The advancement of scientific and medical knowledge depends on the timely publication of novel research, which relies on the adequate functioning of the peer review process. Peer review is the bedrock of scientific publications; it is vital in maintaining the credibility of research and ensuring scientific integrity. As researchers, clinicians, and scientists, we have a professional responsibility to peer review science within our scope of expertise to ensure the fidelity and continued growth of evidence-based research. However, most reviewers have little, if any, formal training in conducting reviews and might often be unaware of the ethical guidelines of peer review. Understanding the ethics of peer review is an important component of the scientific practice of reviewing. While JGIM has strived to consistently deliver high-quality reviews of submitted articles,1 a review of both the ethics of peer review and the components of a quality review is advantageous for new and longtime reviewers.

As a member journal, JGIM follows the Committee on Publication Ethics (COPE)2 guidelines for managing manuscripts. COPE guidelines cover a broad range of issues, from recommendations on journal independence from society owners, to qualifications for editorial board membership, to the ethical handling of manuscripts. COPE states that reviewers are responsible for timeliness and professionalism in reviews and are required to declare any conflicts of interest prior to completing a review.

Timeliness encompasses both responses to the journal on whether the reviewer is willing to conduct the peer review or not, and if so, to conduct the review in a timely manner. JGIM gives reviewers 4 business days to respond to invitations and 14 days to complete the review. Before agreeing to review, the reviewer must determine if there are potential conflicts of interest. Conflicts of interest may arise for several reasons. The COPE guidelines note that “competing interests may be personal, financial, intellectual, professional, political or religious in nature.” Reviewers are responsible for declaring to the editors any potential relationships or activities that might bias evaluations and to recuse themselves from the peer-review process if a conflict exists. If a reviewer is unsure about a potential bias, contacting the editor to make the final decision is best practice.

Professionalism in conducting a review includes maintaining confidentiality throughout the peer review process. Reviewers must understand that the manuscript and the ideas in the manuscript are privileged and confidential information and the property of the authors. Reviewers shall not share any manuscript details nor copy any ideas or novel methods until the manuscript is published. Professionalism also includes refraining from using an overly critical tone, being self-referential, or pushing a personal agenda in a review. A quality and professional review provides constructive, honest, and polite comments. Even if you do not believe the article under review should be published, providing feedback to improve the work may benefit a resubmission in the future.

Peer-reviewers and editors should refrain from unethical practices aimed to booster a journal’s impact factor, such as requesting authors to include additional citations from the journal. Reviewers may critique a manuscript’s references and may suggest additional references including their own, but they should suggest their own publications very judiciously and only do so if their publication provides valuable additional background. Similarly, sometimes appropriate citations are from the journal handling the submission; however, systematically “stacking” citations for impact factor is unethical. Finally, a quality review incorporates both big picture and specific comments without summarizing the article in detail. The peer reviewer’s ultimate job is to assess whether an article merits publication. A thorough review requires a careful read of all submitted material; dedicating time to conducting a quality review means higher quality publications and subsequently more benefits to medicine and science.

A common question is what should reviewers include in confidential comments to the editor? In general, most reviews do not need such comments. Editor comments should be reserved for remarks that the author should not see only if they will help the editor make a decision. For example, if the reviewer selects “reject” as their publication recommendation, they might clarify their primary concerns, but it is not necessary to simply reiterate their recommendation. Unfortunately, reviewers sometimes put comments in this section that authors should see; editors may use their discretion and add such comments to the letter to the authors.

While more practice in conducting peer review can certainly hone one’s reviewing skills, there are also several options for learning more about conducting quality reviews, which can be beneficial for anyone (even those with years of reviewing experience!). One such example is the “Focus on Peer Review” online course available through Nature Masterclasses.3 Continuing to improve on peer review skills and understanding the ethical components of being a peer reviewer will undoubtedly lead to stronger science in the future.