Dr Eric Rubin to Take the Helm at NEJM

Alicia Ault

June 22, 2019

Eric J. Rubin, MD, PhD, an infectious diseases specialist, will be taking over as editor-in-chief of the New England Journal of Medicine and NEJM Group in September.

Dr Eric Rubin. Jon Chomitz

NEJM's publisher, the Massachusetts Medical Society, named Rubin to succeed Jeffrey Drazen, MD, who announced his retirement in October. The society said an international committee had conducted a global search for a new editor, and ultimately landed in its own backyard. Rubin, born in Brockton, Massachusetts, and a Boston-area resident, has been an associate editor of the NEJM since 2012. He also has served as an editor or editorial board member of Tuberculosis, Current Opinion in Microbiology, PLoS Pathogens, and mBio.

"Jeff Drazen is a really tough act to follow," said Catherine DeAngelis, MD, MPH, University Distinguished Service Professor Emerita, professor of pediatrics emerita at the Johns Hopkins University School of Medicine in Baltimore and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, and editor-in-chief emerita of JAMA (2000–2011). 

"The New England Journal of Medicine is unarguably, I think, the premier general medical journal in the United States, perhaps in the world. Jeff did a lot not only to maintain that, but to advance it," DeAngelis told Medscape Medical News, adding that she worked closely with him during her tenure at JAMA.

Although she does not know Rubin, she said, "He's no novice. He's coming into this with experience. And he knows what it takes."

DeAngelis, the first woman editor-in-chief of JAMA, said although there may have been women qualified to lead NEJM, it would have been wrong just to name a woman or person of color just for the sake of naming them. "It would be a disservice," DeAngelis said.

"As a woman, it's always nice to see another woman get a leadership position," Christine Laine, MD, MPH, editor-in-chief of Annals of Internal Medicine, told Medscape Medical News. "I think that diversity is important. But I think that the most important thing is to have somebody who has the knowledge and the expertise to do the job."

Rubin is chair of the Harvard T.H. Chan School of Public Health Department of Immunology and Infectious Diseases and the Irene Heinz Given Professor of Immunology and Infectious Diseases. He has authored 147 scientific articles.

He "is a recognized and respected leader in the field of infectious disease, where he is known for his groundbreaking tuberculosis research and his personal dedication to often neglected populations of patients," said Maryanne C. Bombaugh, MD, president of the Massachusetts Medical Society, in a statement. "We are thrilled that he will lead the Journal and NEJM Group," she added.

NEJM spokesperson Jennifer Zeis said that Rubin has been described as strategic, creative, imaginative, and a natural collaborator.

Laine is hoping that Rubin will continue a collaboration between NEJM and the Annals in which authors submitting to NEJM can choose to have rejected papers automatically sent on to the Annals.

Both Laine and DeAngelis noted that a challenge for editors is culling through the 6000 or so papers submitted each year to each of the top journals, such as JAMA, NEJM, and the Annals. For DeAngelis, it meant relying on a trusted cadre of assistant editors and reviewers, and in particular, statistical reviewers. The statisticians "are the hardest to find and that's where most of the problems come," she said, noting that many papers that have been retracted have had issues with data.

Being an editor-in-chief "is like being the conductor of an orchestra," said DeAngelis. It means choosing the people who are the best at their craft, she said. "But overall you are the one that gets them all together to play, you choose the song or the symphony, and you are the person responsible for making the music come out beautifully."

Laine, who was mentored by many, including DeAngelis, Drazen, and the previous editor of Annals, Frank Davidoff, MD, said she learned "that you have to be thoughtful and not make rash decisions. You have to be tough because people frequently complain about decisions that we make, and you have to be fair."

One of the challenges of being an editor-in-chief is managing conflicts of interest, in particular with industry sponsoring so much research, they said.

"The public is getting very cautious about trusting a lot of things in medicine and that's sad," said DeAngelis, who said drug companies are particularly problematic in their push to publish only positive studies.

"Collaboration between industry and academia has resulted in some pretty fantastic advances in medicine and it's good to have those collaborations, but sometimes you have to walk a tightrope," said Laine. The editor has to determine how "to prevent the bias or bring the potential bias to the user's attention in a way that doesn't shut down the collaboration completely," she said.

"And how do you make people remember that they are on a board where they get paid $3 million a year," said Laine, adding that some conflicts were going to be egregious, while others might be subtle.

Challenges in Open-Access Era

Both Laine and DeAngelis said they hoped Rubin would continue to defend the guidelines and processes of the NEJM's subscription model of publishing, which they said was particularly important in an era of an increasing number of journals that rely on authors to pay for their own submissions and allow open access to content.

DeAngelis said that under the author-pay model, editors are tempted to publish everything, because it's profitable. She blames the model for what she calls an "astronomical" number of journal retractions in the last 5 years.

"The worst nightmare is that you publish something that you have to retract," she said. "Now it's rampant and most of it is because of these open-access journals."

Laine said, "You can understand why it's good for medical research to be free, but somebody has to pay for the peer review and for the dissemination of it and the ancillary things that go along with it."

She believes that eventually there will be fewer subscription-model publications, because of the cost of peer review and online and print distribution. "I think the evolving publication models are a challenge in medical publishing, just like they are in the newspaper world," Laine said. "We're just a little bit behind the curve of the changes that are happening in publishing generally."

She advised Rubin that his challenge would be "sticking to policies for scholarly publishing that are standards and holding fast with those policies."

Rubin did not respond to a request for an interview by press time, but he indicated in a statement that upholding those standards is paramount.

"All those associated with the Journal truly believe that they are stewards of a public trust and that the Journal has an obligation to rigorously evaluate and impartially present the most important findings in medicine and help translate them into practice," he said. "I look forward to continuing to uphold the standard of excellence for which the Journal is known."

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