Developing Medical Writing Support in South Korea

The need for scientific-English support for non–native-English speakers in other countries is obvious, but the methods of execution are not always straightforward. The demanding workloads of biomedical scientists do not always allow them to embark on the seemingly long path of learning how to communicate effectively in scientific English. Throughout 19 months as a full-time medical editor at Yonsei University College of Medicine in the large, bustling city of Seoul, Republic of Korea (South Korea), I developed from a beginner writer and editor to a committed life-long learner in and contributor to the field of scientific communication. Recreating our work environment to promote efficiency and serve as a place of continuing education quickly became passionate goals.

When I entered the position, I was concurrently enrolled in my last semester of graduate school, working toward completion of a master’s degree in public health from Yonsei University. As the only foreigner and only native speaker of English, I was constantly challenged throughout graduate school to use my beginner Korean, adapt to the different work environment, and be the main “English resource” in the department. The latter role resulted in frequent requests from colleagues and professors to read and revise their manuscripts written in English. My colleagues and professors assumed that this would come naturally to me solely because I am American and have an undergraduate degree. I did not want to disappoint them, of course, but quickly recognized that I did not know and was never taught “best practices” in scientific writing. I called on my diligence and curiosity as an independent learner, which I had used to position myself in Korean graduate school. Aware that drafting my thesis was just around the corner, I began reading books about scientific writing and several newly published papers in top English-language medical journals each week, paying close attention to style and word choice. Unbeknownst to me at the time, those efforts would help me long after thesis writing when I joined the Department of Research Affairs as one of two medical English editors for the entire college.

The Department of Research Affairs at Yonsei University College of Medicine is, to my knowledge, the only one of its kind in South Korea. Yet South Korea is home to many biomedical research centers and peer reviewed biomedical journals with ambitious, hard-working researchers who competitively publish work. As a result, the need for specialists in fields who can aid these authors in publishing their work was evident. In 2007, the biostatistics and medical-editing branches of the department were launched, and a medical illustrator was recruited in 2008.

Shortly after medical editors joined the department, their duties spread beyond manuscript review, translation, and speech writing to all-around support in other fields and departments that required English. For example, the number of international students and guest lecturers who visited the college steadily increased, and this required documents and communication in English. In addition, editors were called on to assist in running biomedical-research symposiums and meetings with international guests hosted at the college.

The scope of our work has not changed, although the execution and management of our duties have changed. In addition to our diverse roles in the college, most of our time is still dedicated to editing manuscripts of original research. When I joined the department, I saw that a lack of clear guidelines and inconsistencies in workflow were creating long wait times for authors who submitted work for English editing. Some authors would ask to have the same manuscript viewed multiple times and sometimes by different people. That resulted in longer wait times and inconsistent levels of service. My first goal was to create guidelines that clearly communicated our available services and our expectations of work sent to us, including reasons why a manuscript could be rejected without editing. For example, we instructed authors to perform checks for basic grammar and spelling and to format for the target journal before submitting their manuscript for English editing. I proposed that all manuscripts be sent first to outside editing companies for full, comprehensive English editing, which had already largely been supported by the college since 2008, before submitting their manuscript to us, the in-house editors. This pre-editing greatly improved our ability to return work to authors in a speedy manner and to keep up with the large influx of work during the semester months.

Initially, those changes were met with some backlash from authors accustomed to the old system, but support and approval from the directors of our department allowed us to stand by our guidelines. The new workflow helped to create an equal playing field for all authors to submit work and receive it in a timely manner. It also created more work for our administrative staff members, who were required to screen all submissions and communicate our new guidelines before authors could have their papers viewed by in-house editors. But the new process was seen as an overall success.

Once our workflow was running more smoothly, the lack of direct communication and interaction between in-house editors and authors created an unnecessary distance that did not help authors to improve their manuscripts or writing. We theorized that if we could share our knowledge and observations with authors, perhaps we could mutually benefit. In November 2012, we opened our first workshop, “Oral Presentations in English”, in response to the substantial increase in the number of presentation scripts we received for English editing and voice recording that semester. Eager graduate students and professors filled the room to over capacity, hoping to learn something useful for future presentations (or perhaps it was the free coffee and snacks?). This year, we held another round of open programs that discussed problems in scientific writing that we believed Korean authors struggle with the most; the other in-house editor and I spoke on the basis of our experiences. Faculty members were encouraged to attend both sessions, which were received well.

To understand the audience’s reaction to the workshops, a short survey was distributed to workshop attendees asking whether they believed that the sessions were helpful and whether they had any other suggestions for sessions on scientific communication. After collecting just over 100 surveys, I was surprised to find that an overwhelming number of audience members asked for a “formula for writing” that would permit them to plug in their key words and draft their manuscripts. Having been excited and energized by the full seminars and the 98% positive feedback, I was initially disheartened by the request for a “plug and chug” approach to writing. However, I welcomed the open communication, and we came up with the idea of smaller workshops with limited numbers of participants that allowed us to work closely on writing exercises and to answer questions. The smaller workshops were also well attended and well received. Topics included how to use synonyms, articles, and transitions in scientific writing and how to write cover letters and respond to reviewer comments.

One of the major advantages of starting the workshops was that they opened lines of communication between authors and inhouse editors. Before the workshops, in-house editors rarely met with authors, and all communication went through administrative staff. The new interaction created mutual trust and understanding, and the number of complaints about guidelines and wait times decreased substantially. That led to the creation of editor office hours, when authors are invited to visit us for short advice sessions about anything related to scientific communication.

The last items needed to aid the editing process were such resources as books, manuals, and other educational materials that could be used to train future in-house editors and for general reference. Numerous reference materials have been purchased, and an educational training course for the next group of in-house editors is being developed.

Throughout my short but productive 19 months in my first role as a scientific-English editor, I came to see that the most important factor in developing and maintaining an English editing office in a large research institution is establishing cohesion among authors, editors, and administrative staff by setting reasonable, fair expectations and offering resources for all staff to improve their knowledge and skills in scientific writing. Despite the numerous challenges in writing for non–native-English-speaking scientists, more effort should be made by such institutions to distribute reliable, relevant resources widely to improve their ability to communicate effectively in science.

KATHERINE M STEFANI is a medical editor in the Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea.