On submission of the manuscript, the editorial review process begins with an initial reading by the Chief editor, looking at the relevance and novelty of the manuscript and its conformity to the journal guidelines, before either rejecting or considering it suitable for journal review process. Once considered suitable, it is then forwarded to reviewers or to one of the associate editors to assigns reviewers, who are subject experts in a field related to submitted manuscript. The reviewers report back within a given time frame with their comments, both for the authors and confidential comments for the editors. The editor then uses these reviews to make a decision on suitability of the manuscript for publication in the journal. The comments of the editors and the reviewers are then conveyed to the corresponding author.

There are four primary types of editorial decisions that are made: Acceptance, Minor revisions needed; Major revisions required, and Rejection – with the first one being highly uncommon. Any author worth his salt would have received most of these editorial decisions in his writing career.

If revisions are required, the author is required to resubmit the manuscript after modifying in light of the comments. The editor would again go through it and in all probability forward it to the same reviewers to assess whether their comments have been addressed satisfactorily and seek their opinion about suitability of publication of the revised manuscript. At any step, the editor and/or the reviewers may return the manuscript with a request for further revisions. The process continues till the modifications have been made to the satisfaction of the reviewers and the editor. The acceptance of the manuscript is then conveyed to the corresponding author.

There are slim chances that your manuscript may be accepted without any changes. If this happens, you may count yourself lucky, because such an editorial response is not easily forthcoming [1].

If only minor revisions have been suggested, it is advisable to do so without making any fuss. You should then send the revised manuscript back to the editor as soon as possible.

Request for major revisions, is the commonest editorial decision made. This means that the current version of your manuscript has been rejected, but would be reconsidered after the suggested changes have been made. It may feel like a body blow even to seasoned authors. But you must always remember that if major revisions have been suggested, you are still in the game and have a good chance of success. Moreover, the manuscript under evaluation is a product of your hard work. You can not afford to let it go without ‘fighting’ it out with all your might.

Once rejected, there is little you can do to get your paper published in the same journal. You must revise your manuscript according to the suggestions received and submit it to another suitable journal for publication.

An editorial decision for changes usually indicates that the Journal is interested in your article, which is good news [2]. In any other case, one must not be discouraged and you would be well advised not to fret. Take a break, and then re-read the comments. One should not take the reviewers comments personally. In most cases, the reviewers are blinded to the authors’ identity and the place of study. You must realize that they are only doing their job to the best of their ability and that too on complimentary basis just for love of research. Editors strive hard to make their journal better and this they can achieve by helping you improve your manuscript. Even though the comments may appear grave and direct; by and large they have been made in the spirit of constructive criticism [3]. After the cooling-off period, discuss the editorial decision with your co-authors and get to work on it. As all authors are equally responsible for the paper, it is prudent to get their observations and suggestions on the comments received and approval on the changes to be made.

It is worthwhile for an author not to immediately react to the comments of the reviewer with defensive reasoning. Try to understand the reasons behind the comments, look at the issues with a critical eye just like an ‘editor’ and not as an author. This will help you appreciate the reviewer’s point of view and may even help you to identify other factual or typographical errors which might have been previously missed. After having ‘educated’ yourself regarding the deficiencies in the manuscript you would find yourself in a better condition to revise the manuscript and respond to the reviewers comments.

Based on the reviewer’s comments, make the changes in the manuscript as planned. It is prudent to adhere to the journal guidelines while formatting the manuscript. Underlining or highlighting the modifications in a different color will make them easily visible. If the journal so accepts, the ‘track changes’ option of the software could be used to highlight the revision done. All this will help to facilitate the review. Do remember to also send a ‘clean’ (without track changes and highlighting) copy. The referencing style and the in-text citation must also be re-checked after revision.

Most of the Journals either use ‘US English’ or ‘UK English" as their preferred choice of language; check the journal guidelines and set your word processor accordingly. If there are major grammatical mistakes the reviewers may want you to get the manuscript vetted by a person who has reasonable expertise in ‘English language. You may sometimes be asked to reduce the size of your manuscript. Deletion and/or mergers of tables and/or figures is also requested by the reviewers. Suggestions of inserting of bulleted lists may also sometimes be given

As such these reviewer suggestions, especially those which lead to reduced word-count of the manuscript, should ordinarily be accepted. If the authors feel that suggested changes are not advisable, the editors should be requested for reconsideration. Journals are usually short of printing space and editors have to keep the final layout in mind, and so chances are that the editor is unlikely to heed to such requests. The other option of sending the unrevised manuscript to a different journal is always available.

Authors may consider a complete rewrite of the manuscript incorporating the suggestions available. But unless requested to do so by the reviewers, it is likely to be considered a new submission and the whole rigmarole and the emotional roller coaster ride of manuscript submission process would have to be faced again. In any case, treat the revision with same diligence as you had shown to the original version. Do not abandon the revision and the subsequent resubmission for long, as the chances of acceptance decreases with time

You may decide not to make any changes in the manuscript and submit the same to some other journal. But here lies the catch! There are chances that the manuscript may land up with the same reviewer as before. In that situation the reviewer is unlikely to bestow any kindness if his earlier issues have not been addressed to his satisfaction. As such any inherent issues present in the paper would have to be sorted out before the manuscript is finally accepted.

The response process is akin to be interviewed, you would be required to defend your position and paper. Do not underestimate the task. It might sometimes take a long time and a lot of effort to address the issues

The revised manuscript should be accompanied by a covering letter detailing point-wise modifications that have been made in the manuscript. The journal guidelines should be adhered to in the layout of the letter. There are three basic ‘tips’ or golden rules for responding to reviewer’s comments. Answer politely, answer completely, and answer with evidence [4]. It would be a good gesture to begin the letter by thanking the reviewers for their effort and time spent. A gratuitous approval in acknowledging the same is always appreciated by the reviewers and editors alike. The information given should be clear and concise. Do give raw data when asked for. The reviewer may want to cross check your results or calculations.

The comments of the reviewers/editorial board should be typed verbatim (ideally use copy-paste commands of the word processor) and point-by-point response provided while giving sufficient attention to details. If the comments are too many, they may be depicted in a tabular form with comments on the left and your responses on the right side. Try to identify the main concerns of the reviewers. Even if the comments are in form of big paragraphs it is advisable to split them into separate points and address them individually [1]. The changes done in the revised manuscript need to be mentioned along with the place where they have been made. The numbers of the page and the lines therein may also be cited wherever possible.

It is suitable to use present tense or past perfect tense in the covering letter, to intimate the changes made; for e.g." We now add the following sentence…………/ we have added the following line ….."[2].

It is not always feasible for the Journal editor to get two subject experts to review the manuscript within stipulated time. So he/she may have to get the manuscript reviewed by general experts only. On such occasions the comments from the reviewers may be conflicting and sometimes even differ drastically; though such occurrence is rare, it would be reasonable to go with one reviewer’s comments, justifying your reason to do so.

It is also human nature to make mistakes. Reviewers and even editors are known to make their share of errors in the review process [3]. You might sometimes not be willing to accept the opinion of the reviewers and are of the opinion that he/she is wrong. There is always an option of ‘disagreeing’ with the reviewer on certain points or comments. You would need to be thorough in your reply and give well-supported reasons for your divergent views. You will be well advised to watch your tone and tenor in your reply. Don’t try to justify/ argue unnecessarily. After all you need the reviewer/s to only yield to your point of view rather than become your ardent supporter.

You can always write to the editor imploring him to change the decision. However deriding the reviewers and questioning their judgment is a low yield strategy [5]. It is more in your interest to give it another shot and get your work published rather than to ignore it [6].

Even if your paper has been rejected, it is not the end of the world. In a previous study [7], the top reasons for rejection of articles submitted to Indian Pediatrics in one calender year were ‘absence of a message’, ‘lack of originality’, ‘inadequate methods’, ‘not relevant to journal’, ‘over-interpretation of results’, ‘unsatisfactory writing style’, ‘inaccurate/inconsistent/insufficient data’, and ‘inappropriate statistical analysis’, in that order. The rejection may not be a reflection of your manuscript. It happens, that for stated or unstated reasons, the editors decided that your paper was not what they wanted. It may just have been bad timings as the journal might have just published or accepted a study similar to yours [5]

A good paper would always get published in one or the other journal more often than not. In fact, out of papers rejected by Indian Pediatrics in the year 2002, 18% were detected to have been subsequently published elsewhere, some even in journals with Impact Factor higher than that of the rejecting journal [6].

One should consider the reviewers’ comments as free expert advice on the shortcomings of the manuscript. You must take the comments with all seriousness and respond to best of your ability. After all; you, the editors and the reviewers all are on the same side and would like to see a quality manuscript getting published.

1. Rocco TS, Hatcher TG, editors. The Handbook of Scholarly Writing and Publishing. San Francisco: Jossey Bass; 2011.

2. Kotz D, Cals JWL. Effective writing and publishing scientific papers, part XII: responding to reviewers. J Clin Epidemiol. 2014;67: 243

3. Shaw JD. Responding to reviewers. Acad Manage J. 2012;55:1261-63.

4. Millette D. Dealing with reviewer’s comments. J Orthod. 2006;33:69-70.

5. Cummings P, Rivara FP. Responding to reviewers comments on submitted articles. Arch Pediatr Adolesc Med. 2002;156:105-7.

6. Dewan P, Gupta P, Shah D. Fate of articles rejected by Indian Pediatrics. Indian Pediatr. 2010;47:1031-35.