Abstract: This paper discusses different forms of open access publishing and argues that small independent journals that are funded though subsidies provide an important niche in scholarly publishing. One such journal, Medical Education Online (MEO) is used as a case study characterizing the dilemma these journals can face in maintaining their operations as they become successful and their need for resources grows. The paper discusses several strategies for addressing this problem and how they have been implemented for MEO.
The conversion of scholarly journals from paper to electronic dissemination has been extremely rapid. By at least one measure electronic publication became the dominant mode of disseminating scholarly journals by as early as 2002, a mere nine years after the development of the Web (Van Orsdel and Born, 2002). The inherent differences between paper and electronic media and the speed in which the conversion is occurring has created tremendous turmoil in the 340 yearold scholarly publication system.
With electronic dissemination many of the most resource intensive roles that have traditionally been played by both publishers and librarians are disappearing and it is not as yet clear who will perform the roles that remain and how the evolving electronic publication system will be structured or financed. A number of models are evolving and it is anyone’s guess which one or more likely ones will predominate.
One striking difference with electronic publication is that there is essentially no cost for dissemination. The resources it takes to publish electronically are the same whether one copy of a journal article is distributed or a thousand. While there is some disagreement over the extent, it is also clear that the Internet is reducing other costs in the publication process . These developments provide a great deal of flexibility in how the scholarly publishing and its financing can be structured. Publishers, librarians as well as researchers are experimenting with a variety of models for electronic dissemination (Guédon, 2001).
Almost as soon as electronic journals began appearing there were calls to make scholarship freely available over the Internet and find alternatives to subscription fees for financing publication. With the costs of dissemination no longer an issue, making scholarly journals freely available over the Internet became both feasible and in the view of many people highly desirable. By 2001 these calls for a change in the financial structure of scholarly publication grew into what is now known as the open access initiative (OAI) . There are compelling ethical as well as practical arguments for open access .
The issues involved in financing electronic publication are complex. Ann Shaffner (1994) has noted scholarly journals play a number of different roles in scientific communities. Each of these roles has somewhat different implications for the transition from paper to electronic publication. I have argued elsewhere that differences in perspective on these roles have been the root of at least part of the controversy over how to structure and finance the dissemination of research and scholarship (Solomon, 2002). This controversy extends not only into whether we should move to open access publishing but over what form and at what pace it should be done (Guédon, 2004; Harnad, et al., 2004).
Open access is not an all or nothing phenomena but rather a continuum with many forms. Willinsky (2006) defines 10 styles of open access publication that largely reflect how the publications are funded. At its heart are two basic forms of open access, open access journals and author archiving of copies of their own publications from nonopen access journals. These have been referred to respectively as the Gold and Green roads to open access (Guédon, 2004).
Within the gold road, there are several different models that provide varying levels of open access. On one end of the spectrum there are journals that provide freely accessible abstracts but restrict access to full articles to paid subscribers. On the other end of the spectrum is what Willinsky (2006) has called subsidized journals. These journals provide unrestricted access to the full texts of articles from the date of publication without having to resort to charging authors for publication. In between there are delayed access where open access is restricted to subscribers for a period of time, partial open access where some content is open and some restricted to subscribers and dual mode where some forms of the publication such as printed or PDF versions are restricted to subscribers but other less desirable or less expensive forms of access such as HTML are freely available. There are also models where there is open access to the content of journals but authors are charged to fund publication.
Open access is not an all or nothing phenomena but rather a continuum with many forms.
All of these models provide at least some improvement over the restricted access of traditional subscriptionbased journals. However any restriction on access including charging authors for publication places barriers to the dissemination of scholarship that tends to limit access and reduce the value of the scholarship contained in these journals.
In the developing word, which includes approximately 80 percent of the worlds population, even modest charges for access or publication can be beyond the economic means of libraries and individuals who wish to access the material or authors who wish to publish their material. In the developed world, it is not necessarily the costs but the hoops one has to jump through to access the material that is restrictive and time consuming and hence costly to the process of conducting research. University faculty members can gain access to an increasingly large number of electronic journals through their university libraries. While there are no charges involved for the faculty member, they are forced to work through their university librarys portal to the publishers site, the particular journal, volume, issue and article that is desired. In my experience this is often a tedious fiveminute process as opposed to the instantaneous access article via a hyperlinked reference that is provided by open access. Scholars often review 50 or more articles when developing a scholarly paper or conducting a research project. Having to work through their librarys Web portal is extremely cumbersome and frustrating process as compared with unfettered open access to the content of open access journals.
Most of the discussion on open access publishing has focused on large well organized initiatives such as the Public Library of Science, BioMed Central and author selfarchiving in PubMed Central. While these are laudable endeavors what is often forgotten are that there are hundreds of small open access journals that have been created over the last decade by individuals and small groups of colleagues . In many cases, these are excellent journals that have become well respected and are having a significant impact on disseminating scholarship. They generally fall into the category of subsidized journals that neither charge for access nor charge authors for publication. In this sense, they are the purest form of open access and as such, the most efficient and effective means of disseminating scholarship.
Electronic distribution and the use of the Internet for peer review have substantially reduced the resources necessary for publication. Journals that are distributed via the Internet require very little if any actual funding. All that is needed are email for correspondence a Web server for content distribution. These are available to virtually any university faculty member through their institution or they can be purchased for less than $US50.00 from a commercial Internet service provider.
While little if any funding is required for operating an electronic journal, it does require effort. This includes operating the editorial/peerreview process, copyediting and formatting manuscripts, maintaining the Web site and responding to journal related email and other administrative tasks such as indexing the contents of the journal. The effort required to conduct these tasks is largely tied to the success of the journal. Unfortunately this is both the strength and the weakness of subsidized open access journals. The power of the pure open access to increase dissemination is well documented . As access increases, the number of submissions and hence the effort required to maintain these journals also tends to increase and potentially quite dramatically. Since these journals receive no direct income from their operations and are generally operated with the volunteer effort of a few or even a single individual, they can easily become overwhelmed.
This was the case for Medical Education Online, a subsidized open access journal I created in 1996. The paper presents MEO as a case study of how this problem developed for the journal and a discussion of how my colleagues and I are trying to sustain the journal while maintaining its core values of publishing quality scholarship, quick manuscript review and providing good constructive feedback to authors while access to the journal and the number of submissions steadily increases.
MEO was founded as a Web portal designed to facilitate communication concerning educating physicians and other health professionals. The site initially contained a variety of content including a peerreviewed journal, sections for resources, posting informational notices and a threaded discussion list. Most of these sections were later dropped because it was felt that there were better alternatives available or other modes of electronic communication that were a better vehicle for that type of communication. The peerreviewed journal which was always the central focus of the site however has grown to be very successful.
The journal was initiated by me with help from a number of colleagues at the University of Texas Medical Branch at Galvestons (UTMB) Office of Educational Development (OED). Additionally two librarians, a few interested colleagues at other universities and the intellectual property officer for the University of Texas System provided advice in designing the journal and its policies.
The journal was launched in April 1996 with several invited articles. For the first five years, the journal received between 10 and 20 submissions a year publishing around six or eight of these manuscripts. After journal became established, the workload during this period was moderate and I maintained the journal pretty much by myself. In 1999 I accepted a position at Michigan State University (MSU) and moved the journal with me where I continued to maintain the journal myself. Starting around 2000 the submissions to the journal and subsequent publications began steadily increasing. Figure 1 shows the number of articles published in MEO over the first 10 years of the journals history. The rapid rise in submissions and subsequent publications continued through 2004 when 73 manuscripts were submitted for publication and 24 were published. By this point managing the journal became an overwhelming task for me alone. After having maintained the journal for nine years and feeling it was well established I decided it was time for someone else to take over the journal and it was clear that it would require more than a single individual.
Two of my former colleagues at UTMB, Steve Lieberman, MD and Ann Frye, PhD agreed to take over the journal as coeditors and enlist the help of a few other colleagues at UTMB in operating the journal. We worked together to implement the transition over the spring of 2005 and in the summer they took over the operation of the journal while I remained available for advice.
Several events occurred during the late summer and early fall that disrupted the transition and kept Drs. Frye and Lieberman from keeping up with the growing number of submissions to the journal. The first were two major hurricanes. Although Katrina did not strike Galveston, UTMB was one of the closest medical schools to New Orleans and took in several dozen students from the two New Orleans based medical schools, Tulane and LSU that were shut down by the storm. As the Associate Dean for Academic Affairs, Dr. Lieberman was heavily involved with integrating these students into the medical school which largely kept him from working on the journal. Shortly after that, Rita then struck the Gulf Coast. Although it largely spared Galveston from serious damage, the area was evacuated and UTMB was shut down for a week. The disruption this caused kept both Drs. Frye and Lieberman from putting any significant time into operating the journal for several weeks. I took over maintaining the journal during the period they had to evacuate from Galveston however we continued to fall behind in managing the peerreview process and getting accepted manuscripts published.
About this time Dr. Lieberman took on additional responsibilities as the Senior Associate Dean of the Medical School and could no longer put any effort into editing the journal and Dr. Frye was promoted to the Director of the Office of Educational Development which substantially increased her responsibilities as well. By this point they were several months behind in keeping up with submissions and it was clear Dr. Frye could not handle editing the journal alone. I stepped back in and have been coediting the journal with Dr. Frye since around November 2005.
While we have been catching up the backlog of submissions, the journal continues to grow and it is clear we need to develop a new strategy for maintaining the journal. During 2005 we receive 80 submissions and while the number of manuscript published dropped to 18, this reflected the fact we had gotten significantly behind in the publication process. By the last week in April we had already received 39 submissions in 2006. During March access to the journal Web site was at an all time high receiving an average of 890 visits a day from different computers and a total of 16,379 different computers accessing the journal from approximately 110 countries during the month.
We have been implementing several strategies in an attempt to keep MEO sustainable as access and submissions increase. Beyond those, there are several other strategies available that for a variety of reasons we have considered but have not implemented.
Streamlining the peerreview and publication process through the use of serverside databases and software — Beyond removing the cost of dissemination, the use of the Internet can streamline and significantly reduce the cost and effort of conducting the peerreview process. From its inception MEOs peerreview process has been conducted online. Initially it was done manually using email and the use of email attachments to distribute manuscripts and review forms. Even this modest advancement over a paper distribution system significantly reduced the workload and negated the materials and mailing costs of the submission/peerreview process.
In 2001 I partially automated the submission/peerreview process using a rudimentary serverbased software system. The system allowed authors to submit their manuscripts via a Webbased form which uploaded the manuscript to the server and stored the authors contact and submission information in a serverside database table. Interested individuals could volunteer to be a manuscript reviewer by completing a Webbased form that stored their contact and interest/expertise information in a database table.
The software allowed me to view the expertise and review history of the reviewers in the database and then select reviewers for a particular manuscript review using a Web form. The software sent email requests to the selected reviewers to review the manuscript and maintained a history for the reviews assigned each reviewer. Reviewers continued to respond back via email their willingness to review the manuscript and I manually sent them an email with a copy of the manuscript and review form as email attachments. The rest of the review and feedback to the authors were conducted as they had always been via email.
Although fairly simple, this semiautomated process actually saved quite a bit of effort over conducting the whole process via email and helped me keep track of our growing reviewer pool. I hesitated to further automate the system though it was clear it could reduce the workload even more. The reason I hesitated was the effort it would take to develop a more automated system, Secondly I valued the contact I had with the reviewers emailing back and forth during the review process.
In the fall of 2005 when I rejoined Dr. Frye in coediting MEO, it became clear we needed to further automate the review system as a means of reducing our workload and providing better tracking for the growing number of manuscripts in the review process.
It should be noted that there are a number of widely available Internetbased software systems for managing the peerreview process and other aspects of maintaining electronic journals. Many of these are commercially available and very expensive however there is at least one notable exception, Open Journal Systems (OJS), which was developed as part of the Public Knowledge Project . OJS is a freely available open source system that provides a very sophisticated and comprehensive software solution for managing the whole process of publishing a peerreviewed journal. Although the software is excellent, I chose to continue to develop the semiautomated peerreview software I had been using for MEO rather than convert to OJS. This was partly due to the legacy issues of converting the existing material on the MEO journal site to a new format. Additionally I wanted to design a system that would support a second strategy described below for keeping MEO sustainable.
Over the December 2005 holiday period I extensively revised MEOs peerreview software to automate the process of managing the peerreview system. The peerreview system is now almost entirely automated. Manuscripts continue to be submitted via a Web form and reviewers are selected via a Web form and sent emails requesting they review a particular manuscript. Reviewers now agree to participate in the review of a manuscript by clicking on a link in the email review request which brings up a Web page that contains links to download the review copy of the manuscript and to a Web form for entering feedback and ratings for the review. The editors can track the review process including which reviewers were asked to review each manuscript; whether they have agreed to do the review and the date they returned their reviews. The whole process is tracked and all the information is stored in the server database. Once a given reviewer has completed their review, the editor can view summaries of the individual reviews from each reviewer or an aggregated summary of all the reviews received for a manuscript. The editor enters their feedback letter summarizing the review and indicates the publication decision via a Web form. This information is archived in the server database along with the individual reviews and the system sends the author and each reviewer participating in the review the feedback summary letter from the editor with a link to the summary of the feedback from the reviewers. A review history is maintained for each reviewer including the manuscripts they have been asked to review, whether they accepted the request to review and the dates they returned the review as well as the as well as their written feedback and ratings. Editors can also easily add comments on the quality of the review and a summary of this information is available for each reviewer that the editors can easily access when selecting reviewers. The status of all manuscripts submitted to the journal can also easily be tracked.
The system has significantly streamlined our review process and reduced the chance of manuscripts falling through the cracks and getting overlooked or lost in the review process. Although it will take some time, we are also building a comprehensive review history for our volunteer reviewers which is extremely helpful to the editors given MEO has over 250 people who have volunteered review manuscripts for the journal.
Making the workload more manageable by spreading it over a number of volunteer review editors One of the goals of developing the new peerreview system was to allow us to recruit a cadre of colleagues to act as review editors. We decided this would be a viable way of addressing the increasing number of submissions that we were receiving. Without an automated serverside database system for managing and tracking the review process it would be very difficult to manage a distributed review model such as the one we are currently using.
I designed the review software system with two types of editors; managing editors and review editors. Dr. Frye and I as managing editors, perform a preliminary review of new manuscripts as they are submitted. If a manuscript is not within the scope of the journal or is clearly not publishable, one of us uses the review system to send an email notifying the author that their manuscript can not be published and the reasons for its rejection. If the manuscript is suitable for external review, we assign it to one of the review editors who are notified through the review software that they have been assigned the manuscript. From that point on, they manage the review process for the manuscript including preparing it for review, selecting reviewers, tracking the review process, making a publication decision and writing the feedback letter to the author(s). For those manuscripts that are accepted with revisions, they also work with the author to complete the revisions.
At the point of writing this article, we have been using the review software successfully for about four months and have identified six review editors and are in the process of piloting the new system. We are optimistic that this approach can address the workload of managing the review process for an increasing number of submissions. We can identify and add additional review editors as necessary and the flexibility of having multiple editors should allow us to share the workload and not overburden anyone when our schedules are particularly packed.
Enlisting the help of authors in the publication process While conducting the peerreview process constitutes a significant portion of the workload of running the journal, copyediting and typesetting the manuscripts can also be quite timeconsuming. One strategy that can be effective in reducing the workload of operating a subsidized open access journal is enlisting the help of the authors in minimizing the work of copyediting and typesetting their manuscripts. BioMed Central (BMC) , a forprofit open access publisher has used this strategy very effectively to reduce their costs. They provide a specific word processing template which authors are required to use in formatting their manuscripts. For at least some of their journals, they do not provide copyediting. As part of their review process, they ask the external reviewers to assess the suitability and quality of the writing of the manuscript for publication and make it clear to the authors that they are responsible for ensuring the written quality of their manuscripts. I am sure this helps BMCs keep their costs down allowing them to charge authors far less than for example the Public Library of Science, that also operates open access journals by charging authors for publication.
MEO has used this strategy to some degree but not to the extent used by BMC. Over the years we have gotten more and more specific in the formatting requirements for manuscripts and have become very rigid about enforcing them. We are fairly lax in terms of the formatting requirements for manuscripts submitted for the review process. When we receive manuscripts that have not adhered to the formatting requirements for publication in MEO we will still send them out for review as long as the manuscripts can be easily read by reviewers. It is however made clear to authors that before their manuscripts can be published they must reformat the manuscripts to our requirements. This avoids requiring authors to put in a lot of unnecessary work reformatting their manuscripts to MEOs specific requirements before the manuscript has been accepted for publication.
Manuscripts are still copyedited. we are reluctant to give this up though at some point we may not have the resources to continue copyediting manuscripts. MEO has a large international audience and many of our manuscripts come from authors for whom English is a second language. These manuscripts often need significant revisions to be suitable for publication and these authors often do not have access to colleagues for whom English is their native language to help in revising their manuscripts. Since these manuscripts often contain very useful information and provide a broader perspective for the journal, we are trying to continue to maintain some level of copyediting. Even for well written manuscripts, editing by a second reader can improve the manuscript and catch additional typographic errors.
Enlisting the support and expertise of academic librarians who understand the value of open access publication In my experience there is no group more knowledgeable and supportive of open access publishing than academic librarians. They also tend to be very knowledgeable about the publication process as well as the intricacies of indexing and archiving. Librarians can be a potential source of both support and advice for starting and maintaining a subsidized open access journal. Libraries have also begun to develop systems for supporting peerreviewed open access journals and manuscript archives. An example is the Digital Library and Archives at Virginia Tech University . First Monday is also an example of a subsidized open access journal that receives support from an academic library, the Library at the University of Illinois at Chicago.
In my experience there is no group more knowledgeable and supportive of open access publishing than academic librarians.
When I was in the process of implementing MEO, two librarians, Deirdre Becker, MLS and Andrew Venier, MLIS were very helpful in organizing the journal. Over the last six months Julie Trumble, MLS has been working with us as an editor both helping in copyediting and working towards getting the journal indexed in major indexes such as Medline.
Other potential strategies There are several other potential strategies for maintaining a subsidized journal that we have as yet not chosen to implement for MEO. One obvious strategy is seeking financial support from organizations, foundations or government grants. I have considered over the years but have not attempted to obtain external financial support for operating MEO. Applying for external support from foundations and governmental agencies takes a significant amount of time and effort with no guarantee of success. When just trying to keep your head above water operating a journal it is difficult to find time to seek external funding. Such support is also generally for a fixed period of time limiting its value for use in the day to day operations of the journal. Finally, if maintaining external support requires a significant amount of administrative overhead.
External support can also be somewhat seductive in that with resources you tend to build infrastructure that in turn requires continued resources to maintain. For example if we were to obtain funding and hire people to perform copyediting, typesetting and Web development, we would be spending a significant amount of our time hiring and managing these employees as well as worrying how we would pay their salaries. All this has made me very hesitant to seek external support and grow the infrastructure of the journal. Although it is a struggle to keep the journal operating on volunteer effort, it keeps the organization very lean and focused directly on the tasks of publishing MEO.
Obtaining support from our institutions for operating the journal is another option that I originally took advantage of but we have more recently largely avoided . When I started MEO, UTMB provided access to a Web server and email. While a minor issue today, ten years ago, this was much more significant. My supervisors also provided support and protected time. When I transferred to MSU, no one tried to stop me from taking MEO with me but my supervisors were not pleased. This made me sensitive to the issue of accepting support from MSU. Additionally the MSU copyright policy made me somewhat concerned that if I accepted significant resources for operating the journal, I could potentially lose control of the journal or at least encounter a lot of resistance if I tried to move it from MSU.
Another potential option for support is advertising on the journals Web site. One approach suggested by Peter Suber (2006) is to use Google AdSense as a relatively painless way to provide some revenue. AdSense uses Googles proprietary algorithms to place advertisements on your Web site that match the sites content helping ensure the relevance to the people who are likely to visit your site. You can identify where you want the ads to appear on your site and Google places ads from advertisers it feels are most relevant to your site into the spots you have blocked out. You then receive income for the number of times people click through to the advertised site or purchase their products. The Journal of Medical Internet Research  is an example of a very successful open access peer-reviewed journal that uses AdSense.
We have not chosen to use ASense or any other form of advertising on the MEO Web site at least at this point. Including advertisement could change the perceived character of the site and at could create the perception of conflicts of interest. Suber (2006) notes that that the design of AdSense avoids the potential of conflict of interest because it is Google rather than the journal selects the content of the ads. Although his argument is sound, there is still the potential for the perception of conflict of interest and the sense that it would change the character of the journal.
Although it is a continual struggle, we have managed to keep MEO in operation now for over ten years. Over the last year we have not been able to maintain the responsiveness and quick turnaround of the peerreview and publication process that has always been a core value for the journal. I am optimistic that we can continue to keep the journal operating and improve its responsiveness as submissions increase by being as efficient as possible and sharing the workload among multiple review editors as well as the authors. We may have to become more prescriptive in the formatting authors must use for the manuscripts and at some point put the full burden of copyediting manuscripts on the authors.
Seeking financial support to subsidize an open access journal is certainly a reasonable approach and has worked well allowing many subsidized open access journals to operate without charging authors. Obtaining our resources through the volunteer effort of a number of people and keeping the review and publication process as efficient as possible at the moment appears to be the best option for MEO; at least at this point.
Small independent subsidized open access journals will never be the dominant mode of disseminating scholarship. They can however continue to provide an important and viable niche in the dissemination of research and scholarship as journals complete the transformation to electronic publication and hopefully universal open access. On a broader level those of us involved in independent open access journals should focus on working together to create a community of open access journal publishers that can share ideas, software, procedures, and provide mentoring for individuals interested in forming new subsidized open access journals. The Public Access Project  provided a good start toward this goal with the development of high quality open access software for both hosting open access journals and open access conferences. As subsidized open access journals continue to evolve it would be helpful to develop additional areas of communication and support for working together in publishing these journals.
About the author
David J. Solomon is an Associate Professor in the Department of Medicine and the Office of Medical Education Research and Development in the College of Human Medicine at Michigan State University. He is editor and founder of Medical Education Online (http://www.med-ed-online.org), an open access, peerreviewed electronic journal that has been covering all aspects of health professions education since April 1996. He has a Ph.D. in educational psychology and works mainly in the areas of distance learning, program evaluation and performance assessment. His other major scholarly interest is the communication of research.
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Strategies for developing sustainable open access scholarly journals by David J. Solomon
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