Predictors of ManuScript Rejection sYndrome (MiSeRY): a cohort study.

Objectives: To assess whether specific factors predict the development of ManuScript Rejection sYndrome (MiSeRY) in academic physicians. Design: Prospective pilot study: participants self-administered a questionnaire about full manuscript submissions (as first or senior author) rejected at least once during the past 5 years. Setting:Single centre (tertiary institution). Participants: Eight academic physician-authors. Main outcome measures: Duration of grief. MiSeRY was pre-specified as prolonged grief (grief duration longer than the population median). Results: Eight participants provided data on 32 manuscripts with a total of 93 rejections (median, two rejections per manuscript; interquartile range [IQR], 1-3 rejections per manuscript). Median age at rejection was 37 years (IQR. 33-45 years); 86% of 80 rejections involved male authors (86%), 56 of the authors providing data about these rejections were first authors (60%). The median journal impact factor was 5.9 (IQR. 5.2-17). In 48 cases of rejection (52%). pre-submission expectations of success had been high, and in 54 cases (58%) the manuscripts had been sent for external review. Median grief duration was 3 hours (IQR.1-24 h). Multivariate analysis indicated that higher pre-submission expectation (adjusted odds ratio [a0R], 5.0; 95% CI, 1.5-18), first author status (a0R, 9.5; 95% CI, 1.1-77), and external review (a0R, 19.0; 95% C12.9-126) were independent predictors of MiSeRY. Conclusions: To help put authors out of their MiSeRY. journal editors could be more selective in the manuscripts they send for external review. Tempering pre-submission expectations and mastering the Coping and reLaxing Mechanisms (CaLM) of senior colleagues are important considerations for junior researchers.