I recently came across an interesting post on The Scholarly Kitchen titled Focusing on Value — 102 Things Journal Publishers Do. Originally posted in 2012, it’s been updated every couple years as journal publishing changes and becomes more complex. Working at JAMA Network, I’ve been amazed at the breadth of skills needed to publish our array of journals. As a copyeditor, I only experience a narrow part of the publishing process, so I appreciate the overview and seeing how all the pieces fit together.-Heather Green
editing process
How Many Is They?
Since I’ve been a manuscript editor, JAMA Network journals have published a few articles about health care for transgender patients. I’ve had the good luck to edit a few—they are always interesting—but this week, I realized that there is a grammatical issue in editing these articles that I have never heard fully addressed.
The issue is not what pronouns to use for transgender individuals—that question is well-known. Because the English language uses gendered pronouns, people who change their gender expression or whose gender isn’t accurately defined by labels are faced with several choices: should they go by she, he, a singular they, or a neologism, such as xe?
The news media has addressed this, including The New York Times articles in 2016 and 2017, with another written by transgender English professor Jennifer Finney Boylan in 2018. These articles often make the same points: that people can get confused by this transformation of language, but that people who want to use pronouns that reflect a gender different from their assigned sex should have their wishes respected. This squares with the approach used in JAMA Network journals.
But it also raises a question rarely addressed: what about verb conjugation? In the present tense, English applies a letter s to the third-person singular (he, she, or it runs) but not to the first-person singular, first-person plural, second-person singular, and third-person plural (I, we, you, and they run). So, if an article uses a singular they, should it be conjugated like the third-person plural (run) or like the third-person singular (runs)?
While editing, I have realized that the default method of using the singular they along with someone’s name (or a descriptor, such as the patient) involves flip-flopping between singular and plural verb conjugations (eg, “The patient is receiving gender-affirming treatment, and they are pleased with the outcome thus far”). A consistent use of the singular they would seem to require using third-person singular conjugations throughout (“The patient is receiving treatment…. They is pleased…”) or plural conjugations throughout (“The patient are receiving treatment…. They are pleased….”). Is either approach correct?
The public discourse on pronouns has not provided much insight. It has prompted the argument that we all use forms of singular they-series pronouns in casual language, in sentences such as “If someone wants gender-affirming treatment, that is their choice” or “Give them an injection.”
But that is distinct from the current issue. In these usages, the pronoun is usually objective (them) or possessive (their or theirs), and the verb is conjugated in the third-person singular alongside another subject. (In the example sentences, these are “someone” and “that,” and in the command, an unspoken “you.”) When the singular they is placed immediately before the verb, the question of conjugation instantly reappears.
Weighing “they run” vs “they runs,” I looked for guidance in the AMA Manual of Style. It offered a few relevant thoughts: “In an effort to avoid both sex-specific pronouns and awkward sentence structure, some writers use plural pronouns with singular indefinite antecedents… Editors of JAMA and the Archives Journals prefer that agreement in number be maintained in formal scientific writing.”
But that seemed short of clear instructions. Still uncertain if constructions like “they is pleased” would please anyone, I reached out to Jennifer Finney Boylan, the New York Times contributor whose article on pronouns was published in 2018.
A quick email to her university address got an equally quick response. “I’m not certain about this,” she wrote. “I want to endorse ‘they is’ because the non-specific pronoun is still referring to a singular individual. On the other hand, ‘they are’ sounds better to my old, English professor ears.”
That seemed similar to how our society is handling the matter. On her authority, I decided to stick with conjugations that shift from singular to plural and let the matter rest until a thoughtful body of grammarians, popular opinion, and perhaps the next edition of the New York Times’ article series on pronouns weigh in with a definitive answer to conjugating verbs after a singular they.—M. Sophia Newman
Follow Instructions!
It was my first day of high school, and the bell had just rung announcing first period. There I sat in Mrs Ruth’s earth science class at a desk on the opposite side of the room from the blackboard, but not so far away, I hoped, that it was obvious I was trying to make myself invisible among the other wide-eyed freshmen. The desks were arranged in clumps, and as Mrs Ruth introduced herself, she stopped at each one, licking her thumb and counting out worksheets.
“Read the instructions,” Mrs Ruth said, “and then complete the worksheet. It shouldn’t take you more than 2 minutes.”
Two minutes?! I thought. A list of bullet points ran the length of the page. I looked to see if anyone else was feeling similarly overwhelmed, but my new classmates were already scribbling away as fast as they could, so I followed their lead. Per Mrs Ruth’s directions, I read the instructions—“Write your name neatly in the top right-hand corner, and read every question before answering any.”—and moved on to the first bullet point.
- How many sides does a triangle have?
Three, duh. I scrawled the answer. The second bullet point told me to, from memory, list as many dinosaurs as I could. The class was quiet except for pencils dutifully scratching answers. These questions were a breeze. Maybe this worksheet would only take 2 minutes after all.
- What is the capital of Ohio?
Columbus!
- What is Will Smith’s character’s name on The Fresh Prince of Bel-Air?
Will Smith—he plays himself!
And before I knew it, I reached the last bullet point, which, surprisingly, wasn’t a question at all.
- Do not answer any of the previous questions. Make sure your name is written neatly, and hand in a blank worksheet.
Groans rippled across the room as other students arrived at the last bullet point. When all our pencils were down and our cheeks were red with embarrassment, Mrs Ruth asked who’d read the instructions. Of course, we all raised our hands. But Mrs Ruth corrected us: no, we hadn’t. Reading the instructions meant more than glancing the words. It meant understanding and acting on them; if we’d written anything on the page other than our names, we’d already failed our first high school assignment.
The AMA Manual of Style is, at its core, a gigantic set of instructions, and on top of the style guide, the websites for JAMA and the journals comprising the JAMA Network each contain links to lengthy Instructions for Authors that explain everything from how manuscripts should be formatted to the number of tables, figures, references, words, etc, individual article types allow. A large part of the job of a manuscript editor is to make sure articles follow the instructions they’re supposed to in preparation for publication, and on a surprising number of occasions, I’ve worked with authors who have argued or rejected fundamental style points or have ignored instructions on the website specific to the journal that’s publishing their research. The instructions aren’t arbitrary, and the AMA Manual of Style exists to help ensure the reporting of research and data is rigorous, lucid, and consistent.
I think back to Mrs Ruth and my first day of high school often: if you don’t read, understand, and follow the instructions, you’ve failed before you’ve even begun.—Suzanne Walker
Talk to Me
Imagine this scenario: it’s 4:30 pm on a Friday, you’ve been stalking your Outlook account for 7 straight hours, your deadline is coming up fast, and STILL the corresponding author of the article you’ve been working on for the whole week hasn’t gotten in touch via email or phone or passenger pigeon to answer your one SIMPLE QUERY that you probably already know the answer to but for the sake of best practices have to receive from them.
So with the prospect of being late for a much-needed end-of-the-week happy hour hanging over you, you consider your options. Do you ring for reinforcements? Do you call in the cavalry?
Sound familiar?
Communicating with authors is one of the most important and challenging parts of being a manuscript editor. There might be an impulse to jump to stereotypes about physicians when speculating why an author isn’t getting back to you (eg, Mr/Ms Ivory Tower can’t stoop to take time from being important and well-known to speak to Plebeian You) but the truth is that there are myriad reasons why authors can fall behind on their communication. While nobody wants to be the jerk who is insensitive to a busy schedule with patients, family emergencies, or a vigilant spam folder, you also have a job to do. If your work performance is at least partially based on meeting deadlines, you may want to consider one or a few of the following strategies to encourage a response.
1. Round up the gang. If a corresponding author isn’t responding to you in a timely way, you may want to reach out to some of the article’s other authors to enlist their help. You could do this in a simple, relatively nonconfrontational way by copying them on correspondence you share with the corresponding author, or you can give them a quick call. This may give you an uncomfortable feeling that you are tattling on the author (I’m not sure what the editorial version of “snitches get stitches” is–maybe “nerds get words”?), but remember that they also have a professional obligation to you. By reaching out you may be giving them an opportunity to re-delegate responsibilities in light of things going on behind the scenes.
2. Phone a friend. Manuscript editors are often only dealing with articles after they’ve been accepted, but it is likely that the authors have talked to multiple people affiliated with the journal along the article’s journey toward publication. If your journal has an editorial office that has shared correspondence with the author or somebody who worked with them during the peer review process, reaching out to them to ask if they can contact the author might yield a result. Some people are more comfortable communicating with people they’ve already dealt with, and a roundabout way of getting the information you need is a better alternative than radio silence.
3. Appeal to a higher power. In a perfect world titles wouldn’t matter, but let’s be real: they do. If the lack of author communication has gotten to the level where it is seriously gumming up the works, and if you can assess that it’s worthy of your supervisor’s time, escalating the situation upward might be your best option. It is truly astonishing how the words “Executive” and “Senior” can expedite a response!
4. Deploy the Shame Lady from Game of Thrones.
(Just kidding.)
So the next time you find yourself with a failure to communicate, don’t despair and whimper “Why won’t you talk to me?” to the computer screen—consider using one of these strategies to get the conversation rolling, the deadline met, and yourself to happy hour.—Amanda Ehrhardt
Dictionaries: An Editor’s Best Friend
Part of the fun of editing medical content is learning all about the newest treatments and scientific advances, but as someone without a science background, I find myself looking for resources that can help me understand some of the more technical terminology.
You may ask, “What about Google?” Google offers the collective knowledge of the Internet right at our fingertips, right? Well, sort of. Sometimes I don’t have the time to sort through all of the results. I want the correct answer now! Subject-specific medical dictionaries are just the thing when I’m in a hurry (which is almost always because DEADLINES).Two resources that I use are A Manual of Orthopaedic Terminology (print) and the National Cancer Institute (NCI) dictionaries (web).
In the days when I edited orthopaedic surgery manuscripts, A Manual of Orthopaedic Terminology (Nelson FR, Blauvelt CT. A Manual of Orthopaedic Terminology. 8th ed. Philadelphia, PA: Elsevier Saunders, 2015) was my go-to resource for terminology related to musculoskeletal disease, brief descriptions of imaging techniques, and common orthopaedic abbreviations. The section on fracture classifications saved me from sifting through a ton of search engine results. Don’t even get me started on the eponymous procedures and approaches! As much as I love this resource, it’s not comprehensive. My heart sank when I used this book to look up surgical approaches for hand surgery and saw “Surgical approaches are too numerous and complicated to describe here. Refer to Canale ST, Beaty J, 2013.”Um, okay.
I found the web-based NCI dictionaries one day when I was working on an oncology manuscript and found myself turning to Google for the 10th time in 2 hours (I love you, Google, but this is ridiculous!). Enter the NCI Dictionary of Cancer Terms and the NCI Drug Dictionary to save the day. Of the 2 dictionaries, I use the Dictionary of Cancer Terms the most. The definitions aren’t too technical, and new terms and definitions are added monthly. Right now, 8386 terms are included. The search interface is easy to use, and allows you to search for partial terms.
As you might expect, the definitions and descriptions in the NCI Drug Dictionary are more technical than those in the Dictionary of Cancer Terms. In addition to definitions, the Drug Dictionary entries include alternate drug names and hyperlinks to more information on each drug (such as active clinical trials using the drug). The NCI Drug Dictionary was useful when I recently came across a table with an alphabet soup of chemotherapy regimens. What exactly is the FOLFIRI regimen?
Let’s use the NCI Drug Dictionary to break this down. A search of FOLFIRI returns 4 results (click for larger):
Those definitions seem pretty straightforward. They even include the trade names for some of the regimens (FOLFIRI-Avastin). The NCI Drug Dictionary seems like a good place to begin a search, but it may be a good idea to cross-check some of the drug names using the USAN Council website; “5-fluorouracil” may not be the preferred name. Clicking on the link for the regimen will redirect you to a page that lists the full definition and another link to the NCI Thesaurus. In this case, the full definitions are short and are right here in the search results—no need to click on another link!
Subject-specific dictionaries can be a reliable alternative to wading through thousands of Google results. What about you? Do you use any subject-specific resources? Tell us in the comments.—Juliet Orellana
Patient Privacy
Sometimes before I go to bed, I like to check in on one of my favorite YouTubers, Dr Pimple Popper (the nom de internet of dermatologist Sandra Lee), who posts videos of dermatologic procedures and skin care treatments. I particularly enjoy watching videos of dilated pore extractions, and I don’t mind watching lipoma extractions either (although I do sometimes fast-forward through the excisions). I know these types of videos can get viewers’ stomachs churning a bit, but I think it’s no worse than various photographs in medical journals I have worked at over the years. And because of my occupation, I do wonder about patient privacy and anonymity.
Patients featured on this YouTube channel may have a cyst near their eye or ask for blackheads to be removed from their cheek, and their faces are clearly visible. In many videos, Dr Lee chats with her patients, and although she sometimes edits out personal details, some of it stays. Dr Lee says that patients do sign consent forms before videos are published.
Similarly, when manuscript editors of medical journals encounter photographs of patients, we must review whether the photograph might intrude on patient privacy. Authors must obtain written permission from patients (or their legally authorized representatives) for any descriptions, photographs, or videos of patients or identifiable body parts and indicate that such consent was obtained in the Methods or Acknowledgment section. When I started in this field as an editorial assistant, I processed a manuscript that described a skin lesion on a patient’s back. In an accompanying photograph, the patient’s distinctive tattoo was visible, and I needed to ask the author to either obtain patient consent or have the photograph cropped because the patient (as well as anyone who knew he had that tattoo) would be able to identify himself. Results of imaging studies and photos of laboratory slides may also have identifying information that should be removed.
Protecting patient privacy also extends to what is in the text of an article. When editing case descriptions, case reports, and personal essays, nonessential identifying data (eg, sex, specific ages, race/ethnicity, occupation) should generally be removed unless the author has permission or the information is clinically or scientifically relevant and important. Authors and editors should not falsify or fictionalize details; doing so may introduce false or inaccurate data.
Read more about patient’s rights to privacy and anonymity in section 5.8.2 of the AMA Manual of Style.—Iris Y. Lo
Transitions of Note, As Such
I come to praise the lowly transition, the chemical drain opener of scientific writing. A transition unclogs copy. Just pour it in and it works.
In our daily responsibilities, time does not always allow for an examination of language functionality at that level of detail. More pressing concerns prevail.
In processing a manuscript into final article form for JAMA Network journals, an editor applies several rounds of detailed attention to the information. The process involves many musts. The title must not be declarative or give away the conclusion. The abstract must be complete. The type of study must be specified. The results section must include appropriate data. The methods section must identify ethical or institutional review board approval or waiver as well as informed patient consent. The statistical analysis section must specify the statistical tests used and not present P values alone without comparative data. Figure and table elements must be complete. Abbreviations must be tracked for consistent use. The discussion must include a paragraph about the limitations of the study type. The conclusions must not be overstated or absolute.
Along with including these musts, the copy must follow JAMA Network style conventions, from the picayune (no period after “vs”) to the consequential (wording presents patient first: patients with diabetes instead of diabetics). The end matter also has to follow the author contribution, conflicts of interest disclosures, and identification of funding requirements.
The introduction, methods, results, and discussion format for scientific articles lead readers from section to section. Within those sections, subheads guide readers from one major topic to another.
What about finer divisions of thought than can be accommodated by subheads? In the dash to process 3000 words according to scientific format and AMA style directives, something often gets lost in the shuffle: the utility of the transitions used to move the reader within and between paragraphs of a subsection. One could argue that if transitions go unnoticed then they have done their job. Readers have gone from point A to point B, and no one has gotten hurt.
There is no must for transitions, but the AMA Manual of Style lists 6 functions of a transition with standard examples that perform those functions.
When I review a proof after the list of musts has been confirmed, I am sometimes startled that a conjunction or transition at the paragraph level appears several times in rapid succession. Three uses of of note occur at the end of the discussion section. Four occurrences of as such appear as an opening phrase. Even that being said has slipped by although no one is actually talking. A couple of buts might more properly be ands. Suddenly I am surrounded by however, furthermore, in addition or additionally, and therefore. A little CTRL + 4 action shows 7 however, 4 furthermore, and a walloping 9 additionally uses all within a 9-page original investigation.
Gliding across all-purpose transitions is quite easy as one goes about identifying and focusing on the musts. An all-purpose transition works because it is a transition regardless of whether it functions specifically. When faced with rapid-succession infelicities, I strike them, perhaps keeping the first. Items of note are apparent from their inclusion. As such in most cases has no actual antecedent. A congenial and from a misbegotten but adds to readability. A quick note to the author usually begets a response ranging from “ok thanks” to something a little more effusive but not overboard.
We have become accustomed to reading right past transitions perhaps because we are not striving for literary awards. No one throws a parade to celebrate a sentence whose dispatched as such has hit the bricks.
Why note how transitions are used? I’m not advocating parades, which would eat significant processing time. Accurate transition use is part of a standard of completeness. Every movement toward specificity is worthwhile to give readers a clearer view of the author’s point. With this in mind, every transition, as such, is of note.—Timothy Gray
What’s the Magic Word?
At the beginning of this year, I had the opportunity to escape the slowing thawing tundra of Chicago to attend the 2018 Council of Science Editors Annual Meeting in sunny, Spanish moss–scented New Orleans. In between trips on the streetcar (where I resisted yelling “STELLA!!!” out the window at French Quarter passersby) and consuming half of the Western Hemisphere’s stock of powdered sugar on a plate of beignets, I—along with several women from JAMA Network (#squadgoals)—took in panels on several pressing topics in the scientific publishing community, such preprint servers, image manipulation, diversity in publication staffing, social media, and data sharing.
One of the most highly anticipated discussions was the last panel on the last day, and although conference fatigue was beginning to set in, we sipped our Diet Cokes with determination to soldier through and gain insight from “The Copy Editor–Author Relationship: A Delicate Balance.”
The panel was led by Peter Olson, Senior Copyediting Coordinator at Sheridan Press, and Jessica LaPointe, Managing Copy Editor at the American Meteorological Society. Mr Olson was the first to present and spoke on the “Anatomy of an Author Query.” He highlighted the symbiotic relationship between copy editors and authors and the various challenges that are involved in the editorial process, including tight deadlines, busy schedules, the differing interpretation of editing comments, and the need to convey complex concepts in a way that maximizes the author’s experience and answers the questions of what, when, and why. He offered 4 central tenets for copy and manuscript editors to follow when querying authors:
- Be clear. When queries are unclear it can confuse and/or annoy the author, and you may get an equally unclear response. You can’t assume that the author has a perspective on the comment’s meaning or on the ins and outs of your publication’s editorial process or style guide. Instead of simply asking if edits are okay, provide a brief rationale for the change being suggested and indicate if something is a journal/style requirement. When asking the author to clarify something in the text, articulate what is unclear and, if possible, suggest an edit.
- Be concise. If your queries are concisely worded then it saves the author time in reading and understanding them, which can make them happier with the editorial process in general. Try to imagine the author’s perspective when creating queries and consider consolidating comments into 1 query (eg, “Please approve all edits in the sentence beginning…” or “Please provide corresponding data for all P values in this paragraph”). Formulating and using standardized queries for comments that you find yourself frequently making in manuscripts can also help save time for you and the author.
- Be accurate. Make sure that the way you have phrased your query reflects the edits that need to be made. Although there are no doubt highly trained PhDs and statisticians among us, many manuscript editors (present company included) do not come from a scientific background, and on occasion it may be appropriate to indicate that you are unclear of the subject matter of the sentence. For example, it is better to point out a perceived inconsistency than to just make a change in cases in which the same abbreviation is used to mean 2 different things, or if a sentence has multiple subjects and it unclear to which one data are referring.
- Be professional. Avoid language that is informal, flippant, curt, contentious, critical, or hostile, as well as casual abbreviations and exclamation points. Instead of making an open-ended comment like “Can we be more specific here?” specify what needs to be explained. Comments like “This reference needs to be sourced” provide a directive but are not helpful in indicating what information is needed. With authors you sometimes get more with sugar than with spice, so please be sure to actually use the word please and ask them for the exact thing that you need for them to do. As my mother used to say when I pleaded for a Fruit Roll-Up or the chance to watch Bill Nye the Science Guy, “What’s the magic word?”
Ms LaPointe was up next with her presentation on “Maintaining the Delicate Balance.” She stressed the importance of using a light touch to balance editing for clarity with changing meaning and taking your time during editing to potentially lessen the number of queries you need to make. Additionally, she focused on how to work successfully with international authors and presented a series of myths on the challenges that dynamic presents:
Myth 1: Papers from Asia present particular challenges. These authors actually usually write very clearly, utilize effective editing services before submitting articles, and consult with English-speaking colleagues extensively during the writing process.
Myth 2: An extensive English-language education eliminates problems. Authors who are very familiar with English, such as European authors, may have more confidence in than ability with the language and may be reluctant to use US English.
Myth 3: Copy editors prefer editing for English speakers. I think that we can all attest that courteous, cooperative authors are the best authors, no matter where they come from!
Ms LaPointe finished her presentation with a reminder that frankly, English is hard (even for native speakers!), and pointed out some common errors to look for when working with international authors, including preposition confusion (on words such as associated, accompanied, based, center, dissimilar, identical, off, and trade), plural vs singular, disconnected sentences, word choice, the confusion of “eg” and “ie,” and the incorrect use of “et al.”
We all know that maintaining the delicate balance between applying style rules and accommodating author satisfaction can sometimes feel like being stuck in a hamster wheel, but hopefully some of these tips will prove helpful for your editorial process and professional interactions. Just remember the magic word, and if all else fails (and you don’t happen to work on a cardiology publication), you can always treat yourself to the best cure-all for all author woes—a heaping plate of beignets piled with powdered sugar.—Amanda Ehrhardt
Pop Quiz, Hotshot
What’s the most important quality to have as a manuscript editor?
A few obvious traits come to mind, like attention to detail and command of the language and style.
When I was hired a few years ago, I wasn’t worried about developing those skills because I figured they would all get better with time and experience. My biggest worry—and what I thought was the most important quality—was speed.
I had 2 types of speed in mind. I wasn’t as worried about speed of editing for style because I knew I just needed to keep working with the style guide. After enough repetitions, of course I wouldn’t need to refer to the book as frequently, and the recognition of a style point would become recall of the answer.
No, I was most anxious about speed of reading. Obviously, reading comprehension was the key, but I even Googled how to strengthen eye muscles to prevent fatigue. Manuscript editing is sort of professional reading, so I thought the best editors should be the best readers.
I don’t know when exactly my anxiety went away. I don’t think it was just the repeated advice from my manager and coworkers—I heard that for months without it truly sinking in. But eventually, I stopped thinking about it, started focusing on other aspects to improve, and fell into a steady editing pace.
The change in thinking has been good for my sanity, but I’m not convinced my original idea is entirely wrong. Reading speed isn’t as important for me as I once feared, but I still wonder where speed ranks in the list of necessary qualities for an editor.
Freelancers, proofreaders, and managers: how important is reading speed in your job? Leave us a comment!—Kevin Brown
AMA Style in the Wild
For many years, my best friend Conchita (not her real name—but she’ll appreciate this reference) and I lived accidentally parallel lives. We were band geeks together, shined in the back row of the chorus during high school musicals, and scrambled to compose an extremely derivative opera (a recording of which I’m pretty sure still exists, unfortunately) to satisfy a creative writing assignment in physics class. But whereas I dreaded said physics class with the fire of a thousand burning suns, Connie excelled in all things scientific. It was no surprise to me when she earned her Masters in Public Health, but it was a surprise when we both ended up in careers relating to the medical field. What was especially enjoyable was that the idle chit-chat usually reserved for whichever high school classmate had just had a baby could now be applied to hyperspecific work-related things, including our beloved AMA style.
Although initially I seized on our collective use of AMA style to complain about authors who had only used abbreviations 4 times, I became interested in learning how she used it in her corner, as I had previously assumed that AMA style was the domain of journal manuscript editors. So I gathered some questions together and polled both Connie and Edgar (name also changed), a former colleague of my fellow blogger Iris, to ask how they used AMA style in different areas of medical communications.
Edgar is an editor for a global advertising company whose clients provide products such as pharmaceuticals, medical devices, and guides relating to health and wellness. The writers and account managers creating their copy are required to be familiar with AMA style, and the style guide for each account has a template of “[X drug] uses AMA style with the following exceptions.” These exceptions usually come in the form of client preferences for the text and layout, which leaves Edgar with the challenge of how to be the resident style stickler while keeping the client’s dictates in mind. Ultimately, while a client’s spatial limitations may not allow for the correct number of thin spaces between P values, “no client style guide can match the AMA for depth and breadth” and it is an important organizing tool. The final product represents a mix of both AMA style and client preferences, but, as Edgar puts it, “One veteran editor told me years ago, rather cheekily, ‘Not even AMA uses AMA style.’ … What he was getting at was that it’s a great tool to be adapted rather than followed in strict orthodoxy.”
In Connie’s previous role in the editorial services group of a medical communications agency, “The AMA Manual of Style was THE BIBLE. Past colleagues achieved mythical status for their ability to recall which section of the AMA manual housed the elusive answer to the day’s grammatical conundrum.” (As you can see, Connie also excelled in English class.) She now works for a pharmaceutical company in their labeling and product packaging divisions, which comes with its own set of complicated rules. The documents she works on (such as a product insert for a specific drug) are not organized with any one editorial style in mind, but rather in terms of their audience (eg, patients vs prescribers). Because these documents are written by multiple authors and pass through many hands before Connie sees them, the text can sometimes represent a hodgepodge of styles. However, because the text is also regulated by the FDA and any changes beyond simple typos would be subject to review by medical, legal, and regulatory teams, these inconsistencies often remain intact. In the rare opportunity when Connie is allowed to make edits on small items, she uses AMA style as a guide on things like italicization, reference lists, and capitalization to make her process more straightforward and efficient.
So my takeaway from these conversations is that while nobody will probably ever apply AMA style as strictly as manuscript editors do (and if we’re honest with ourselves, we probably take some proud satisfaction in that!), AMA style is a useful and important fall-back in other areas of medical communications because of its consistency, specificity, and efficiency. But for your sake, I promise that Connie and I won’t compose an opera about it.—Amanda Ehrhardt