My rules for writing academic manuscripts: a #tweetorial

I love writing, and write with students/colleagues constantly, and yet the same issues pop up again and again.

Sharing this thread if useful. My take, everyone has a different style. #medtwitter #dermtwitter #meded

1. Communication is your number one priority.

The point of your manuscript is to tell a story or argument that the reader will receive. Your writing should easily walk the reader through your research or editorial. Never forget that.

Many people, especially students, have a “show all your work” mentality, perhaps afraid the reader won’t trust their authority. Data is important (yes, do the work), but only show as needed or you will bore the reader. You need a narrative, or you’ll lose people’s attention.

2. Avoid redundancy.

Forgive me if I repeat. Give the reader credit. If you say something once, don’t repeat, unless important. If generally understood to be true, you don’t have to explain, and put data into a figures/tables instead of text, if possible.

Interrogate every sentence with, "is this the most direct/brief way to serve the point?" If not, find a different way. Shakespeare wrote, “Brevity is the soul of wit.” (Imagine him on @Twitter). If a paper's on disease X, don't mention disease X constantly. Just every so often.

3. Avoid passive voice whenever possible.

Science/medical training beats into people that we must always avoid first person (e.g. “We”) and that pushes us to use the passive voice more, which also somehow seems more objective sounding. Yes minimize "we," but I firmly disagree.

Keep sentences active voice, and engaging/direct. Passive voice feels evasive and distanced. E.g. don’t say “The study was designed to test the validity,” say “We aimed to validate”; Don’t say “Medical care has appeared to be equivalent”, say “Medical care appears equivalent”

4. Simpler is always better.

You can say, “this study was determined to be exempt by the institutional review board.” (12 words) Or “This study was institutional review board exempt.” (7 words). And ask yourself, if you take a sentence out completely, is any understanding lost?

If not, cut it out. Every sentence and word should have to justify its existence to take up space. And don’t use a fancy word if it doesn’t add extra value. I love “exacerbate,” but “worsen” may be better understood.

5. Read the piece aloud.

That’s my best piece of advice for how to edit. When you read, do you find yourself stumbling over any turns of phrase? Do you get bored at any point?

Do you find yourself wanting to move on to another sentence, but your momentum feels stalled by more words to say? These are all signs of where you need to cut or simplify.

6. Don’t be afraid of writing a crappy first draft.

Always easier to work from a bad draft than from no draft. And sometimes you need a crappy sentence to inspire the more accurate turn of phrase.

Think of that first draft like Michelangelo did with his work:

“The sculpture is already complete within the marble block, before I start my work. It is already there, I just have to chisel away the superfluous material.”

Exactly!

7. Perfect is the enemy of good.

You want to have high standards, but don’t get caught in the trap of obsessing over insignificant details that won’t affect a paper’s acceptance. Obsessing over typos is often more a way to procrastinate and ignore bigger problems!

Anyhow, one typo is unlikely to be the difference between acceptance and rejection, so I say better to submit with one typo, and not waste extra days/weeks. (Proofread of course, but don’t let it stop you from submitting!)

8. Specific tips cutting down word count:

Get rid of filler words.

E.g. “which occurred when,” “were able to”, “a total of”, “who received” to “receiving”. Sometimes you can cut fillers like “the”, “a”, “an.”

Change “it is well documented that disease X is associated with Y.” (11 words) to “Disease X is well associated with Y(citation).” (7 words, more active, direct)

- Change words from singular to plural. E.g. “Each subject had 10 fingers” to “Subjects had 10 fingers”

- Make possessives, e.g. "of the patient" to "patient's"
- Hypenate words when possible. Will save you one word for every hypen added.
- Replace gerunds with active verbs. E.g. “Patients are turning to” to “Patients turn to”

- Unnecessary repetition. If a paragraph's topic sentence says "pathology findings,” you needn’t say “on pathology” again–it’s understood.
- Minimize adverbs (“very” “significantly”). Instead of “compensated monetarily,” say “paid”. Use strong, direct verbs to avoid extra words.

Specific phrases/words I change:

“has the ability to” – change to “can”
“utilize” – change to “use”
“amongst” – can almost always just be “among”
“delineate”- change to “describe”
“a lot” to “frequently”
“furthermore” to “further”

9. Other tips for better flow:

Two short sentences >> one long one.

Vary your transition words:
However, Certainly, Importantly, Interestingly, etc. – minimize but when needed, vary how you use. And you definitely cannot use more than one “furthermore” per manuscript.

Specialized words –

I have an affinity for certain words, like “myriad,” “exacerbate,” – but you can only use once or twice perhaps in the manuscript or it stands out. Use a thesaurus if you have to, but stick with the shorter, simpler synonyms.

Avoid using “This” without clear antecedent. Don’t say, “This has been seen with,” not as clear as you think. Add a word to clarify, “This phenomenon/This disease/This pattern has been seen with” will be better.

Avoid starting any two consecutive sentences with the same word.

10. Keep writing!

Don’t call yourself a bad writer, and anyway most doctors are terrible writers. But the more you write, the better you will get at it!

Resources:

Similar to some of my thoughts: George Orwell’s rules for writing: https://medium.com/personal-growth/george-orwells-six-rules-for-great-writing-4db6d31ff136

@nytimes on editing oneself: https://www.nytimes.com/2020/04/07/smarter-living/how-to-edit-your-own-writing.html

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