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Challenges in Starting
a New Journal

Nazeer Khan1, Masood Hameed Khan2

Dow University of Health Sciences has just started its medical journal, namely: Journal of Dow University of Health Sciences (JDUHS). This manuscript will enlighten the readers about the background and difficulties faced while starting of this journal.
The number of biomedical journals currently being published all over the world are somewhere from 15,000 to 17,0001. The problem is that mortality rate is quite high among journals, as well as the birth rate.2 Therefore, to start a new biomedical journal is a challenge for a society or institution. The editors, publishers and institution of new journals undertake such endeavors because they believe that these publications will make positive contribution in this field – as well as the literature.3
To start a new journal, there is no prescribed way to do the job. It all depends upon the resources available. However, there are some ideas and points which can be followed and implemented4. The sequence is also not very important.
Purpose or Mission: There should be a purpose (mission) of publication of new journal. Who, what and why should be clearly identified. Reader and the editorial team should be clearly indicated. JDUHS has started its publication under the publication department of Dow University. The Vice Chancellor is guiding the journal as the Editor-in-Chief and it was his idea to have medical journal for Dow University. Reason was very obvious. Dow University of Health Sciences (DUHS) has 8 constituents’ institutions, namely, Dow Medical College (DMC), Sindh Medical College (SMC), Dow International Medical College, Dr. Ishratul-ul-Ebad Khan Institute of Oral Health Sciences, Institute of Nursing, Institute of Medical Technology, National Institute of Diabetic and Endocrinology and Ojha Institute of Chest Diseases (OICD). There are two affiliated hospitals, namely Civil Hospital Karachi and Lyari General & Teaching Hospital. Its students and postgraduates have also got facilities of training at Jinnah Postgraduate Medical Centre (JPMC) as well as Sindh Institute of Urology and Transplantation (SIUT). DUHS is deeply rooted in the medical arena of Pakistan. One of its constituents, Dow Medical College (DMC) was established in 1942, even before the creation of Pakistan. The University has more than 700 teaching faculty and more than three thousand students. After DMC, SMC and OICD all combined were declared as DUHS about four years ago, many research activities were initiated. Many research projects have been developed and many are under progress. The research outcomes are emerging and need to be published. Therefore, there was a genuine need to start a medical journal to document these research activities carried out by the faculties and students of DUHS.
Competition: Even though this journal has a big readership of itself in the Dow University, it will have to create some space in medical community outside of its boundary of Dow University. According to PakMediNet, 53 biomedical journals are published from Pakistan and are indexed in its website. Therefore, the next challenge for the JDUHS is to make a respectable place among the medical community in Pakistan and abroad. To face this challenge, the editorial staff of JDUHS is working hard to achieve and maintain quality and respectable standard of this journal. The peer review system is strictly followed. The standard of editing and presentation is being maintained.
Selection of Editorial and Advisory Board Members: DUHS is a large medical university with several hundred teaching faculty. Many of them are very senior professors. They were interested and had the capabilities to be in the editorial or advisory board. It was very difficult for the Editor-in-Chief to pick up the right and the best team for editorial and advisory board for the journal.

Business Plan and Budget

Subscription Fee: It is very important for a new journal to have a solid business plan and reliable budget. Subscription fee should be one of the major sources of income. However, in Pakistan very few doctors and institutions subscribe to medical journals. Majority of the medical professionals wish to get it free of cost. A reasonable subscription fee has been proposed for the JDUHS. We hope to generate some funds from subscription.
Cost of Advertisement: The second main source of income could be from the advertisements. For biomedical journals, only pharmaceutical companies or medical suppliers could be interested to place their advertisements. For a new journal it is very difficult to get a reasonable number of advertisements. The journal has to have very nominal rates as compared to the market price to get some advertisements. Furthermore, it is also very important to decide the number of pages assigned for the advertisement. Too many pages will make the academic journal as commercial magazine and too little will offset the budget. However, due to the institutional attachment of JDUHS, we do not have very serious problem of finance right now. However, in future, we have to cover a significant part of the expenses by subscriptions and advertisements. Most of the advertisements in medical journals come from pharmaceutical companies. These companies have their own priorities, they would not welcome any adverse comments about their products and might insist on publication of company sponsored clinical trials which otherwise after peer review may not merit publication.5,6 There has been lots of data supporting the consequences of medical journals becoming dependent on this type of advertising.7 However, JDUHS will not be so much dependent on pharma industry support because its deficit is being covered by the institution itself. But we have to increase our income to cut down the deficits, without losing the academic freedom that is the core of medical information.
Circulation Plan: For a new journal, it is also important to have appropriate mailing list for introductory copiers. The first issue of JDUHS has been distributed free of cost to the faculties of medical universities, libraries, indexing agencies, corporate sectors and hospitals. It is also available at the university website: www.duhs.edu.pk, PakMediNet and EMRO websites.
Publicity: All in-house co-promotion and publicity opportunities, including conferences, magazines, newsletters and e-mail addresses, have been used to inform the medical community about the launch of the journal. A launching ceremony was conducted and print and electronic media personnel were there to cover the event.
Publication Schedule and Number of Articles: After thorough discussion on all related issues, we decided to publish two issues in a year to begin with. As we will get more experience and will get more articles, after recognition from Pakistan Medical and Dental Council and Higher Education Commission, the frequency will be increased. The number of articles, including, original articles, systematic review, case reports, short communication, commentaries, book review etc., would be about 12-13 per issue.
Editorial Staff Capabilities: Most of the editorial staff is working on honorary basis, because they are DUHS employees. Initially, we did not know the exact capabilities of those people. Due to this fact, we got some editing problem in the first issue. Proof reading was not up to the mark. However, the problem has been resolved successfully. The job descriptions of staff in the editorial team was also not very clear in the beginning. Now, all the ambiguities have been removed and the job descriptions of all the team members have been explained and approved from the editorial board.
Minimum Backlog of Accepted Articles: It is very essential for a healthy journal to have enough articles for at least two future issues. JDUHS had some problem to have enough articles in the first issue. However, after the 1st issue, the response from other researchers is very encouraging. We are planning to have backlog of at least one issue of accepted articles within one year. We are inviting capable authors to write other features, including book reviews, review of literature and editorial. The well-known researchers are being invited to submit their original articles for the journal. We have developed the system to know, number of articles submitted, number sent out to referees for review, number of articles revised prior to acceptance, review cycle time and number of articles accepted for publication.
Peer Review Procedure: Editorial criteria for peer review of articles was developed and approved by the editorial board members. The peer review process will be double blind and will be kept confidential. Reviewing form with rating system is being used for reviewers’ responses. Reviewers’ list with different specialty has been made and will be modified according to their responses. The acceptance, modification or rejection of the articles will be made on the basis of reviewers’ comments by the editorial board. However, editorial board will be the final authority to make the final decision.
Registration and indexing: For maintenance and progress, the journal must be registered in agencies like, ISSN, HEC and PMDC and should be covered by different index agencies, like, Science Citation Index Expanded, Excerpta Medica, IMEMR, INIS and Medline. We are able to register in ISSN and got covered in PakMediNet and EMRO, are working to register in other agencies. Policies for publications as suggested by College of Physician and Surgeons Pakistan have been approved by the editorial board.
In conclusion, starting a new medical journal is a challenging job. It is a team work, under the supervision of Vice Chancellor of DUHS, that we were able to accomplish this task. Now, the next task is to make the publication appear on regular basis on time and keep trying to improve the standard in terms of quality and material.


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2. La Porte RE, Marler E, Akazawa S, Sauer F, Gamboa C, Shenton C et al. The death of biomedical journals. BMJ 1995;310:1387-90.
3. Liebert MA. Responding to Alan Edelson’s comments about new journal start-up. www.library.yale.edu/~license/ListArchives/9910/msg00018.html
4. McHugh JB. 22 Ideas to ensure a Successful Journal Start-Up. www.publaw.com/22ideas.html
5. Jawaid SA. Problem faced by editors of peer reviewed medical journals. Saudi Med J 2004;25, Suppl.I:447-511.
6. Jawaid SA. Proceedings of First regional conference on Medical Journals in the WHO EMRO Region held at Cairo, Egypt. Pak J Med Sci 2003;19(4):330-43.
7. Talaga T. Fired editors launch online medical journal. www.thestar.com/printArticle/198412

1. Dr. Nazeer Khan Ph.D.
Professor of Biostatistics
Editor, Journal of Dow University of Health Sciences
E-mail: nazeer_khan54@hotmail.com
2. Professor Masood Hameed Khan FCPS
Vice Chancellor,
Editor-in-Chief, Journal of Dow University of Health Sciences
1-2: Dow University of Health Sciences
Baba-e-Urdu Road, Karachi – Pakistan.