The BMJ

The journal began publishing on 3 October 1840 as the Provincial Medical and Surgical Journal and quickly attracted the attention of physicians around the world through its publication of high-impact original research articles and unique case reports.[4] The BMJ's first editors were P. Hennis Green, lecturer on the diseases of children at the Hunterian School of Medicine, who also was its founder and Robert Streeten of Worcester, a member of the Provincial Medical and Surgical Association council.

Cover of the 1st issue of the Provincial Medical and Surgical Journal

The first issue of the Provincial Medical and Surgical Journal (PMSJ) was 16 pages long and contained three simple woodcut illustrations. The longest items were the editors' introductory editorial and a report of the Provincial Medical and Surgical Association's Eastern Branch. Other pages included a condensed version of Henry Warburton's medical reform bill, book reviews, clinical papers, and case notes. There were ​2 ¹⁄₂ columns of advertisements. Inclusive of stamp duty it cost 7d, a price which remained until 1844. In their main article, Green and Streeten noted that they had "received as many advertisements (in proportion to the quantity of letter press) for our first number, as the most popular Medical Journal, (The Lancet) after seventeen years of existence."[4]

In their introductory editorial and later statements, Green and Streeten defined "the main objects of promotion of which the Provincial Medical and Surgical Journal is established". Summarised, there were two clear main objectives: the advancement of the profession, especially in the provinces and the dissemination of medical knowledge. Green and Streeten also expressed interest in promoting public well-being as well as maintaining 'medical practitioners, as a class in that rank of society which, by their intellectual acquirements, by their general moral character, and by the importance of the duties entrusted to them, they are justly entitled to hold'.[4]

In April 1842 the journal was retitled the Provincial Medical Journal and Retrospect of the Medical Sciences, but two years later reverted to the PMSJ under the sole editorship of Dr. Streeten. It was then in 1857 that the BMJ first appeared when the PMSJ was merged with the Associated Medical Journal (Vols. 1 to 4; 1853 to 1856), which had itself evolved from the London Medical Journal (Vols. 1 to 4; 1849 to 1852) under the editorship of John Rose Cormack.[5]

The BMJ published the first centrally randomised controlled trial.[6] The journal also carried the seminal papers on the causal effects of smoking on health[7][8] and lung cancer and other causes of death in relation to smoking.[9]

For a long time, the journal's sole competitor was The Lancet, also based in the UK, but with increasing globalisation, The BMJ has faced tough competition from other medical journals, particularly The New England Journal of Medicine and the Journal of the American Medical Association.[10]

The BMJ is an advocate of evidence-based medicine. It publishes research as well as clinical reviews, recent medical advances, editorial perspectives, among others.

A special "Christmas Edition" is published annually on the Friday before Christmas. This edition is known for research articles which apply a serious academic approach to investigating less serious medical questions.[11][12][13] The results are often humorous and widely reported by the mainstream media.[12][14]

The BMJ has an open peer review system, wherein authors are told who reviewed their manuscript. About half the original articles are rejected after review in-house.[15] Manuscripts chosen for peer review are first reviewed by external experts, who comment on the importance and suitability for publication, before the final decision on a manuscript is made by the editorial ("hanging") committee. The acceptance rate is less than 7% for original research articles.[16]

The BMJ is included in the major indexes PubMed, MEDLINE, EBSCO, and the Science Citation Index. The journal has long criticised the misuse of the impact factor to award grants and recruit researchers by academic institutions.[17]

The five journals that as of 2008 have cited The BMJ most often are (in order of descending citation frequency) The BMJ, Cochrane Database of Systematic Reviews, The Lancet, BMC Public Health, and BMC Health Services Research.[18]

As of 2008, the five journals that have been cited most frequently by articles published in The BMJ are The BMJ, The Lancet, The New England Journal of Medicine, Journal of the American Medical Association and Cochrane Database of Systematic Reviews.[18]

In the 2019 Journal Citation Reports, published in 2020, The BMJ's impact factor was 30.223.[19] ranking it fourth among general medical journals.[20] However, The BMJ in 2013 reported that it had become a signatory to the San Francisco Declaration on Research Assessment (commonly known as the Dora Agreement), which deprecates the inappropriate use of journal impact factors and urges journal publishers to "greatly reduce the emphasis on the journal impact factor as a promotional tool, ideally by ceasing to promote the impact factor or by presenting it in the context of a variety of journal-based metrics."[21]

The BMJ went fully online in 1995 and archived all its issues on the web. In addition to the print content, supporting material for original research articles, additional news stories, and electronic letters to the editors are its principal attractions. The BMJ website has the policy of publishing most e-letters to the journal, called Rapid Responses,[28] and is shaped like a fully moderated Internet forum. As of January 2013, there had been 88,500 rapid responses posted on the BMJ website.[29] Comments are screened for libellous and obscene content, however potential contributors are warned that once published they will not have the right to remove or edit their response.[29]

From 1999, all content of The BMJ was freely available online; however, in 2006 this changed to a subscription model. Original research articles continue to be available freely, but from January 2006 all other 'added value' contents, including clinical reviews and editorials, require a subscription. The BMJ allows complete free access for visitors from economically disadvantaged countries as part of the HINARI initiative.

On 14 October 2008, The BMJ announced it would become an open access journal. This only refers to their research articles. To view other articles, a subscription is required.[30]

The BMJ is principally an online journal, and it is only the website which carries the full text content of every article. However, a number of print editions are produced targeting different groups of readers with selections of content, some of it abridged, and different advertising.[31] The print editions are:

• General Practice (weekly) for general practitioners
• Clinical Research (weekly) for hospital doctors
• Academic (monthly) for institutions, researchers and medical academics

In addition, The BMJ also publishes a number of overseas/ foreign language editions: Argentinian (in Spanish), Greek, Romanian, Chinese, and Middle Eastern (in English). There is also Student BMJ, an online resource for medical students and junior doctors which publishes an annual print edition each September.