1 What Is the Importance of Using Correct English in a Medical Paper?

Although India is the second-largest country in the world where the English language is spoken, we often use it incorrectly and tend to be verbose. When it comes to writing skills, we use convoluted phrases and complex words when simple ones would do. A medical paper does not need to be written in theatrical or Shakespearean English. We should express ourselves using short words and simple sentences which convey to a reader why we did the study, how we did it, what the results were and whether they are important, what is known about the subject and what your paper adds. Often, even if your article contains good science it may be rejected by Western journals because you did not state clearly what you wanted to convey. We need to improve not only our scientific endeavours but also our writing skills to be accepted for publication in the world’s best journals.

2 What Are the Common Challenges Faced by Developing World Authors with Regard to Writing English?

One of our major problems is that English is not the mother language for most of us [1]. We think in our native languages and then convert into English and this makes the final product a bit difficult to understand. However, we cannot get away from the fact that English is the medium of writing which is required by nearly all medical journals. The global demand for English is constantly increasing because it removes the barriers to scientific communication. Helps disseminate knowledge and improves the visibility of your work [2].

Another problem which we face is that English communication skills are never discussed in medical college courses or in any research methodology workshops. This has to be addressed urgently and it has been proposed that English writing should be integrated into science programmes in non-English speaking countries as it is the language used in 95% of all cited articles [3].

3 What Is the Fate of a Poorly Written Manuscript?

Once received at the editorial office if the script does not comply with basic language standards, it may be rejected outright. Most leading journals have to deal with many more submissions than they can cope with and will not waste time trying to correct those written in bad English. Some others who may be more charitable may send the article for peer review, where the referee is unlikely to look upon it favourably if it is written badly [4].

4 Are There Any Words in English Which Sound Alike but Have Different Meanings?

English cannot be learned overnight especially if it is not your mother tongue [5]. There are some words that sound alike but have different meanings. These words are called ‘Homophones’ (Table 25.1).

Table 25.1 Confusing words in the medical literature
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5 What Is Redundancy?

Redundancy means the use of extra or excessive use of unnecessary words. These include repeating information in the written manuscript, tables and Figs. A common form of redundancy occurs when a writer lines up 2 or 3 synonyms in the same sentence. The meaning may be clear even after the use of the first word. An example of this is using ‘accurate, exact, and precise’ in one sentence whereas it can be replaced by any of one word.

6 What Are Roundabout Words?

Roundabout words are ways in which as many words as possible are used when one or two will do. Table 25.2 represents some examples of these. The problem with using roundabout words is that they increase the word count of an abstract or text when more important information needs to be conveyed. Writing succinctly is another important aspect of language skills.

Table 25.2 Roundabout words
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Examples.

Original: ‘The experiment, which was just published, highlights numerous challenges of importance’.

Suggested revision: ‘The recently published study highlighted several important challenges’.

7 What Are Some Examples of Indianisms?

Indianisms refer to terms or phrases which are typical of Indian English and refer to the way a sentence has been designed as if it was directly translated from an Indian language. Some examples of common Indianisms are in Table 25.3.

Table 25.3 Examples of Indianisms
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8 What Is a Thesaurus?

A Thesaurus is a book that lists words or groups of related concepts or synonyms. It is very useful to refer to when writing a paper and is available on Microsoft Word. All you have to do is to highlight the word, right click and then select the synonyms [6].

9 What Is Hedging?

In biomedical research, it is sometimes necessary to be careful in one’s statements to distinguish between known facts and purported claims. This is commonly known as ‘hedging’. Hedging is encouraged in scientific writing as it uses non-commital or vague statements [7].

  • Introductory verbs—seem, tend, look like, appear to be, think, believe, doubt, be sure, indicate, suggest.

  • Certain lexical verbs—believe, assume, suggest.

  • Modal adverbs—possibly, perhaps, conceivably.

  • That clauses—It could be the case that…, it might be suggested that…, there is every hope that….

10 What Is Syntax?

Syntax is the ‘arrangement of words and phrases to create well-formed sentences in a language’.

Examples:

Wrong syntax—The handwashing technique with soap in COVID-19 and also alcohol-based sanitizers is described.

Correct syntax—The technique for handwashing using soap or alcohol-based sanitiser for preventing COVIV-19 is described.

11 In What Tense Should an Article Be Written?

If it is a project report or protocol it should be written in the future tense [8]—‘we will conduct the study under all aseptic conditions’ or ‘laparoscopy will be performed in all emergency obstructed hernias during this trial’. Once the work is completed and you are writing the article you should use the past tense. It should now be written as ‘we conducted the study under all aseptic conditions’ or ‘during the trial laparoscopic repair was done in all patients with obstructed hernias’.

figure a

12 Are There any Online Grammar Correction Sites?

Yes, there are. Grammarly software can be downloaded and is useful for checking spelling, grammar and also for plagiarism. Writers from non-English speaking countries can also be helped by using Ref-n-write website. Sci flow is an online portal that helps in improving writing skills and has citations as well [9,10,11].

13 Can External Editing Agencies Help in Improving Language?

Many authors whose native language is not English are using these services. However, there are many ethical issues involved. These agencies help the author with queries from the editor, revising the manuscript and, at times, unfortunately providing the wrong data. These agencies also provide the authors and editors with fake peer reviews accounts which help in publication.

Besides this many physicians hire professional authors to help in their publications and it is estimated that medical writing is the fourth most commonly outsourced clinical service.

14 What Are the General Instructions for Using the English Language in a Research Paper?

  1. 1.

    Use simple sentences (containing words of less than three syllables) with no flowery words.

  2. 2.

    Write short paragraphs starting with a central theme and end with a link sentence to the next paragraph.

  3. 3.

    Make sure ideas flow smoothly one after the other.

  4. 4.

    Use grammar and spellchecking tools which are available online. Misspelled words annoy editors.

  5. 5.

    Revise the manuscript at least five times and get it looked at by two knowledgeable and experienced colleagues.

15 Conclusions

  • A good scientific content but poorly written English is a source of distraction to editors.

  • Construct short readable sentences and avoid tortuous ones.

  • Use the past tense if your experiment has already finished.

  • Use commas carefully as extra commas can change the meaning of a sentence.