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Publishing scientific articles is often viewed as a requirement in medicine. Scientific output remains one of the main indicators of professional performance for researchers and physicians affiliated with academic institutions.

For frontline clinicians, however, publishing may be less of a requirement and more of an opportunity to strengthen critical appraisal skills, a core component of evidence-based medical practice.

The impact factor of a journal often carries considerable weight and is often regarded as a marker of prestige. However, experts have cautioned that it should not be the sole criterion used to evaluate scientific literature or select a journal for manuscript submission.

“The impact factor reflects the influence of a journal largely on the basis of citation counts,” explained Clarissa Baldotto, MD, a clinical oncologist, and president of the Brazilian Society of Clinical Oncology. “It is one way of measuring influence but depending on the specialty and the type of article being submitted, a journal with a lower impact factor may be a better fit.”

More important than publishing in a high-impact journal is the quality of the research itself. Deciding whether an article is of high quality requires careful reading and critical evaluation.

“Even journals with high-impact factors may publish articles that are not of the highest quality. There is no absolute criterion that allows me to determine whether an article is good before reading it,” said Diego Adão, MD, PhD, professor in the Department of Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil. “What determines the quality of an article is the use of appropriate methodology and adherence to the principles of evidence-based medicine.”

If the impact factor should not be the only consideration, what factors should guide journal choice?

Scope of the Journal and Target Audience

The first step is to ensure that the journal regularly publishes studies in its field.

“Sometimes you’ll submit [an article] to a reputable journal, but its scope doesn’t align with your research,” Baldotto said.

She recommended reviewing the journal’s website, where authors could find information about accepted article types and the journal’s scope. Reading recently published articles can also help decide whether a journal is a suitable fit.

Some publishers, including Springer Nature and Elsevier, offer journal finder tools that allow researchers to submit abstracts and receive suggestions for suitable journals. According to Baldotto, these tools are still underused despite their potential value.

Another important consideration is whether the journal will reach its intended audience.

“One of the goals of publication is to generate citations and ensure the article has an impact,” Baldotto noted.

A highly specialized article may have a greater influence in a niche journal that reaches experts interested in the topic than in a prestigious medical journal, where it could be overlooked by its target audience.

According to Adão, an article’s relevance is directly linked to how easily it can be found and read by a suitable audience.

“When a professional publishes in a high-impact journal, the article is more likely to be seen, cited, and recognized by peers, but that’s no guarantee,” he said.

Peer Review

The peer review process is one of the foundations of scientific publishing. The process may involve multiple rounds of revision before a manuscript meets the quality standards needed for publication.

“It functions as an external audit. This filtering process increases the likelihood that published information is reliable and free from major bias or inaccuracies,” Adão explained.

In practice, peer review begins after a journal’s editorial team completes a first assessment to find whether a manuscript meets the journal’s scope and quality requirements. Manuscripts that pass this stage are then sent to external reviewers.

“Every reputable journal uses peer review. If a journal claims to be of high quality but does not use peer review, that should raise concerns,” Baldotto said.

Reputable journals also make their editorial boards publicly available. The presence of recognized researchers with verifiable credentials is often a positive indicator of editorial rigor.

Reviewers may request substantial revisions to the methodology, analysis, or interpretation. If the requested changes are extensive, the authors may decide not to continue the submission process.

“Sometimes, [requests for] revisions come in that seem simple to address, so you make the changes and resubmit. However, the article goes through another round of review — and this can happen two or three times. It is precisely this back-and-forth that makes the process so time-consuming,” Baldotto said.

However, peer review is conducted on a voluntary basis. “There’s a debate about this in the academic community because it’s very difficult, time-consuming, and labor-intensive work. Scientists must familiarize themselves with the subject and conduct research to evaluate an article, all without receiving any compensation,” Baldotto said.

Although serving as a reviewer can strengthen an academic résumé, the activity may provide limited professional benefits for physicians who balance research responsibilities with clinical practice.

“There has been ongoing discussion about how to maintain review quality and reviewer engagement,” Baldotto noted.

Adão emphasized that peer review alone does not guarantee quality.

“We are talking about a process conducted by people, and people make mistakes,” he said. “That is why even peer reviewed articles in high-impact journals can sometimes have important limitations. When conducted rigorously, peer review is an important marker of quality, but it is not a guarantee.”

The growing availability of AI has prompted discussions about whether AI tools can accelerate the review process. However, Adão noted that no AI system has yet been validated for rigorous scientific peer review.

Response Time

After submission, patience is essential. High-quality journals often require months to complete the review and publication process.

Because peer review is voluntary, reviewers must balance their responsibilities with their own research, teaching, and clinical obligations.

“The capacity for peer review is limited by time and availability, which contributes to a backlog of manuscripts awaiting evaluation,” Adão said.

In contrast, journals that provide acceptance decisions within days and offer little or no substantive feedback should be approached with caution.

Journal Indexing

Researchers should also verify whether a journal is indexed in a recognized database. The major indexing services include Scopus, Web of Science, PubMed, MEDLINE, and Embase. In Brazil, SciELO and LILACS are important resources.

“In general, indexed journals are far less likely to be predatory because it undergoes a process that evaluates its quality control, publication frequency, and the quality of its articles,” Baldotto said.

Predatory Journals

The expansion of scientific publishing has been accompanied by the growth of predatory journals that charge publication fees without providing meaningful peer review. Their primary objective is financial gain rather than scientific quality.

Warning signs include:

• Unsolicited email invitations unrelated to your area of expertise
• Promises of rapid publication without peer review
• High publication fees with little editorial justification
• A history of sensationalist or poor-quality articles
• Lack of indexing in recognized databases
• Editorial boards that are unknown or difficult to verify

“Many applicants enter residency selection processes with articles published in predatory journals,” Baldotto said.

In some cases, authors may be unaware that a journal is predatory; however, such publications can negatively affect a researcher’s academic record.

Resources such as Think. Check. Submit, Beall’s List, and Preda Qualis can help researchers evaluate journals. The retraction Watch is another valuable resource for tracking articles that have been questioned, corrected, or retracted.

Costs and Access

Researchers who are new to academic publishing often hear that publishing in reputable journals is expensive and that predatory journals will publish articles if authors pay a fee. In practice, however, publication costs are often covered by research institutions or funding agencies.

In 2025, the Coordination for the Improvement of Higher Education Personnel announced an agreement with publishers including Elsevier, Springer Nature, and the Association for Computing Machinery to support access and publication opportunities for Brazilian researchers.

The only costs that may be borne by the authors are those associated with ensuring open access to articles.

“Open access can improve dissemination, but it does not make a journal higher quality,” Baldotto said. “The advantage is that you expand the article’s reach because access is expensive, and if the institution doesn’t cover the cost [of journal subscriptions], it’s difficult for researchers to access everything.”

According to Adão, many researchers lack the resources to cover open-access publication fees and are often unable to obtain institutional or grant support. As a result, many choose traditional publishing models.

Conflicts of Interest and Transparency

Finally, Baldotto highlighted the importance of a journal’s ethical standards, an aspect that is often overlooked.

Reputable journals require disclosure of conflicts of interest, registration of clinical trials on recognized platforms, approval of ethics committee when applicable, and disclosure of the use of AI during research or manuscript preparation.

Rather than focusing exclusively on prestige indicators, such as impact factors, researchers should evaluate editorial standards, credibility, transparency, and methodological rigor. These factors influence not only academic success but also the quality of evidence that ultimately guides clinical practice.

Letícia Naísa  is a journalist who holds a degree from Pontifícia Universidade Católica de São Paulo, specialization in Scientific Journalism from the Laboratory for Advanced Studies in Journalism at the State University of Campinas (Labjor/Unicamp) and is currently a master’s student in science and cultural communication at Unicamp.

This story was translated from Medscape’s Portuguese edition.