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The future is here: the first issue of BMJ Military Health
  1. Johno Breeze1,2 and
  2. C E J Langford3
  1. 1 Royal Centre for Defence Medicine, Birmingham, UK
  2. 2 Department of Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  3. 3 BMJ, London, UK
  1. Correspondence to Johno Breeze, Royal Centre for Defence Medicine, Birmingham B15 2SQ, UK; editor.bmjmilitary{at}bmj.com

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BMJ Military Health is the continuation of the Journal of the Royal Army Medical Corps (JRAMC), a medical journal that was first published in 1903 and was continuously in print until its last issue in December 2019.1 Like all great journals it went through various iterations, originating primarily as a method of promulgating new ideas from officers of the Royal Army Medical Corps (RAMC). Submission rate, and often quality, increased during the Great War and the Second World War, with another peak following the Falklands conflict. Two excellent synopses of the JRAMC can be found in its last issue,2 3 along with a foreword from the editor in chief (EIC),1 that will explain this history in greater detail.

The appointment of Colonel Ian Greaves as editor in 1999 in particular was instrumental in improving quality and encouraging greater engagement from beyond RAMC officers as well as changing the size, shape and frequency of the journal. This was continued by the appointment of Lieutenant Colonel Jeff Garner as editor in 2009. They brought clinicians of other services onto the editorial board and altered both the academic content and style to reflect contemporary medical journals. It was under Jeff’s tenure that the subsumption of publication of JRAMC by BMJ occurred, after Major General Von Bertele approached BMJ with an offer. Both were amazed that Peter Ashman, Publishing Director of BMJ at the time, had even considered publishing JRAMC, let alone enthusiastically embraced it. At the time, JRAMC was a small print journal with a very limited target audience. Peter, however, clearly recognised its potential, with its then 110-year history, a dedicated author group and a focused interest in military medicine that was unlike any other in the BMJ portfolio.

The first issue of BMJ Military Health occurred in February 2020, for which much of the thanks must go to Claire Langford, our Associate Publisher at BMJ, along with Janet O’Flaherty. Transitioning a journal as old as JRAMC, along with the unique challenges that come from being a military journal, was almost a full-time job in itself. We would also like to thank Brigadier Peter Fabricius for his vision and Colonel Simon Mellor for his subtle negotiating skill; both individuals recognised that the JRAMC had to diversify in the longer term to survive as an entity. It would have been easy to have maintained the status quo for many years to come, but this would have likely risked any future for the journal. By embracing this courageous change, they instead used the opportunity to ensure that a future journal would evolve which could represent the needs of those wider than RAMC officers alone.

The new journal faces significant challenges, many of which have been discussed in previous issues of JRAMC. Despite the consternation of publishers and editors throughout the world, the impact factor (IF) remains the primary metric by which journals are compared.4 This is despite widely recognised concerns in both its validity and susceptibility to manipulation. In 2019 we were proud as JRAMC to announce an IF of 0.993, the highest the journal had ever sustained, and so close to exceeding the figure of 1.00 that is often seen as a benchmark. Again, we are indebted to Jeff Garner for his work in getting us to that stage to begin with. Security has always been a challenging process for the journal to follow; the name of JRAMC was often incorrectly assumed to represent that it reflected the formal position of the military ownership. This was compounded by the vast majority of the board being serving members of the military, with inherent restrictions, for example, in the use of social media. Finally, those submitting to the journal were required to demonstrate that they had gained formal permission to publish, as is expected of every service person.

The number of submissions to the journal has always fluctuated, reflecting multiple factors, but has risen overall in recent years.5 We have always had the majority of our submissions from the UK, reflecting our origins as a predominantly Army journal. This meant that following the withdrawal from the conflicts in Iraq and Afghanistan, submissions on these subjects decreased. The Editor Emeritus, Jeff Garner, recognised this and commissioned special issues as yearly supplements. As the current EIC, this has been taken further with the commissioning of multiple special issues per year, most of which were a resounding success judging by downloads, and it was many of these commissioned articles that resulted in our increased IF.6 We have used the topic of ‘Emergency Preparedness’ as the first issue of BMJ Military Health, recognising the increased role that the military has in providing assistance to civil authorities in the future.7 We strongly feel that commissioning both special issues along with editorials on topical subjects stimulates debate to the benefit of the journal. To that end, Colonels David Ross and Duncan Wilson kindly agreed to alter their previous roles from being members of the editorial board to becoming commissioning editors.

In the same way that the journal will transition to a new title and ownership, the membership of the new editorial board will be refreshed. A number of the editorial team have already seen this moment as a natural time to step down and we are indebted to their hard work. Agreement has been reached that BMJ Military Health will represent all services of the military, have international representation, be multidisciplinary and include civilian members. Prospective members will be asked to apply for entry following public advertisement, with acceptance based on evidence and made objectively in conjunction with our BMJ colleagues. For our continued success it is essential that the board is representative of the diversity of individuals responsible for delivering military health on a daily basis. Although certainly for the time being the journal remains a voice for original academic publications from the Defence Medical Services (DMS), and with a board that is highly representative of those serving within the DMS, we must always remain independent of the hierarchy in a manner that the JRAMC successfully did.

The choice of title for the new journal was challenging. Without being able to publicise the progress of transition until the very end, the EIC surreptitiously sought opinion from authors, reviewers, fellow members of the board and other editors. The choice of BMJ as a prefix came from a lecture by the editor of Journal of the American Medical Association at one of the BMJ annual editor retreats. He identified that in the new world of thousands of online journals, it was branding and author recognition of a title that is essential for sustainability. All of us know that if you are willing to pay enough, almost any paper of any standard can now be published. Sometimes it is almost impossible unless you are highly familiar with the subject to recognise such journals. As many authors will observe, multiple emails are received daily from such journals guaranteeing publication within a matter of days. BMJ is global brand of high quality, which both authors and readers unfamiliar to the subject will instantaneously understand reflects quality of product. The second component of the title was chosen as ‘Military Health’. Although tempting to shorten to just the word military, analogous to many other BMJ journals, it was felt to be too ambiguous. The word ‘Health’ was deemed essential, and had already been added by the EIC to the strapline of JRAMC to better reflect the broadening remit of the journal.

Taking the journal through the transition from JRAMC to BMJ Military Health has been a huge undertaking for everyone involved both personally and professionally. From a publishing perspective, it is often easier to launch a new journal than to transition an existing one. We hope that the Journal of the Royal Navy Medical Services will join us, such that we finally become a single journal representing all three services. We will strive to surpass the IF threshold of 1.00, create a multidisciplinary and multinational editorial board and increase our international presence. We at the editorial board of BMJ Military Health, and BMJ as the publisher, thank you for your patience during this transition. We hope you will bear the fruits of our labours with a powerful journal for generations to come.

In arduis fidelis

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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