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THE A-Z OF MEDICAL WRITINGAtoZprel.qxd 22/02/00 13:49 Page i Tim Albert learnt the long words studying psychology and the shortones as a Daily Mirror trainee. He then worked for the broadsheetsand the BBC and was education correspondent of the New Statesman.Rampant hypochondriasis steered him into medical journalism, andhe was executive editor of World Medicine and editor of BMA NewsReview. Since 1990 he has run his own training company, deliveringhundreds of courses on writing to doctors and other health profes-sionals. He is a fellow of the Institute of Personnel and Development,organiser of the BMJ’s annual short course for journal editors, andvisiting fellow in medical writing at Southampton University.AtoZprel.qxd 22/02/00 13:49 Page ii THE A-Z OF MEDICAL WRITINGTim AlbertTim Albert Training, Surrey, UKBMJBooksAtoZprel.qxd 22/02/00 13:49 Page iii © BMJ Books 2000BMJ Books is an imprint of the BMJ Publishing GroupAll rights reserved. No part of this publication may be reproduced, stored in a retrievalsystem, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording and/or otherwise, without the prior written permission of the publishers.First published in 2000by BMJ Books, BMA House, Tavistock Square,London WC1H 9JRwww.bmjbooks.comBritish Library Cataloguing in Publication DataA catalogue record for this book is available from the British LibraryISBN 0-7279-1487-1Typeset by Saxon Graphics, DerbyPrinted and bound in Great Britain by J W Arrowsmith Ltd, BristolAtoZprel.qxd 22/02/00 13:49 Page iv ContentsForeword viiHow to use this book ixThe A–Z of Medical Writing 1AtoZprel.qxd 22/02/00 13:49 Page v ForewordThis book has not been written to be read – at least in the usual senseof starting at the beginning, ploughing on to the end, and thenremembering (at best) one or two points. I have written it for acompletely different purpose, which has come from my experiencesover the past 10 years working with doctors and other health profes-sionals to sort out a wide range of writing problems.It is clear that they face several difficulties when it comes towriting. They are torn between the pressure to communicate withpatients on the one hand, and meet the expectations of their peers forhorrendously prolix prose on the other. Although they will have hadno formal training on writing since they were 16, they will beexpected to publish in high status journals if they are to advance intheir careers. Writing cultures have grown up that are, frankly,destructive of effective communication and individual talent. And ofcourse, as trained doctors rather than trained writers, they have moreuseful things to do anyway.So this is not another reference book laying down rules ongrammar, style, or journalology, or the presentation of statistics orthe ethics of publication, even though I stray into these areas fromtime to time. What this book sets out to do is to give support, encour-agement, and informed advice, so that people who have foundwriting hard will somehow find it less hard. Acting on the experienceof training courses, I have chosen a large number of topics, which arearranged alphabetically, from abbreviations to zzzzz.Tim AlbertviiAtoZprel.qxd 22/02/00 13:49 Page vii How to use this bookI expect this book to be used in two ways. The first is as an old-fashioned companion, to be kept by a bedside or on a desk, so thatyou can dip into it during an otherwise idle moment and find the oddentry that will interest, amuse, stimulate or annoy. The second is touse it for advice and encouragement when you have a specific writingproblem. You have been asked to write an obituary, for instance, oryou are suffering from writer’s block. In such cases, you should turnto the specific entry, which in turn should guide you to other relatedentries, and in some cases to details of books that I have on my book-shelf and find useful. A word in bold type shows that there is anothersection also of use.This book, as the title makes clear, is a personal choice, and I amsure that many topics could have been dealt with differently, and thatsome important ones have been left out altogether. I hope that thisbook will evolve, and that we shall be able to make regular updates,both in the paper version and in electronic form. To that end I hopethat readers will send me their comments, including suggestions fornew items to be covered in the next edition, and other pieces ofadvice and comment. Finally I would like to thank all those who have helped, in theirvarious ways, with this book. These are Gordon Macpherson, HarveyMarcovitch, Pete Moore, Geoff Watts, Geert-Jan van Daal, DonRowntree, Margaret Hallendorff, Mary Banks and Michèle Clarke.The person who has suffered most for my art, as always, has been mywife Barbara, to whom I offer my special thanks.Tim AlbertDorkingtatraining@compuserve.comixAtoZprel.qxd 22/02/00 13:49 Page ix A–Z of Medical WritingAbbreviationsModern science writing is written increas-ingly in a kind of code, littered with phrases such as ‘a breakthroughin PE’ and ‘no laboratory monitoring of APT’. Proponents argue thatthis is inevitable; it reflects the increasing specialization of medicineand saves valuable space for yet more papers.Opponents say that abbreviations mislead and confuse. Oneperson’s British Medical Association will be another’s British MidlandAirways, or (as I once saw in a conference hotel in America) a BranchMarketing Assistant. The initials CIA are identified so closely with USspies that it may be difficult to remember that they also stand forcommon iliac arteries. The confusion intensifies when the abbrevia-tions disappear for a while, only to resurface after an absence of severalparagraphs when you have completely forgotten what they stand for.For this reason, and because they are in upper case, they slow thereader down. They also send a strong message to the reader: this is ourlanguage, if you are uncomfortable with it, you don’t belong.Those who want to avoid abbreviations can usually do so, forinstance by spelling out in full one of the component words: ‘theassociation’, ‘the airline’ or ‘the assistant’. If you do insist on usingabbreviations, make sure that you spell out the words in full at theirfirst appearance, and try to use no more than two sets per document(see acronyms; political writing).AbsolutesMany people use phrases such as ‘absoluteperfection’ and ‘completely exhausted’, where the first word isredundant (though not ‘totally redundant’!). See also tautology.AbstractsThere are two types of abstracts. There are thosethat stand on their own, as a means of securing an invitation topresent at a conference. I call these conference abstracts and theyhave an entry to themselves (see below).The other type are those that appear at the start of a scientific paper,summarizing the information contained in that paper. According tothe Vancouver Group, an abstract should state the purposes of thestudy or investigation, basic procedures, main findings, and the prin-cipal conclusions: ‘It should emphasize new and important aspects ofthe study or observation’. In some respects they are a marketing tool,ABBREVIATIONS1AtoZtext.qxd 22/02/00 13:51 Page 1 enabling potential readers to decide whether they should read thepaper in detail. With the development of electronic databases, theynow have a role as a stand-alone unit of scientific knowledge.Approach writing an abstract in the same way as you wouldapproach any other writing task (see process of writing). Don’t justtry to cut your article back to fit the space available, but treat this as aseparate piece of writing. There are two pitfalls to avoid.• Ignoring the specifications. Journals will make it absolutely clear inthe Instructions to Authors how they like their abstract to appear,and it is senseless to ignore these requirements. A modern trend isthe structured abstract, which has carefully defined sections tocomplete. Study the instructions carefully, and look at abstracts inyour target journal. One of the most commonly flouted require-ments is length: if they say 300 words they mean 300 words; anymore may be cut and your work could become meaningless.• Deviating from the original. It is not hard to find examples ofsubmitted (and sometimes published) articles where details in theabstract simply do not appear in the article itself. This danger isparticularly acute when the abstract has been written first. By thetime the paper has been written and the co-authors have agreed,all kind of subtle changes have been made.AcceptanceThe supreme moment when something youhave written is accepted for publication. Treasure it.AcknowledgementsAccording to the Vancouver Groupthese are the statements accompanying a scientific paper that ‘specify(a) contributions that do not justify authorship, such as generalsupport by a department chair, (b) acknowledgements of technicalhelp, (c) acknowledgements of financial and material support, whichshould specify the nature of the support; and (d) relationships thatmay pose a conflict of interest’. Naming people in this way assumesthat they endorse the contents, so you must have their writtenpermission. Technical help should be acknowledged in a separateparagraph. Journals will vary in their approach to this (seeInstructions to Authors). The word can have a slightly differentmeaning when it comes to books. In such instances it is used toacknowledge Copyright material.THE A–Z OF MEDICAL WRITING2AtoZtext.qxd 22/02/00 13:51 Page 2 [...]... someone has to edit them Those chosen may not have to spend hours researching topics just below the horizons of their immediate knowledge, but they will have a host of other problems Here are some tips 10 , BOOKS EDITING OF • Be absolutely clear that you want to do the book Editing takes up huge amounts of time, and will eat into the rest of your life It is flattering to be asked to edit a book, but... insisting that they want to contribute, but never get around to doing so Approach the project as you would any other writing task (see process of writing) Divide the chapter into manageable chunks of 100 0 words or so, and use the structure of a feature article for each section Your main reward will be satisfaction of a job well done You are unlikely to get paid, and if so it will rarely be above £200... have decided on your message and need to collect and arrange the information needed to prove it All you need is the message, a large piece of paper with at least one pen or pencil (some say more) and 5 10 minutes Write the message in the middle of the paper (‘All writers should buy a treadmill’) and then start asking questions (‘What kind of writers?’, ‘What kind of treadmill?’, ‘How should writers use... could be included if space permits All will be related to the message Breaks Locking yourself in a room for three hours at a time is unlikely to boost your creativity Try to write in short bursts of, say, 10 15 minutes, and make sure that you really are writing and not worrying about what you have just written (see free writing) 15 – THE A Z OF MEDICAL WRITING Nothing benefits a piece of writing more than... in the following five points • Message Work out the most important thing you want your readers to take away from your writing This is the message, and should take the form of a simple sentence of about 10 words For instance: ‘Wearing sandals with socks reduces the incidence of athlete’s foot.’ The key is to include a verb (‘reduces’, ‘increases’, ‘does not affect’, etc.) which gives it direction It will... those who know will lose confidence in the rest of your writing – and gleefully tell others of your shortcomings On the other hand, the nature of writing is such is that it is almost impossible to achieve 100 % accuracy So pay particular attention to things that matter: dosages, for instance, or names and titles And don’t become suicidal when the occasional error creeps in (see law of late literals) Checklists... to ‘write it up’ This sounds a straightforward task, but isn’t The main problem is that these conferences churn out thousands (if not millions) of words; the writer’s task is to cut them down to about 100 0 and arrange them in a way that will attract the uncommitted reader You clearly cannot cover everything and everyone, so these reports are neither a précis nor a set of minutes Avoid clinging to the . otherproblems. Here are some tips.THE A–Z OF MEDICAL WRITING10AtoZtext.qxd 22/02/00 13:51 Page 10 • Be absolutely clear that you want to do the book. Editing. acompletely different purpose, which has come from my experiencesover the past 10 years working with doctors and other health profes-sionals to sort out a