Professional Documents
Culture Documents
Submission guidelines
Shortcuts to Research, Practice, Analysis, Commentary, Review, Humanities
Scientific articles should conform to the International Committee of Medical Journal Editors (ICMJE)
recommendations for manuscripts submitted to biomedical journals. The Canadian Medical Association Journal
(CMAJ) also follows the Committee on Publication Ethics (COPE) guidelines.
Cover letter (should provide context for the submitted manuscript within the existing medical landscape and
literature and should outline why you think your manuscript should be published in CMAJ. State the specific
contributions of each author to the preparation of the manuscript. Please note the maximum number of authors for
specific article types)
Title page (may be uploaded as a separate file, or as the first page of the manuscript)
title (for research, the title must include the study type)
authors' names, degrees (no fellowships) and up to two affiliations for each author
funding statement
Text (editable files), tables, figures, references, appendices (clear, legible; they should adhere to CMAJ's
requirements for the manuscript type)
Required At Revision
A contributor's statement (states the specific contributions of each author to preparation of the manuscript). Each
author must meet the four authorship criteria of the ICMJE: substantial contributions to the conception, design,
acquisition, analysis or interpretation of data for the work; drafting the work or revising it critically for important
intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of
the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately
investigated and resolved
Contributors who do not meet all four authorship criteria may be listed in the Acknowledgements section
photographs and images: high-resolution (300 dpi or greater), grayscale or CMYK, Graphics Interchange
Format (gif), JPEG (jpeg, jpg, jpe), Tagged Image File Format (tiff, tif); any manipulation of the image should be
identified in the Methods section; see examples on our Pinterest page
text should be written in the active rather than the passive voice
No footnotes
Multimedia, if possible; we encourage submission of video abstracts or clinical demonstrations on video; see
examples on our YouTube channel
If your article contains previously published material (table, figure, appendix, box) or modified material, you must
obtain permission from the publisher and/or copyright or licence holder. CMAJ Group's requirements are as
follows:
Commercial use
In perpetuity
FAQs:
Review the publisher's policy (look for: Terms of Use, Copyright and Permissions, Policies).
Compare the previously published, original material to that in the manuscript you are submitting to the CMAJ
Group. If the material in your manuscript is the same as or is a modified version of the source material, you need
to obtain permission. If you are modifying the material, the permission you obtain from the publisher and/or
copyright holder must specify that you are allowed to modify it. If you have consulted other sources to create an
original table or figure you do not need permission, but those sources should be referenced.
2. How do I determine who needs to give permission?
Find the original source online; there is usually a link to request permission.
If you are the author of the original article and hold copyright, please ensure that you have commercial
permission to reproduce.
If the material is published under a CC-BY-4.0 content license (which allows for commerical re-use), then you do
no need to request permission; however, in almost all other cases, you do. Please consult the publisher's policy.
CMAJ Group sells its material to online aggregators (e.g., EBSCO, Clinical Key)
Research Research about humans, with focus on patients, diseases, populations and 2,500 words
health services; topics relevant to the medical profession
Practice — Cases Common presentations of important rare conditions; important unusual 1,500 words
4 authors
Practice — What is Emphasizes an area of controversy or difficulty in diagnosis, investigation or 1,500 words
Practice — Highlights recent diagnostic and therapeutic innovations (e.g., devices, tools, 1,000 words
4 authors
Practice — Practical evidence-based approach to a common presentation in primary care 650 words
Decisions 7 references
Practice — Five 5 of the most important, most missed, most controversial or newest pieces of 300 words
things to know information on a topic of interest to physicians, general medical audience 5 references
about… 3 authors
Practice — Clinical Intriguing, classic or dramatic image(s); common presentations of important rare 300 words
3 authors
2 images
Practice — 360 Details the differing perspectives of people involved in a single healthcare 250 words maximum
Cases encounter to highlight interpersonal and systemic aspects of healthcare (case description) + 400
words maximum per
author; 2-4 authors, one
of which must be a
patient, caregiver or
family member
Analysis Assessment of current thinking on a topic and presentation of future options; 2,000 words
Commentary Opinion pieces on controversial issues in health care or clinical medicine 1,000 words
10 references
2 authors
Review Up-to-date guide to clinical practice based on comprehensive understanding of 2,000 words
4 authors
Humanities — Social analysis of the medical and health sciences; discussion of ongoing 1,400 words
Humanities — Narratives written by patients and health care practitioners commenting on their 750 to 1,400 words
Encounters experience of illness or medicine; personal, professional encounters with a
sense of immediacy and realism
See below for details on how news articles, letters, clinical guidelines, and supplements are handled.
Research
CMAJ publishes research of interest to a general medical audience that also contributes to the international
literature. This includes:
research about humans, including patients, diseases, populations and health services (NOT research on animals
or healthy human volunteers)
topics relevant to the medical profession (e.g., medical education, medical workforce, physician behaviour,
medical journal publication) including, but not limited to, CMAJ's four areas of focus — mental health, health of
vulnerable populations, health services and sepsis.
research that uses any method – including quantitative, qualitative and modelling methods – that is appropriate to
the research question
Maximum length: 2,500 words (longer only by agreement with the editor), excluding title page, abstract, figures,
tables and references. Accepted manuscripts may be published as a synopsis in print, with complete versions
appearing online.
For details about the review process, see Editorial process
If we judge an article to have demonstrated sound methods but it is not selected for publication in CMAJ, for
example, because the findings have limited generalizability, we may offer transfer to CMAJ Open. CMAJ Open also
publishes some types or research which CMAJ does not publish or only rarely publishes (e.g. case series, protocols,
quality improvement studies, and others).
Methods: This should include the research design, setting of the study, and participants, including
number participating and criteria for selection, entry and exclusion. The interventions, if applicable,
should be clearly outlined, as well as primary and secondary outcome measures.
Results: The main findings should be quantified with 95% confidence intervals and the number
needed to treat or harm, if applicable. Absolute, rather than relative, risks are preferable.
Trial registration: Registry and number should be included for clinical trials and, if available, for
other study types.
Results result for main outcome reported using absolute and relative terms (where possible)
5. Conclusion
Randomized trials
Registration: In common with other major medical journals, CMAJ asks that reports of randomized controlled trials
adhere to CONSORT guidelines and requires treatment trials to be registered in a clinical trials registry if patient
recruitment began on or after July 1, 2005. For more information, see Clinical Trial Registration on the ICMJE
website.
Data-sharing: We also require authors of clinical trials of drugs and medical devices to provide a data-sharing
statement that indicates (1) whether any, all or portions of the data are available to others; (2) where, through whom,
when and on what terms data will be available; (3) how data may be accessed.
Systematic reviews and meta-analyses should attempt to answer a focused question and adhere to PRISMA
methods. In some circumstances, we will publish secondary or duplicate publications of Cochrane or other
published reviews. Authors of such reviews must make it clear that the prior publication exists, and must seek the
permission of the other journal before submission to CMAJ. To be considered for publication, these reviews must be
especially relevant and important to the journal's readers.
Observational studies
Such studies need not be registered but if they are prospectively registered a registration number should be
supplied. All observational studies should seek to address a specific pre-defined research question and primary
outcomes should be outlined in a protocol before study inception. Observational studies should follow the STROBE
reporting guidelines. Those that make use of routinely collected data should additionally follow the RECORD
reporting guidelines.
Surveys
Survey studies and studies which use survey data should include a reporting guideline, such as CHERRIES for
reporting a web based survey, or COREQ for reporting interviews and focus groups. The 2015 CMAJ article on
"How to assess a survey report" is recommended for further guideance.
Practice
The Practice section publishes evidence-based, educational articles intended to be useful to practising clinicians. All
published articles have been peer reviewed.
For all practice sections, the writing should be evidence-based and authors should comment on the referenced
articles, instead of merely adding a reference number (e.g., "A well-designed randomized controlled trial found
that…", "Most of the evidence that supports this intervention comes from small observational studies…").
Authors of articles based on real patients must obtain patient consent before submission. See Author Forms for
more information. If the patient’s face is shown, or if distinctive markings (e.g., an unusual tattoo) are shown that
might make the patient identifiable, please include the patient consent form with your submission. A consent form
that indicates the patient is aware that they will be identifiable is preferable.
Each submission should identify a senior clinician or expert as guarantor so that readers can identify who takes
overall responsibility for the content. We request therefore that submissions include the following statement: "
[guarantor name] is the guarantor of the clinical content of this submission."
Submissions whose number of authors exceed the maximum for the article type must justify the presence of
additonal authors in the cover letter. Each author must be shown to meet the four authorship criteria of the ICMJE.
Visual and multimedia elements are encouraged for each type of article (high-resolution images, videos, boxes,
etc.). Also encouraged is a box with helpful resources for patients or physicians.
We particularly encourage submission of video abstracts or clinical demonstrations on video; see examples on our
YouTube channel
Cases
These are brief case reports that convey clear, practical lessons relevant to a general audience. Preference is given
to common presentations of important rare conditions and important unusual presentations of common problems.
Explicit demonstration of the diagnostic reasoning behind investigation decisions and the clinical approach to the
patient's symptoms is important for these submissions. Topics are varied and include, but are not limited to, CMAJ's
four areas of focus — mental health, health of vulnerable populations, health services and sepsis.
Structure:
1,500 word limit; up to four authors; up to 10 references, formatted in the Vancouver style
discussion of underlying condition (≤ 1,000 words) with an emphasis on practical information and new or changing
practice
visual elements (e.g., boxes with the differential diagnosis, clinical features or diagnostic approach, videos or
high-resolution images (300 dpi or greater)) are encouraged
include up to four key points – each in a short sentence – highlighting the article's main message
These articles emphasize an area of controversy or difficulty in diagnosis, investigation or treatment of a condition
and involve clinical reasoning. Topics are varied and include, but are not limited to, CMAJ's four areas of focus
— mental health, health of vulnerable populations, health services and sepsis.
Structure:
1,500 word limit (including questions, answers and discussion); up to four authors; up to 10 references formatted
in the Vancouver style
subheads are questions, each followed by multiple-choice questions and the answers; of particular interest are
questions involving steps in clinical reasoning
writing should be evidence-based and authors should comment on the referenced articles (e.g., "A well-designed
randomized controlled trial found that…", "Most of the evidence that supports this intervention comes from small
observational studies…")
visual elements encouraged (e.g., high-resolution (300 dpi or greater) images with captions, box of
patient/physician resources, differential diagnosis, videos)
Innovations
Recent diagnostic and therapeutic innovations (e.g., new devices, diagnostic tools, decision rules, therapies) are
highlighted. Novel uses of older treatments will also be considered. Benefits of the innovation, its availability and its
limitations must be highlighted — clearly but briefly. Topics are varied and include, but are not limited to, CMAJ's
four areas of focus — mental health, health of vulnerable populations, health services and sepsis.
Structure:
1,000 word limit; up to four authors; up to 10 references formatted in the Vancouver style
Introduction describing the setting for the innovation (why was it developed, what is the background, etc.)
Description of the innovation, including three subsections: What is it? How is it delivered? Who is eligible?
What can be expected in the future? (For example, should this innovation be widely adopted, what might help its
adoption?)
include up to four key points – each in a short sentence – highlighting the article's main message
visual elements (high-resolution (300 dpi or greater) images or videos) are encouraged
Decisions
Focus is on a practical, evidence-based approach to a common presentation in primary care (clinic or emergency
department). Include information that would usually be covered in a typical primary care appointment. Topics are
varied and include, but are not limited to, CMAJ's four areas of focus — mental health, health of vulnerable
populations, health services and sepsis.
Structure:
650 word limit and up to 1 box or figure; up to four authors; up to seven references formatted in the Vancouver
style
2. Three to four clinical questions addressing key decisions the clinician must make during the appointment (e.g.,
examination, investigation, treatment, harm reduction, follow-up, referrals); the questions should directly relate
to the patient described in the case
3. "Case revisited" section that provides a summary of the decisions/actions the clinician makes at the end of the
patient visit (e.g., testing, follow-up appointment, referrals)
'Five Things to Know' articles are meant as high-level summaries for clinicians on a range of relevant clinical topics,
with the main focus being on helping doctors in primary care and hospital practice. Our aim is to go beyond just
summarizing textbook information, to succinctly identify the most pertinent issues, especially in relation to new, high
quality evidence that changes the management of a condition or the use of an intervention. When preparing a 'Five
Things to Know' article, we suggest that you think in terms of the “what, who, where and when questions” facing
physicians. In general, the first two points should describe the clinical problem and/or intervention, putting it into an
epidemiological context when possible. Subsequent points move on to practical clinical guidance including relevant
investigations and interventions, which may include referral thresholds. When possible, please provide a measure of
absolute benefit or harm such as the number needed to treat or the absolute benefit or harm. Interventions should
be supported by recent guidelines, if available. Papers will be reviewed by generalists as well as specialists.
Articles present five key statements on topics of interest to physicians. The focus is on the most important, most
missed, most controversial or newest information on the topic. The articles are not meant to be comprehensive.
Areas covered may include diagnosis, prevalence, red flags, differential diagnoses, treatment, prognosis or recent
advances, and will vary depending on the topic. The information should be relevant to a general medical audience.
Topics are varied and include, but are not limited to, CMAJ's four areas of focus — mental health, health of
vulnerable populations, health services and sepsis.
Structure:
Each key sentence should be clear, short and specific, supported by one or two explanatory sentences and a
reference
2. What symptoms and signs do they have? How do patients typically present? What will help doctors recognise the
condition?
3. What is the sequence of appropriate investigations and where are they undertaken?
3. What are the benefits and risks? (Provide a measure of benefit and harm such as the number need to treat and
the number needed to harm)
Clinical images
Images are chosen because they are particularly intriguing, classic or dramatic. Preference is given to common
presentations of important rare conditions and important unusual presentations of common problems. Topics are
varied and include, but are not limited to, CMAJ's four areas of focus — mental health, health of vulnerable
populations, health services and sepsis.
Structure:
300 word limit; up to three authors; up to three references formatted in the Vancouver style
Figure and case pertaining to a real patient; clear, appropriately labelled, high-resolution (300 dpi or greater)
images must be accompanied by a figure caption
A brief case description is followed by a concise explanation of the educational significance of the images that
typically includes epidemiology, differential diagnosis, investigations, management and prognosis
We highly encourage submission of clinical demonstration videos to accompany the article. See examples on our
YouTube channel
360 cases
360 cases highlight the different perspectives of two to four people involved in the same health care interaction.
Perspectives may be provided by anyone involved with the case, including the patient, their family members, a
social worker, a caregiver, a physician, a nurse or any other health care professionals who interact with the patient.
All 360 cases must include the perspective of a patient, family member, or caregiver. These perspectives should not
be simply descriptions, but should be a reflection on the writer's own experience. Each contributor's perspective is
meant to stand alone; an over-arching narrative and literature reviews are not required.
Structure:
Length depends on the number of authors involved; two to four authors permitted
Each case consists of two sections:
1. case description (≤ 250 words) providing information about the patient, their medical condition, management
and outcomes
2. two to four perspectives of individuals involved in the case, either written (≤ 400 words each) or in audio or
video (≤ 5 min each) format; one must be that of the patient, their family member or caregiver
References are not expected for these submissions and are discouraged unless requested by the editors; if
requested, references should be formatted in the Vancouver style.
Guidelines
Clinical guidelines developed or endorsed by relevant national or international specialty societies, colleges and
associations will be considered. Payment of a publication fee is required for all guidelines published in CMAJ. The
fee must be negotiated separately with the publisher in advance of submission. That an author group is able to pay
the publication fee does not affect editorial decision-making.
We expect that guidelines adhere to the AGREE II reporting guideline and that a recognized tool such as GRADE is
used to grade the quality of evidence and strength of recommendations. In particular, relevant stakeholders should
be included in the guideline development group and competing interests need to be managed. All guidelines
submitted after January 1, 2020 need to adhere to the Guideline International Network principles for managing
competing interests in guidelines (full CMAJ policy).
GRADE
GIN principles
We strongly suggest that guideline developers contact editorial@cmaj.ca well in advance to discuss proposals.
Analysis
Analysis articles discuss a topic relevant to health policy or practice to further understanding of that topic area and to
offer solutions or suggestions for ‘next-steps’. Topics vary. Many discuss health systems and policy issues. Topics
are varied and include, but are not limited to, CMAJ's four areas of focus — mental health, health of vulnerable
populations, health services and sepsis.
Analysis articles are not long commentaries. As their name suggests, they must analyse something sufficiently well
to extend knowledge; description of a status quo (or two) and some unsupported opinion that this should change is
inadequate. Although analysis articles may have a Canadian focus, the international context of the topic must also
be discussed. While these articles do not present primary data, they may analyse secondary data, or discuss
particular cases using a framework or theory, for the purposes of extending understanding on a particular issue.
Analysis articles should be written in an evidence-based style, which means that authors must comment on, or
discuss, the type, quality, recency and findings of primary research cited. Merely making a statement and supplying
a reference is usually insufficient.
Structure:
Analysis article template
includes brief introduction (250 words mac) to indicate the direction of the article; must answer "Why should I read
this article?"
organize your article using a scaffold of subheadings framed as questions. Include details about the issue, most
important concerns (strength and weaknesses), knowledge gaps, future direction, recommendations for a way
forward, and more
can present a particular point of view, as long as the other side is presented as well (not necessarily equal in
length)
include up to four key points – each in a short sentence – highlighting the article's main message
visual elements encouraged (e.g., high-resolution image with caption, table, video, etc.)
Editorial contact: Prospective authors who have a well-developed idea and wish to discuss it before submission
should contact Dr. Dorian Deshauer (dorian.deshauer@cmaj.ca). To facilitate the process, send a fleshed out
summary of what you plan to write. An introduction that explains why readers of CMAJ should be interested in this
topic at this time, and a list of main points/arguments to be covered in the article, will usually suffice.
Commentary
Commentary articles are typically commissioned, but we sometimes accept unsolicited commentaries. They are
limited to 1,000 words and 10 references formatted in the Vancouver style, with a maximum of two authors.
Linked commentaries that accompany another article published in CMAJ (usually a research paper). Their aim is
to contextualize the specific research findings or provide extra information related to the subject of another article
or research paper.
Standalone commentaries are scholarly articles that discuss controversial clinical or health care policy concerns.
Authors may support one point of view, but articles must be written in an evidence-based, scholarly style.
Editorial contact: Prospective authors who have a well-developed idea and wish to discuss it before submission
should contact Dr. Dorian Deshauer (dorian.deshauer@cmaj.ca). To facilitate the process, send a fleshed out
summary of what you plan to write. An introduction that explains why readers of CMAJ should be interested in this
topic at this time, and a list of main points/arguments to be covered in the article, will usually suffice.
Review
Reviews provide an evidence-based, current guide to practice in a given clinical area. Although clinical reviews don't
require a rigorous systematic literature review, we expect that authors will base the review on a comprehensive and
up-to-date understanding of the existing literature. Topics are varied and include, but are not limited to, CMAJ's four
areas of focus — mental health, health of vulnerable populations, health services and sepsis.
Reviews are structured around five to six clinical questions that are clearly answered in the text and by tables and
visuals that help to present complex information. They should offer clear advice on how to apply existing evidence in
clinical practice.
Article should be evidence-based and authors should comment on the referenced articles, instead of merely adding
a reference number (e.g., "A well-designed randomized controlled trial found that…", "Most of the evidence that
supports this intervention comes from small observational studies…").
Structure:
2,000 word limit (excluding words in figures, boxes, tables, reference lists); up to four authors; up to 40 references
formatted in the Vancouver style
includes brief introduction (150 words) to indicate the direction of the article; must answer "Why should I read this
article?"; also includes a comment on the overall quality of the evidence
include a box describing the evidence used to develop the paper: details of your search (search terms, databases,
limits), brief description of the number of articles, type and quality of the literature
include up to four key points – each in a short sentence – highlighting the article's main message
visual elements encouraged (e.g., high-resolution image with caption, table, video, etc.)
Editorial contact: Prospective authors who have a well-developed idea and wish to discuss it before submission
should contact Dr. Andreas Laupacis (andreas.laupacis@cmaj.ca). To facilitate the process, send a fleshed out
summary of what you plan to write. An introduction that explains why readers of CMAJ should be interested in this
topic at this time, and a list of main points/arguments to be covered in the article, will usually suffice.
Humanities
This section provides readers with concise critical social analysis of the medical and health sciences. Scholars in
medical sociology, history, sociocultural anthropology and science studies examine biomedical practices and
theories in relation to political, sociocultural, economic, historical or technological developments. Discussion of
ongoing research is particularly welcome.
Submissions should include a maximum of 10 references formatted in the Vancouver style, and be no more than
1,400 words (including references). If appraised as being suitable for the category contributions will undergo peer-
review.
Encounters
Encounters are nonfiction narrative descriptions of health care experiences written by patients, clinicians, and other
caregivers. We encourage authors to reflect on their experience of health care and especially value contributions
that convey personal and professional encounters with a sense of immediacy and realism. Encounters must not
exceed 1,400 words. The writing should be candid, but must respect patient and colleague confidentiality in the
clinical context. Signed releases must be obtained from all people who may potentially self-identify. The forms are
available at cmaj.ca/content/forms
Encounters that potentially meet our needs undergo single-blind peer review. Final decisions are made by
consensus of a minimum of 2 editors.
News
News articles are written by professional journalists; ideas and news tips are welcome. Contact Lauren Vogel
(Lauren.Vogel@cmaj.ca) for more information or to discuss ideas.
Letters
We welcome correspondence and comment on articles published in CMAJ. To submit a letter, find the relevant
article on cmaj.ca, then, in the right-hand 'This Article' column, select 'Respond to this article'.
Supplements
Proposals for print and online supplements will be considered. Payment of a publication fee is required, and is
negotiated separately with the publisher.