Peer Review in Urology

Peer review is the cornerstone of scholarly publishing. In some way, shape or form, we are all dependent on peer review to refine clinical practice over time, even if the bulk of the publishing and reviewing is performed by urologists and researchers in academia. Certainly, in academic urology, a day does not pass without an email requesting peer review of a manuscript, although these requests often come from unrecognizable journals, and sometimes even from unrelated fields. Peer review is essential to determine whether the research work is original and novel, to assess its validity, and to enhance its quality. However, peer review increasingly represents a bottleneck in the publishing process, with good-quality reviews difficult to collect.

The quality of a journal’s peer review process is inseparable from the quality of the journal. A hallmark of so-called “predatory” or deceptive journals is the absence of appropriate peer review. A high-quality journal typically engages multiple reviewers, each of whom provides substantial, thoughtful critique on the unpublished manuscript. Rigorous peer review, in turn, should attract better quality manuscripts from authors who recognize the value of the review. There is no magic number of reviewers per manuscript, and indeed, it may seem wasteful to have too many reviewers for any one manuscript. However, it is remarkable how different reviewers’ comments can be, so some diversity in opinion is crucial. We also recognize that even good-quality peer review will not detect all flaws in a manuscript, especially with respect to statistical methodology, so more eyes can be beneficial. At the SIU Journal, we insist on three reviews per manuscript and accept potential delays in favor of ensuring a comprehensive review process.

There is no question that the peer review process is imperfect. Rejected manuscripts will almost always find a home in another journal, and the question is whether the manuscript undergoes improvement in the process or simply drops down a hierarchy of quality until finding the appropriate quality journal. Some of us will have had the sobering experience of reviewing and rejecting a manuscript for one journal only to be invited to review the same manuscript for another journal and finding that the authors have made none of the suggested changes. This is an unfortunate waste of reviewer time and effort. While differences in research impact and quality are inevitable across journals, peer review can at least ensure that a manuscript’s limitations are clearly discussed.

Conflicts of interest in peer review can be challenging to identify. Most journals ask authors to suggest reviewers, and it is often readily apparent that the authors are suggesting former colleagues, mentors, students or collaborators. These connections can sometimes be obscured, making it difficult to ensure unbiased reviews.

As someone who has invited countless urologists and researchers to conduct peer review, it is interesting to note the responses of those invited. Most invited reviewers do not respond in any way—it is easier delete the email in the inbox than to find the link to decline the review. This is a problem primarily because the editor must allow the reviewer a few days before inviting further reviewers, potentially delaying the review process. However, it is also an understandable response to the flood of review invitations that many potential reviewers receive. Some other candidate reviewers decline every review, even from a reputable journal in their field of expertise, even when they have an affiliation with that journal and have published extensively themselves in that journal. These reviewers ignore their responsibility to “give back” if they, too, are publishing their research results. Most individuals in the field readily recognize this—but not all. We need to remember that for every one paper that we publish, there are approximately three reviewers who invest time in conducting a review, so we need to do our best to return the favor accordingly.

I always tell trainees and early career urologists that they should embrace peer review and view it as an opportunity. Early career reviewers do not recognize that they are being tested by their senior colleagues and that good-quality reviews are a gateway to further invitations to write editorials, contribute to review articles, and participate in meetings. In addition, the peer review process is educational, enhancing one’s own research and publishing skills. Of course, incentives offered by the journals, including best reviewer awards and other recognitions, are more tangible rewards, not to mention the importance of peer review in the academic promotion process.

Teaching peer review to trainees is another facet of the process that seems to be garnering more interest. Many reviewers have been asked to review manuscripts early in their careers without prior experience other than being on the receiving end of some peer review. Those in training institutions should consider involving trainees in their peer review activities so that they can learn the process more formally. Peer review is a foundational skill in academic urology that enhances the trainee’s ability to provide constructive feedback and critically evaluate their own work. Acknowledging a trainee’s contribution to a review also serves as an introduction of the trainee to the journal, paving the way for future review opportunities.

Bringing this all back to the SIUJ, we are grateful for all of our reviewers who perform such an important service to the journal and at the same time we welcome many more of you to contribute to the process!