José G Merino, MD: On the Little Decisions That Shape the Future

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As the new Editor-in-Chief of Neurology®, the American Academy of Neurology’s flagship journal, Dr José G Merino has quite a task ahead of him. Not only has he recently taken the helm of a weekly, international journal that typically receives over 7,000 submissions a year, but he’s doing so in the middle of a pandemic that is rapidly changing how research and scientific discoveries are communicated. To see how he is managing this new position, Science Editor’s Patricia K Baskin, Executive Editor of the Neurology Journals, recently spoke with Dr Merino about his dedication to solid, transparent research and reporting practices while trying to stay ahead of the many changes occurring in scientific publishing.

Science Editor: Tell us a bit about your position now and how it fits into the organization.

José Merino: Last Spring, I became the Editor-in-Chief of Neurology, the largest neurology journal, because it publishes the most papers in the field of neurology, anywhere in the world. We publish issues 48 times a year, almost every week. And, our reach is worldwide. Our authors and our editors and reviewers are international. My job really is coordinating the work of 8 associate editors in the different areas of neurology and a large journal staff that is able to handle the 7,500 submissions we received last year, along with coordinating peer review and dealing with any editorial issues or controversies that arise. I also oversee the 3 other journals that have spun off from the main journal, Neurology: Clinical Practice, Neurology: Genetics, and Neurology: Neuroimmunology & Neuroinflammation. Our society, the American Academy of Neurology (AAN), is the largest organization of neurologists, and we are probably the largest group of neurology journals in the world. Two of those are fully Open Access journals.

Science Editor: How did you get involved in scientific editing and publishing?

Dr Merino: I’ve always enjoyed reading and thinking about journals. Even as a medical student, I subscribed to them, and I spent a lot of time in the journal section of the library perusing them. I spent a lot of money making photocopies (more than I could read!). When I was a clinical fellow after completing my residency, my mentor became the editor of a major journal, Stroke, and started involving me. I eventually became a member of the editorial board and did some projects. Eventually, I became editor of the science section of the AAN website and wrote a blog for the Stroke journal. I wanted to become more involved and started looking for more editor opportunities. In 2012, I was alerted that The BMJ was looking for an editor based in the United States who was also a researcher. I applied for that position, and after I became a U.S. research editor for The BMJ, all my nonclinical time was devoted to medical editing.

I was able to do less research because of the increasing editorial work. At The BMJ, I was handling manuscripts and participating, and sometimes leading, the manuscript meetings where we made decisions about which articles to accept for the journal. I also had a large outreach effort, meeting authors and researchers throughout the United States to encourage them to submit work to The BMJ, and participated in the growth of initiatives such as patient partnership, particularly as it related to involvement of patients in the review process for research papers. This was a very fulfilling position, where I learned the details of what being a medical journal editor is about. It prepared me for my current role as Editor-in-Chief of Neurology, where I can combine my editorial experience with my clinical and research passion, which is neurology. I decided to apply for it. It has been a very satisfying and fulfilling opportunity.

Science Editor: What do you enjoy most? What challenges are you facing?

Dr Merino: I enjoy the whole editorial process; that is, seeing a paper from when it’s submitted through the whole peer review process, to all the edits, to a final product. But, I also enjoy very much the different challenges we face as editors when we have to deal with controversies and difficult issues of scientific fraud and misconduct and other issues of publication ethics. And then, being an editor also gives you a perch from which you can try to shape the future of the field as a whole. I enjoy that as well.

Science Editor: I’m sure, as you know, most editors are in a position to influence the field, and this year there’s been the additional challenges with COVID-19. Can you describe how the epidemic affected the journal?

Dr Merino: When the epidemic began, we very quickly put out a call for papers that dealt with the neurological aspects of COVID-19. We’ve received an overwhelming number of papers in this area, as have many other journals. And, we’ve learned about the virus, the disease, and the challenges of curating the scientific literature during a pandemic. It has been a challenge because of the volume of manuscripts related to COVID that we have received, in addition to all the regular manuscripts that have been submitted. We had about 1,000 papers just related to COVID to appraise.

Although it put a strain on the editorial group and staff, it has been exciting in terms of seeing how the field has been developing. It’s also been interesting how COVID has highlighted some of the new areas in medical publishing such as the role of preprints, including the value and the limitations of preprints. Preprints allow rapid dissemination of research and knowledge, but sometimes they include research findings that are preliminary or erroneous, have poorly described methods, etc. During this time, we also had the challenge of “science by press release,” where some of the most relevant results of clinical trials and observational studies were announced via a press release and only days or weeks later, by a peer-reviewed manuscript. That can be confusing and frustrating.

Science Editor: What challenges did you see coming in as a new editor to a journal? And how would you like to put your mark on the journal?

Dr Merino: Neurology has always been a strong journal. It occupies a prominent position in the field, it has been well run and has solid editorial policies that promote transparency and clear reporting of medical research. These are some of the things that made the Neurology opportunity so attractive for me. I am fortunate that I did not have to start from zero, and I can modify what already existed. Every new editor comes in with a different view of how research should be presented, what type of research should be highlighted, what new areas, or maybe new sections to be developed, with different areas of emphasis. The COVID-19 pandemic actually has been a challenge because it has taken up so much time, so it’s been difficult to make a lot of the changes that could have been done at the beginning of the tenure of a new editor.

I think that we’re starting to see those changes—in terms of how manuscripts are processed. Some new sections are being developed to highlight some specific types of research. Neurology has also been leading in some of the issues regarding equity, diversity, and inclusion (EDI) in the material published. We’re seeing that incorporated not only into the papers we publish and the type of language that’s used, but also in terms of how EDI is represented on the editorial team and the editorial board. And, we have achieved gender parity in our editorial team and among members of our large editorial board. In those areas, we’re making great strides as well.

Science Editor: Let’s go back to your career aims and your thoughts about how you would talk to people who are not in your position. How would you describe what you do to someone without a science background or who doesn’t really know much about scientific publishing? What’s your elevator speech?

Dr Merino: Well, this is a challenging topic, because the first thing that people have to understand is that science doesn’t move in a linear direction. Part of what scientists and clinical scientists do, the way we work, is to come up with a hypothesis, trying to test your ideas. And at the end, you have a result where your test was positive or negative, and that’s what you’re submitting to the journal. What a medical journal editor does is appraise the quality of the research as reported, going back to the original question: Is this relevant? Are the research methods adequate to address the questions? Can I trust the results or are these affected by systematic biases? How do these results contribute to our greater understanding of the field? If papers meet these criteria, the editor works with the authors to improve the reporting to make the paper the best possible reflection of the work, and to disseminate these results in a way that makes them accessible to the rest of the scientific community, clinicians taking care of patients, and patients who want to learn more about their condition and the options that they have.

My day consists of making a lot of decisions. Do I send this paper for review, or do I reject it now? After receiving the reviews, should I send for revision or reject? Considering all the papers that we could publish, and the space limitations that we have, which papers should we accept? But then, there are other decisions like, what is going on the cover? What pictures should be there? Which articles should get a press release? It’s making a series of little decisions all day. I think that would be one way of describing what editors do.

Science Editor: Besides the ability to make decisions quickly and firmly, what skills or abilities or other personal attributes have you found to be essential to success?

Dr Merino: You have to be curious and interested because sometimes papers deal with topics that you have not thought much about. You have to be able to see their intrinsic value and engage with them. This means that you can keep learning new things all the time. I also think you have to be patient and you have to like reading. You also have to enjoy editing: how can I improve this manuscript? And, you need to have a thick skin because inevitably some people will disagree with some of your decisions. You have to be able to feel satisfied that you made the best decision that you could, but at the same time you need to have the humility to recognize when you are wrong. I think that curiosity, patience, a thick skin, and humility are the attributes an editor needs to have.

Science Editor: If you hadn’t pursued work in scientific publication, what might you be doing?

Dr Merino: Obviously, I would be working as a neurologist working on research in neurology, my area of acute stroke. And then, continue taking care of patients. I would just be spending more time doing that and less time doing an editor’s job.

Science Editor: Is there something that would surprise readers about you that seems incongruous with being an editor?

Dr Merino: When I finished high school, I wanted to become an economist, not a physician.

Science Editor: What are some of the biggest changes you’ve seen in the industry and where do you see scientific editing and publishing heading?

Dr Merino: The years I was at The BMJ were very important because The BMJ has been at the forefront of many of the changes that have come to the field. One of the biggest changes is that preprints have become a big thing. It used to be that you could only read results through journals; now you can get results through preprints, in addition to trial registries. Another big change that should get even bigger is greater transparency, a push for better reporting, and better registration of studies, not just clinical trials. The other big change has been the ability to leverage the advantage of the electronic media in terms of being able to publish longer papers and being able to provide more data—the big push now is to have greater data sharing and data transparency. Open Access has become important, bringing a big change and challenges to the industry. Different publishing models may have different benefits for different audiences. And, another big change that I’ve seen in biomedical publishing is the rise of patient engagement in the publication of research and the production of research. I think that may end up changing how we report research in journals.


Patricia K Baskin, MS, is Executive Editor, Neurology Journals.