The peer review process

Types of peer review

BMJ mainly operates the following four types of peer review:

  • Open peer review: Reviewer and author are known to each other. BMJ publishes the reviewer comments and previous versions of the manuscript alongside the accepted paper.
  • Single blind peer review: The names of the reviewers are hidden from the author. This is the traditional method of reviewing and is the most common.
  • Double blind peer review: Both the reviewer and the author are anonymous.
  • Triple blind peer review: The handling editor, reviewer and author are anonymous.

Each journal offers a different type of peer review, so please check on their individual websites for details.

Peer review process
  1. The Editor (and if appropriate the Associate Editors) will evaluate the manuscript for scope, fit, quality, originality, interest for the readership, etc. It will then be sent out for external peer review or rejected if it does not meet the criteria.
  2. When the required number of reviews have been received (usually two) the Editor(s) will consider the experts’ opinions and make an initial decision to accept, reject, or request a revision.
  3. If the decision is for revision, the author must respond to each comment made by the reviewers and Editor, and resubmit. Usually, the revised manuscript will be re-evaluated by the original handling editor, who will either make an immediate decision or send the manuscript for further review prior to making a decision. Some journals allow multiple manuscript revisions.
  4. If during the original submission process the author elected to have the manuscript transferred to another journal following rejection, they will be contacted by the editorial office to confirm that they still wish this transfer to take place.
  5. If the manuscript is accepted, it will be checked again by the editorial office before it is forwarded to the production department for publication. In order to ensure your accepted manuscript is not delayed, we urge authors to ensure that their manuscript is complete and all items completed prior to acceptance.

While this is a basic outline of the process, each journal has its own characteristics and so procedures and policies vary from title to title.
One thing that you can expect from each journal is help throughout the submission and peer review process from the journals’ dedicated editorial office.

The Instructions For Authors on the journal websites contain detailed information about each journal’s policy. However, if you are unable to find the answer to your question, our editorial staff will be on hand to answer your questions quickly and efficiently. Contact details for the editorial office are on the journal’s Help page. You can also check the status of your manuscript at any time by logging into the journal’s submission site.


While we aim to complete the peer review process as quickly as possible, please bear in mind that reviewers give their time voluntarily. There may be occasions where several reviewers are invited before the required number can be arranged, or when a reviewer fails to deliver a review and the invitation process needs to start again.
The average time to first decision is published on each journal’s website.

For more information on the peer review process, check out BMJ’s Research to Publication modules on Navigating Journal and Peer Review Processes and Surviving Peer Review.

Article provenance

BMJ is committed to transparency. Every article we publish includes a description of its provenance (commissioned or not commissioned) and whether it was peer reviewed. Articles described as ‘not externally peer reviewed’ will have been assessed by one or more of the journal’s editors.


If you believe that your article has been rejected unfairly please submit an appeal (rebuttal) letter via your Author Center on the journal’s online submission system. Do not try to submit a revised version of your article at this stage.
Appeals must be submitted within 30 days of the rejection decision. Appeals will only be considered if all specific points of the reviewers’ and editors’ comments are addressed in the rebuttal letter, and decisions will only be reversed if the editors are convinced that the decision was a serious mistake, or if the reviewers made errors of fact or showed evidence of bias. Appeals against editorial fit or the journal not being the right journal for the article are unlikely to be considered. If it is thought that the appeal is warranted, the article, reviewers’ comments, and author’s response will be reviewed internally by the editorial team. The editor will decide whether to invite a resubmission, send it to another external reviewer, or uphold the original decision. In all cases, the editor’s decision is final.

Revising and responding to referees’ comments

When submitting a revision, it is important that the response letter and revised manuscript correctly address each of the reviewers’ points. The response letter and revised manuscript must also be consistent with each other.