Editorial Process & Peer Review

Once you have submitted your manuscript, it goes through the following editorial process:

  1. The manuscript and associated materials are checked for quality and completeness by the journal’s editorial assistant.
  2. The manuscript is assigned to an editor.
  3. The editor and the editorial team decide whether or not to send the manuscript out to review; the corresponding author is contacted with the decision.
  4. The editor contacts potential reviewers to ask them to review the manuscript.
  5. Reviewers read the manuscript and submit their reports.
  6. The editor and the editorial team discuss the reviewer reports, and decide whether the manuscript or a revised version of it could be published in the journal. 
  7. The editor contacts the author with the decision.
  8. If the decision is negative, the author can choose to transfer the manuscript – including the reviewer comments to another journal. If the decision is positive, the author will usually be asked to revise the manuscript and resubmit.

1 – Quality check

The journal’s editorial assistant will check that the manuscript and associated materials are complete. Please see our guidelines for initial submission to make sure that you provide us with all necessary information at this stage.

2 – 3 First editorial decision

After initial checks are complete, the manuscript is assigned to an editor, who reads the paper, consults with the editorial team, and decides whether it should be sent for peer review. Editors decide whether to send a manuscript for peer review based on the degree to which it advances our understanding of the field, the soundness of conclusions, the extent to which the evidence presented - including appropriate data and analyses - supports these conclusions, and the wide relevance of these conclusions to the journal’s readership. 

Like other journals in the Nature family, Nature Medicine has no external editorial board involved in editorial decision-making. However, on occasion editors might consult with expert researchers when deciding whether to review a paper. 

4 – 5 Peer review

If the editor decides to send the manuscript to peer reviewers, they will contact researchers with relevant expertise. Reviewer selection is critical to the review process, and we work hard to ensure that the different technical and conceptual aspects of the work are covered. Authors may suggest reviewers; these suggestions are often helpful, although they are not always followed. Reviewers are not identified to the authors, except at the request of the reviewer.

Find out more about peer review.

6 – 7 Editorial decision

When all the reviewer reports are received, the editors decide to either:

  • Invite the authors to revise and resubmit their manuscript to address specific concerns.
  • Decline publication, typically on grounds of either there being insufficient support for the conclusions or a reassessment of the level of interest or advance in light of the reviewers' comments.

8 – Revise and resubmit

If you are invited to revise and resubmit your manuscript, you should follow the instructions provided by the editor in their decision email. 

You will be expected to provide:

  • a revised version of the manuscript that addresses the issues raised by the editor and peer reviewers
  • a response to each of the reviewers, replying to each of the points raised
  • a cover letter that provides any additional information requested by the editors.

Your revised manuscript should be submitted using the link provided in the decision email, and not as a new manuscript.


Some authors ask the editors to reconsider a rejection decision. These are considered appeals, which, by policy, take second place to consideration of normal submissions.

Decisions are reversed on appeal only if the editors are convinced that the original decision was an error. Further consideration may be merited if a reviewer made substantial errors of fact or there is significant evidence of bias, but only if a reversal of that reviewer's opinion would have changed the original decision. Similarly, disputes on factual issues need not be resolved unless they would have altered the final decision to publish or not. 

If an appeal merits further consideration, the editors may send the authors' response or the revised paper to one or more reviewers, or they may ask one reviewer to comment on the concerns raised by another reviewer. On occasion, particularly if the editors feel that additional technical expertise is needed to make a decision, they may obtain advice from additional reviewers.


If the editors of Nature Medicine decline publication of a manuscript, before or after peer review, the authors can easily transfer their manuscript to a different journal within the Nature Portfolio family by following the link provided in the editor’s decision email. This service is available to authors at the time of decision or at a later time.

If the manuscript has been peer-reviewed, authors should include a note explaining any changes made to the manuscript compared to the original Nature Medicine submission, along with a separate point-by-point response to the reviewer reports. 

Upon transfer, if the manuscript is assessed by the receiving journal to be a good fit and technically sound, it may be accepted without further review. 

In the event of publication, the received date is the date of submission to the journal where the manuscript is published.

Transfer of peer-review reports

If the manuscript is transferred, the original reviewer reports and identities will be shared with the receiving journal (with the exception of transfers to the npj Series and Scientific Reports). The editors of the receiving journal will take the reviews into account when making their decision, although in some cases they may choose to take advice from additional reviewers. 

If authors prefer not to make the review history of their paper at Nature Medicine known to a new journal, they should not use the transfer service and they should make a new submission instead; the editors will evaluate the paper without reference to the previous review process. Please note, this decision must be made at the time of initial submission and cannot be changed later.

More information about the manuscript transfer service can be found here.