Because I have this handy soapbox, I’m gonna use it. Here’s the thing. There is descriptive research and there is experimental research. Descriptive research on its own is not enough. You’ve got to get in there, change something, and see what happens. Just reporting on what you see under the microscope or on a blot is NOT hypothesis-driven science. Descriptive science is a starting point, it sets the baseline, the control state, what is known. Experimental research tests a hypothesis, which means altering a variable in the known system and seeing what happens – the result will lead you to reject or fail to reject either prove or disprove your hypothesis. Of course you’ll repeat the experiment in exactly the same way several times so you can be confident your results are statistically true. But then you’ll need to try changing something else, repeat, repeat, repeat, and so on.

In a research grant proposal (and I’m coming from the NIH perspective here), each aim should independently test your central hypothesis from different angles. Angles meaning using different methods or combinations of methods, or working at different levels (biochemical, molecular, cellular, tissue, organism, ecosystem, etc). What you learn in each aim will come together to shed light on the system you are studying.

Now, one of those angles might be descriptive, but I would argue that a purely descriptive aim is going to be your weakest aim. Devoting an entire aim to descriptive science breaks two rules in scientific grantwriting – descriptive science is not able to test your central hypothesis, and your aims must not depend on each other. (Because if one aim fails, there goes the entire proposal, and no agency will be interested in funding something so risky.) Any aim that is descriptive will be dependent on what you find in the other two aims.

The same descriptive vs. experimental idea applies to journal articles too. If your article is just descriptive, you’ve got half a manuscript. Sorry, but it’s true. The best, most compelling, field-advancing, paradigm-shifting articles are those that have a clear hypothesis, describe what is known (from descriptive science), and then describe a logical progression of changes made to the known and what happened. I know you’ve heard this before, but the best paper tells a story, leads the reader into the known system and the hypothesis, and then through each question, discovery, question, discovery, until the Discussion section brings the reader back around and gives some context. I know, some journals will accept purely descriptive articles, but in my experience, those are the smaller, second-tier journals. Not the Cells, Sciences, Natures, etc.

It’s getting more and more competitive out there – for research grant funding and publishing articles. So get in there. Get your hands dirty. Know your system then change it and see what happens.  Then change it again and see what happens. And if you need help telling your story, getting other people to understand exactly what it is you’re doing, I’ve got your back.

2011 Freelance Retrospective

Wow. Be careful what you wish for, I guess. The last three months have been absolutely crazy-busy. Which isn’t necessarily bad for a freelance. Looking back, it took me years to decide to finally take the plunge and become a full-time freelance, but only a few months to reach full capacity. As much as I love what I do, though, there is only one of me. And one of the hardest things for me to realize this year was that I do indeed have an upper limit of what I can handle. There comes a point when the brain just cannot function, let alone edit complex grant proposals, without adequate sleep. So as this year comes to an end and I start planning my 2012 project schedule, I hope I can remember the perils of being too busy, and that I will give myself a more realistic workload, even if that means even saying “no” once in a while. {{gasp!!}}

I’ve also come to realize that most of my clients are not one-project clients; again, not such a bad thing for a freelance. I am gratified and incredibly honored that the researchers I work with trust my ability and judgment, enough so that they come back to me with more projects. As I near a decade of providing editorial support for these researchers, I’m starting to realize that I have been a witness to their careers, as they are published, awarded funding, take on new post-docs and new graduate students, and shift their reasearch focus. It’s helped me to see the overall picture – the entire research program that stretches out over time and subtly shifts based on each new discovery – rather than a single research project or single manuscript. You know, I kinda like this view…I think I’ll try my hardest to keep it.

Finally, I’ve learned that having at least a few months’ pay in the bank as a cushion is not just a “nice-to-have” for a freelance. It’s essential. I simply hate waiting to be paid – the mental and emotional strain is incredibly disruptive, to the point where I start second-guessing my decision to go freelance. So next year, one of my highest priorities is to build up a proper savings account and remove that source of stress once and for all.

These are the things I have learned this year, things I will need to improve upon in 2012.

So what have I accomplished in 2011? The biggest thing is that I finally decided to go freelance full-time. I set up a proper office, with two computer screens, a kneeling chair, and time tracking software. I quickly realized that marketing myself would not be as easy (or hard) as setting myself up on ifreelance or with cold calling; in fact, cold calling would never work for the kind of services I provide. I turned instead to my blog, and then promptly discovered that I was too busy to post as regularly as I’d like! (Another thing I’d like to change in 2012). But I did gain a few new clients — who found me and decided to take a chance on me based on my blog posts, of all things. And I’ve found myself in the position of having to turn down projects. I went to the AMWA  Annual Conference in October and finished my basic skills certificate, and took a grantwriting course at Northwestern that was truly invaluable.

Goals for 2012? I listed a few above: more realistic scheduling, building strong relationships with my clients, and building a financial cushion. Others include attending the NIH grant course in Indianapolis in the spring, updating to EndNote X5 and gaining at least one more client-researcher. And taking one two-week vacation during which I will not work. At all. Even at night. I think that last one might be the most challenging goal to achieve, actually.

So that’s it. The freelance biz is up and running, a bit rocky at times, but it’s running. I think I might call 2011 a successful, busy, and tiring year for The Tobin Touch. But an extremely gratifying year, professionally speaking. I hope to get another post in before the end of the year, but if not, hope everyone has a great holiday and all good things in 2012!!

Back, and then forward

I suppose now is the time of year when I should look back at what I have accomplished and determine what worked, what didn’t, and what I could do differently next year. Unfortunately, I tend to over think everything, so I do this constantly (and obsessively), rather than limiting it to the end of the year. But I’ll go ahead and list some things I have learned…

Things that didn’t work:

Cash flow. This has got to be the most nerve-wracking part of being a freelancer. I just cannot seem get the hang of it. I thought I gave up my need to control things once I had kids, but this is a lack of control even beyond that. I am hoping that I can just learn to go with it next year, rather than harass the mailman daily about whether I got any checks. This is a tough lesson that I’m just going to have to learn if I want to continue with my freelance business.

Going after jobs with low hourly rates just to keep busy. I really don’t need any help in the “busy” department, and so I found that when I took these jobs, my attitude ended up in the toilet because I felt (rightly) that I wasn’t getting paid for the effort I put in. I had to let go of the notion that if I wasn’t actually working on a project I must be wasting time, when in reality, I was catching up on the business side, prospecting, replying to ads, researching, professional development, etc. I’m a much saner person for having realized this and for no longer taking on jobs with unacceptably low rates.

Time management and scheduling. My skills in this department are definitely lacking, and this is somewhat related to the previous issues. Scheduling is yet another thing I can’t completely control as a freelancer, but there are a few things I can do to spread projects out more evenly. Saying no to the low paying clients–or not going after those jobs in the first place–helped a lot. Another thing is setting reasonable deadlines and letting clients know that there is actually a queue – and that I’m not able to work on a job immediately. There’s no harm in asking for a later deadline, but there IS harm in having to extend deadlines. Best to acknowledge how busy I am up front and set deadlines I can actually make, rather than having to sheepishly call a client to ask for more time.

Things that worked:

Getting involved with AMWA. I went to my first national conference this year, as well as a chapter meeting and a freelance group meeting. All were incredibly rewarding experiences that validated my aspirations to become a freelance medical writer. I’m well on my way to the essential skills certificate, and the advanced workshops I took at the national meeting were fantastic; the grantwriting workshop in particular lit a fire under me to expand that side of my business. Above all, I met some great people who succeeded in drawing me out of my shell to talk shop. The most important lesson I learned from my colleagues: each of us has a unique background and training, and finding and promoting my niche within the medical writing field is going to be crucial. One day, I hope that I will be able to give back to AMWA – maybe even become a workshop leader – but right now, my capacity to volunteer is limited. In any case, I recommend to anyone thinking of a career in medical writing: get involved with AMWA. Period.

Taking the BELS exam. This was the first thing I did in the category of professional development this year. I wrote a post about it, and how it really served as another form of validation that a career in medical writing and editing was for me.

Plugging in. I launched my company Web site late last year, but really hadn’t done much to promote myself otherwise. I work part-time in healthcare advertising, and I started thinking about how to advertise my services. But because what I do requires a level of trust on the part of my clients–they are giving me their hard-earned data, manuscripts, and grants and asking for my help–word-of-mouth and networking are really the only two pathways to new clients. Any potential clients visiting my Web site would understand what I offer, but they really wouldn’t know me from any other writing service. Further, there is no metric to measure my effectiveness as a medical writer/editor, and so testimonials are key.

So, I started a blog as an extension of my company Web site so that potential clients could read my writing and see where I am coming from, what’s important to me, and my personal approach to what I do. I also set up a Twitter account (@thetobintouch) so that I could tap into the professional narrative and learn about the issues out there (open-access publishing, ghostwriting, science blogging vs journalism, and credentialing were pretty hot this year) and then share those issues–and my thoughts on them–through my blog. Keeping up the blog and scanning Twitter are time-intensive, but I feel it’s a worthy investment, not only for promoting my business and attracting new clients, but also for keeping up with my own professional development through interaction with peers and thought-leaders within the larger science and medical communications field.

Another plus for the blog: it gives me an outlet for all that constant self-assessment and business analysis – gets it out of my head and onto the page. Very therapeutic.

Things to do in 2011:

Update the company Web site. I’ve been looking at other writing and editing companies’ Web sites and gathering ideas for updating mine. In particular, I want to put some client testimonials up and maybe develop a flowchart showing the administrative and process steps for writing and editing projects. Also, a different head shot. I don’t look so tired these days!

Get my grantsmanship on. This is a big one for me. I’ve been helping out on more and more grants lately–NIH, NSF, NEH, and private–and I want to add grantwriting as an official part of my skill set. I’ve really focused on this part of my professional development in the last couple months, attending Web seminars and the AMWA workshop, and doing a lot of recommended reading.

Finish my AMWA essential skills certificate. Thanks to the self-study modules, I’ve been able to finish 4 of the 8 credits (medical terminology, statistics, sentence structure, and punctuation) – and I am working on 2 more now (grammar). I’ll be buying the next self-study module on ethics in 2011, and I’ll then I’ll have just one more credit to go. I’ve only been asked by one potential client if I have an AMWA certificate, but based on what I have been seeing on Twitter and LinkedIn, recognition of the AMWA educational program is growing. It certainly can’t hurt to have a certificate, in my opinion, and although the workshops have been humbling, they’ve been an excellent review of the basics.

So that’s it for 2010, I think. I hope everyone has a great holiday and great things happen for all of you in 2011! See you on the other side.

In which I defend my chosen profession from wily ghosts

Ah, ghostwriting. Yes, I believe I will step into the fray, thanks very much. Here goes nothing…

At AMWA’s annual meeting last month, the Keynote Address was given by William L. Lanier, MD, editor-in-chief of Mayo Clinic Proceedings, on the topic of preserving the integrity of medical literature. His talk focused on the role of the pharmaceutical and medical device industries (referred to broadly as “industry”) and their influence on the publication of clinical research. Thankfully, Dr. Lanier did not veer to one extreme opinion or the other on this controversial topic, neither defending the need for pharmaceutical companies to profit from their investment in R&D nor advocating a need to purify the medical literature of the taint of industry bias. Rather, he acknowledged the incredible impact that industry has had on medical science, the practice of medicine, and patient care, while also admitting that there are some who would try to hijack the peer-reviewed literature for their own gain, as evidenced by the HRT publication planning “scandal” that was revealed a few months back, and many others that have come to light since.

Once the floodlight was trained on the practice of publication planning and the use of ghostwriters by industry, there have been more than a few articles that have “exposed” these sinister practices and provided profiles of people involved. One particular story in The Atlantic profiled a medical ghostwriter, “David,” who has a background in life sciences research and ended up leaving academia to work at a communications company (sorta like me–maybe that’s why the article irked me so much). David described the type of industry-dictated spin that he was asked to put on his ghostwritten abstracts and journal articles as a source of personal humiliation and a true moral dilemma. He described the profession of medical writing and his fellow medical writers as sad, and the author of The Atlantic piece summed up this way:

Medical writing has little glamour, and whatever moral purpose it might once have carried has been rubbed away by the constant friction with commerce. If you are a true believer in the glory of the market, the work might be invigorating, and the long hours a mark of pride. But if you are a lapsed biologist, raised in the church of science but compelled to leave, it is apparently a source of nagging resentment. Says David, who for all his protests has yet to give up his job, “What a wretched epitaph to a life this would be.”

So…I had a pretty visceral reaction to this article. It really boiled down to the fact that not all medical writing is ghostwriting. To characterize the profession of medical writing as having no moral purpose, with the only source of pride being in furthering the profits of industry, is simply incorrect. Medical ghostwriting? Yes, absolutely. Medical writing? No. There are many, many kinds of medical writers, working for many, many clients who are not even connected to industry. Once I calmed down, I actually found it rather sad that “David,” who is portrayed as resentful and plagued by moral and ethical crises, has not learned that what he does–which is truly medical ghostwriting, with no acknowledgement that he is the actual author of the work AND with named authors who did not contribute–is not the only type of writing that is done by professional medical writers. I hope for his conscience’s sake that he is able to extract himself from his situation and find other ways to use his skills – it really would be a wretched epitaph if he never does.

The article also made me realize how little people understand that there are established ethics for medical writing. AMWA brought together a task force in 2002 to develop a code of ethics for medical writers and to delineate requirements for acknowledging the contributions of medical writers. As a result of their work, the task force published the AMWA Position Statement on the Contributions of Medical Writers to Scientific Publications, which can be found here. There is a fantastic FAQ on ethics in medical writing here, which includes these definitions:

“Ghost authoring” refers to making substantial contributions without being identified as an author. “Guest authoring” refers to being named as an author without having made substantial contributions. “Ghostwriting” refers to assisting in presenting the author’s work without being acknowledged. The term “ghostwriting” is often used to encompass all three of these practices.

What is “substantial contribution?” AMWA quotes the AMA Manual of Style on that one:

“A substantial contribution is an important intellectual contribution, without which the work, or an important part of the work, could not have been completed or the manuscript could not have been written and submitted for publication.”

So, back to our David. David is absolutely right in feeling that his work as a medical ghostwriter is morally perilous. In his current position, he is engaging in ghostwriting and ghost authoring, and the physicians being paid to put their name on his work are guest authoring (at best).

Medical journal editors are in agreement with AMWA and the general public in the recognition that ghostwriting needs to be rooted out and medical writers acknowledged for their contributions. Many, if not most, journals have accepted the International Committee of Medical Journal Editors (ICJME) Uniform Requirements, found here, which echo the same requirements for substantial contributions from named authors. But the journal editors can only do so much – in his AMWA Keynote Address, Dr. Lanier stated that medical writers need to remind their employers and industry clients about the ethical policies of the medical  journals to which they are submitting their manuscripts, and the consequences of being identified as a sponsor of ghostwritten articles. David should be listed as an author. Period. Easier said than done, I know. But that’s the issue.

What about acknowledging medical writers (and editors) who have not made substantial contributions to qualify as a named author? For example, I often help prepare manuscripts based on clinical study reports (CSRs), which involves formatting and rearranging information from the CSR into a journal article format and making sure it meets CONSORT requirements.

The discussion section might be the one place where I do a little more writing, and the place where a client might want some spin introduced. But even then, the CONSORT statement gives medical writers an ethical leg to stand on, by recommending a structured approach to the discussion section, as outlined by the Annals of Internal Medicine:

…Annals of Internal Medicine recommends that authors structure the discussion section by presenting (1) a brief synopsis of the key findings, (2) consideration of possible mechanisms and explanations, (3) comparison with relevant findings from other published studies (whenever possible including a systematic review combining the results of the current study with the results of all previous relevant studies), (4) limitations of the present study (and methods used to minimise and compensate for those limitations), and (5) a brief section that summarises the clinical and research implications of the work, as appropriate.

Preparing a manuscript from a CSR is not ghostwriting, in my opinion, but it does warrant some kind of acknowledgement. This is what the ICJME says:

All contributors who do not meet the criteria for authorship should be listed in an acknowledgments section. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chairperson who provided only general support.

So the demarcation for authorship vs. acknowledgement is substantial contribution vs. writing assistance.

I will sum up this lengthy post by saying that I was heartened by Dr. Lanier’s keynote address at AMWA in that it did not vilify industry or industry-sponsored research, but still acknowledged the need for transparency regarding industry involvement in publications of the research in the peer-reviewed medical literature. There must be a concerted effort among journal editors and professional medical writers to increase awareness of the ethical standards established by both groups regarding authorship and acknowledgement. Otherwise all medical writers run the risk of being mis-labeled as ghostwriters, like our sad friend David.

P.S. As a professional medical writer, I stipulate up front, in the service agreement, how my contribution will be acknowledged in the final article. Many times, the client is completely unaware of ICJME requirements or the policies of specific journals on authorship and they appreciate that I have brought the issue to their attention.

Giving in to the rollercoaster

I knew that this was going to be the hardest part of being a freelancer – the ups and downs of the work schedule. And I anticipated that it would be a source of incredible stress. I like order, organization, predictability. (Which is why I had such a difficult time after my first child was born – what a smack upside the head THAT was!) When the work load is light, I get anxious and start new projects (like, um, a blog, for instance), and when the work load picks up, like it did in the past couple months, I feel like I can’t catch my breath. When I come to a lull in the schedule, I look around me as if I am coming up for air. Then I dive right back in.

The learning curve for setting reasonable deadlines for projects and prioritizing them in a sane manner has been less steep than I’d hoped. But my personal scheduling prowess is only part of the problem. My work really centers around grant deadlines, and also tends to be heavier during the school year, since my clients are primarily academic researchers. I recently finished editing three back-to-back R21 proposals, with the October 16th deadline looming. July and August – pretty slow. Everyone is sharing their work at meetings, taking time off, and preparing for the next school year.

I’ll admit though, part of the problem is me – I really, really love what I do. I love editing, helping researchers organize their thoughts on paper, helping them create a persuasive story around their research. I find myself getting into a grant and looking up a couple of hours later, amazed at the time. I also tend to say yes to everyone. Why in the world would I say no? What it comes down to is giving myself enough time to work on all the projects I want to, and work on them with the level of intensity I want to.

So far, I’ve been able to take on all the projects I’ve been given, with very, very minimal shifts in deadlines. But I’ve learned the importance of setting reasonable deadlines and prioritizing up front, and accommodating with grace any project changes that might result in a steep rise on the rollercoaster (click, click, click). I may have very little say on the actual ups and downs, but I do have access to the brake when I need to slow it down.

What’s up with the ELS, Stace?

Around the beginning of the year, I decided it was time to get more involved in professional organizations, plug into my professional network, get in touch with my peers. And that’s when I found BELS.

What’s BELS? From their Web site:

The Board of Editors in the Life Sciences (BELS) was founded in 1991 to evaluate the proficiency of manuscript editors in the life sciences and to award credentials similar to those obtainable in other professions.

Why certification for editors?

  • To provide qualified manuscript editors in the life sciences a way to demonstrate their editorial proficiency.
  • To provide employers and clients of manuscript editors in the life sciences a way to identify proficient editors.
  • To establish a standard of proficiency for editing in the life sciences.

Potential employers and clients of manuscript editors usually have no objective way to assess the proficiency of editors. For their part, editors are frustrated by the difficulty of demonstrating their ability. That is why both employers and editors so often resort to personal references or ad hoc tests, not always with satisfactory results. The need for an objective test of editorial skill has long been recognized.

To meet that need, the Board of Editors in the Life Sciences developed a process for testing and evaluating proficiency in editing in the life sciences according to internationally recognized standards. The Board administers two examinations–one for certification and one for diplomate status. The examinations, written by senior life-science editors assisted by testing experts, focus on the principles and practices of scientific editing in English.

You mean I can be board certified? As a life sciences manuscript editor? No way.

So I sent in my application materials and was invited to take the credentialing examination. No sweat, right? I do this every day. I have been doing this every day for many, many years. But wait. What if I’ve been doing it wrong? (It went downhill from there.) This was a great opportunity to validate my career choice, prove to myself and others that I am an accomplished editor…unless I failed, of course. And that would open a whole other can of worms.

I finally talked myself into taking the exam, and sent in the fee. And then I took the sample test from BELS (which, by the way, contained a good representative sample of the questions that were on the actual test). I freaked. Even though I know AMA style like the back of my hand, I pulled it off the shelf and read through it again. Okay, I flipped through it. Thought about it, flipped through it a little slower. Came back a few days later and flipped through it again. Repeated the same exercise with the CSE manual. Basically, drove myself nuts for about a month or so.

The day before the test, I drove down to Indianapolis, got a good night’s sleep, and woke up early, ready to kill that test.

All my test-taking strategies came rushing back. Like riding a bike. I arrived early, but not first, and scoped out the best seat, within view of the clock. I set up my calculator and my pencils, even my huge “I Hate Physics” test-day eraser that I’ve been lugging around since college. I went to the bathroom – only to hear one woman say this was her third time taking the test. Zoinks! Didn’t need to hear that.

The test was timed – and I used every second. Don’t dwell on the tough questions, keep going and come back later. Mark the ones you’re not completely sure about to double-check if you have time. On multiple-part questions, read through all the questions first.

I wasn’t the first or the last one finished. I felt good, satisfied that I did the best I could. I drove back to Chicago, went back to work, and proceeded to worry about the test results. I know I sound neurotic, but really, how could I know how my editing skills stacked up to the industry standard?

So obviously, I didn’t need to worry. I passed, and I proudly added the letters signifying that I am a board-certified editor in the life sciences behind my name.