Context: The majority of the peer-reviewed clinical literature is edited by editors whose training in editorial matters may be limited or nonexistent. We suspect that editors are selected for their clinical or academic rather than editorial ability.
Objective: To test the hypothesis that editors of medical specialist clinical journals were recruited from active clinicians rather than those with evident ability or training as editors.
Design, setting, and subjects: Anonymous mail survey to editors of the 262 peer-reviewed clinical journals that had received at least 1000 citations in the 1994 Science Citation Index.
Main outcome measures: Training and editorial practices of editors.
Results: Replies were received from 191 editors (73%): in 1994 the journals they edited had 6060 (27300/1000 [maximum/minimum]) citations, 234 (740/31) source items, and an impact factor of 2.10 (18.3/0.2); nonresponders' journals had similar characteristics. Of the responding editors, 181 (95%) were part-time, 132 (69%) treated patients, and 164 (86%) were recruited by one of the following methods: election by a scientific society (49 [30%]), nomination by the previous editor (41 [25%]), or response to an advertisement (29 [18%]). There was no strong association between method of recruitment or formal editorial training and the status of the journal. Only 9% of editors in the United States send at least half of the papers to reviewers outside their own country, compared with 41% of editors in the United Kingdom and 73% in other countries, and 69% do not feel bound to follow the advice they receive concerning acceptance of papers.
Conclusions: Clinical journals are usually edited by practicing clinicians who are self-taught part-time editors, but willing to accept further training. They usually consult 2 reviewers, but exercise independent judgment on the acceptability of papers.