The distress and frustration that doctors feel when their scientific paper article is turned  down by a medical journal now has an official diagnosis: ManuScript Rejection sYndrome or MiSeRY.

In a satirical article – that was accepted by the MJA – Victorian physician  Hui-Chen Han and colleagues from Austin Health say that ‘MiSeRY’ is becoming increasingly common in medical specialists as more of them seek academic publication to boost career prospects.

In a small survey of their peers, they found that their symptoms of MiSeRY mirrored the Kübler-Ross stages of grief.

• Denial: “Maybe they sent me the wrong decision letter. I should check the submission website and email the Editor just in case.”
• Anger: “How many more patients do you want?!
• Bargaining: “I wonder if I can reformat this as a research letter.”
• Depression: “Is it weird to be in the fetal position at work?”
• Acceptance: “I reformatted that in under an hour: a new personal best!”

In a review of 32 manuscripts submitted to medical journals they found there were 93 rejections (median, two rejections per manuscript).

Applying the standard study statistical techniques methods to the rejections, they found that in multivariate analysis,  ‘MiSeRY’ was significantly more likely for first authors of rejected manuscripts that had been sent for external review and for which authors had high pre-submission expectations of acceptance.

Wearily acknowledging that rejection is a part of other areas of daily life, (“I’ve had better hit rates on Tinder”), they suggest that would-be journal authors learn from their older peers .

“We hypothesise that senior authors, who have undoubtedly encountered MiSeRY during their formative research years, may have developed enhanced Coping and reLaxing Mechanisms (CaLM) that guard against a potential state of permanent MiSeRY,” they write.

“To help put authors out of their MiSeRY, journal editors could be more selective in the manuscripts they send for external review, while first authors need to temper their expectations and master the CaLM of their senior colleagues,” they conclude.