What is the Best Medical Journal?
The New England Journal of Medicine (NEJM), The Lancet, and the Journal of the American Medical Association (JAMA) consistently rank as the top three general medical journals based on impact factor, citation rates, and rigorous editorial standards. 1
The "Big Three" General Medical Journals
These three journals are repeatedly identified across multiple analyses as the highest-impact general medical publications:
NEJM and The Lancet received the highest number of citations among 78 medical journals analyzed, with 47,887 and 53,945 citations respectively, and maintain the highest impact factors. 2
All three journals (NEJM, Lancet, JAMA) are specifically designated as the venues for major cardiovascular randomized controlled trials and are recognized for providing trials "larger and focused on outcomes of greater clinical relevance" than other journals. 1
These journals enforce rigorous standards for reporting outcomes of clinical trials, with explicit requirements for study design, statistical analysis, and transparent methodology. 1
Why These Journals Lead
Editorial Rigor and Peer Review Standards
High editorial standards and rigorous peer review distinguish these journals from the broader landscape of over 20,000 medical journals published annually. 1
Enforcement of reporting guidelines including CONSORT for randomized trials and other methodological standards ensures quality control that many lower-tier journals lack. 1
Biostatistical and epidemiologic support is made available to manuscript reviewers to maintain adherence to quality standards. 1
Impact on Clinical Practice
These journals publish research with the greatest clinical relevance, focusing on hard outcomes that reflect patient well-being, morbidity, and mortality rather than surrogate endpoints. 1
International representation in published research from these journals ensures broad applicability of findings across different healthcare systems. 1
Specialty-Specific Considerations
While NEJM, Lancet, and JAMA dominate general medicine:
The Journal of the American College of Cardiology (JACC) serves as a leading specialty journal for cardiovascular research with similarly rigorous standards. 1
Specialty journals vary considerably in both number (ranging from 5 to 252 journals per specialty) and impact factor levels (from 3.058 to 94.333 for top-ranked journals). 3
Infectious diseases representation is substantial across top journals, with 18.6% of articles in the big three addressing infectious disease topics. 4
Important Caveats
Journal Hierarchy Concerns
A "luxury journal" tier exists that includes Nature, Science, and Cell alongside NEJM, representing a minuscule proportion of all published journals but commanding disproportionate influence. 1
Predatory journals now represent 25-30% of all published articles, with an eightfold increase from 2010 to 2014, making journal selection increasingly critical for assessing research quality. 1
Limitations of Impact Factor
Impact factor as a quality metric is subject to debate and should not be the sole criterion for evaluating journal quality or individual research merit. 1
The ranking of a journal within its specific category list may be more meaningful than absolute impact factor numbers, particularly for specialty publications. 3
Geographic and Specialty Bias
US researchers dominate American journals (52.6% in NEJM, 73.6% in JAMA), while The Lancet publishes more non-US research (76.5%), which may influence the generalizability of findings. 4
Different journals have different disciplinary strengths: cardiology dominates JAMA, hematology/oncology leads in NEJM, and infectious diseases is most prominent in The Lancet. 4