Week 3- Essential skills for the medical writer

Like a complex organism, language grows and evolves over time and according to the environment. Style guides typically do not acknowledge how written language changes, and many writers do not either. Perhaps that is why each generation accuses the next of not correctly understanding language.1 But there are elements of language that are more foundational, like that carbon atom is to an organism. Understanding the foundations of writing will make writers better, regardless of future adaptations of the written word.

These basic elements of writing, like grammar, punctuation, vocabulary, and sentence structure, are the building blocks of the systems we use to make our writing thrive. For the medical writer, we also include foundations in medical terminology, statistics, and ethics.2 Things, such as writing clearly, engaging your audience, elements of style, and infusing writing with humanity, only happen when built with healthy origins.3,4,5 Our words matter. The presentation of an idea is essential. And mastering how to use our words to present those ideas well is a never-ending endeavor.

Having foundational elements like these in their skillset makes a medical writer hirable. For a publication to make a true impact, it must contain both good science and tell the story in a meaningful way. This needs to be supported cohesively by the appropriate content, structure, and language.6 Marchington and Burd’s study found that the majority of people surveyed found medical writers to be the most valuable in grammar, spelling, style, regulatory guidelines, and procedures for submission.7 Strengthening our foundations in writing strengthens our careers.

One of the most significant foundational elements of writing is grammar. Grammar is a funny thing. It provides structure and clarity when used correctly. It can also be a platform for arrogance and pomposity. It is valuable to remember that grammar is a tool and not gospel. There are situations where proper grammar is the wrong choice. Can you imagine reading The Grapes of Wrath if it were written with perfect grammar? Most of the nuances of the culture and language would be lost. In medical writing however, instances where that kind of nuance is required are not likely to occur. And even if they did, you must first understand the rules of grammar before you can know how to bend/ break them in your writing. If this rule is ignored, the result is confusing sentences and misunderstood points.3

But what if grammar is not something you know well? Most scientific curricula do not reinforce it. In fact, many will turn to non-native English speakers to edit their grammar because more grammar is learned when English is taught as a second language than as a primary language.4 So, for my fellow native English speakers, I assume you have less exposure to grammar than our non-native friends. So here is a crash course on the basics as they apply to the medical writer.

Choose your verbs well. Stick to verbs where the action occurs independently, in the present, and without a helping verb.5 The passive voice is used in business documents, conveys a lack of confidence, and should be avoided when possible.3 This is something to keep in mind when reporting patient histories.

Example:

The patient is reporting that he has been smoking 2 packs of cigarettes per day.

vs

The patient reports he smokes 2 packs of cigarettes per day.

This example shows how the passive voice is more confusing and can lead to errors when combined with others like it. However, avoiding the passive voice entirely is bad advice. Sometimes the passive voice is helpful in evoking memory or nostalgia,1 which is sometimes a valuable tool for the medical writer. The best medical writers will know that each sentence component should be useful,5 and if it is not, it should be removed.

Just as we avoid helping verbs, we should also avoid adverbs and limit the use of adjectives. Using adverbs and adjectives clutters a sentence.5 Rather than adding an adverb, it is better to choose another verb that conveys the same meaning,3 such as “She rushed” instead of “She hurriedly ran.” Many disillusioned writers in all fields think that more words make the writing more compelling. Compelling writing is not based on the number or even the complexity of words. Easier reads are often more convincing.

And lastly, good verbs should also be supported by good nouns. Simple noun-verb sentences are the support system for good quality writing.3 Nouns specifically should convey a definable concept over a vague idea. These are often short words that are easy to pronounce.5 But just because simple, concrete nouns are often the better choice in writing, that doesn’t mean vocabulary needs to be elementary.

Vocabulary is a primary element in the organism of writing. It is possible to write a simple sentence with intense vocabulary, which will still be good. Can one look at great authors and say the simple vocabulary of Hemingway and Steinbeck is superior to the intense vocabulary used by HP Lovecraft, T. Coraghessan Boyle, and Cormac McCarthy? To call one better than the other isn’t fair, but they are different.3 When writing, it is best to use the most appropriate word. As long as it is precise and not too obscure, it is fine to use words from a dictionary or thesaurus. But writers must also know the destructive potential of overusing flamboyant vocabulary.1 If the first word that comes to your mind is accurate and true, there is no need to hunt elsewhere for a better one.3 

This is a real danger in medical writing. Medical journals are full of unnecessary jargon and polysyllabic redundancy. The standard is to replace a straightforward word with many larger words that distract from the point.8 There is a standard for using excessive acronyms and unnecessary technical terminology.4 Generally, it is good to use cultivated vocabulary to communicate the topic well, but not to suggest intelligence. Intelligence is often more pronounced by writers who can master simplicity.5 

The sentences below further demonstrate this:

• One fourth of the patients that were reviewed during the medicinal investigation were exposed to an infection causing severe respiratory distress.

• In the clinical drug trial, 4 out of 16 patients contracted pneumonia.

  
  

Which of these sentences is clearer? Which has more potential for misunderstanding? Which turns off your mind before you even read it? Sentences and paragraphs are visual. They catch the eye before the brain, meaning you can tell how difficult the read will be without reading a word.3,5 We know the conscious mind inclines towards laziness.9 A poorly written sentence can alienate your readers before they comprehend your chosen words.

Another way to overwhelm your audience is to combine more than one idea in a sentence. Even the most educated readers will only focus on one idea at a time. Allow your writing to remain linear and sequential.5 Simplicity and clarity are unified forces for the medical writer. They are systems within the healthy organism of writing. However, there are a few pitfalls that medical writers succumb to that feel like simplifying when, in fact, they complicate the writing.

Clichés are abhorred in most forms of writing.3,5 They come to us so naturally that we assume they are helping demonstrate the point. Take the time to replace clichés with a metaphor, example, or just about anything more original.

Signposting is a common occurrence in medical writing, and it serves no purpose. This is when the writer writes about what they will write about.1 “I’m going to tell you three things about muscular dystrophy…” This can also be a recapture of the previous writings, “As you can see, we covered three things about muscular dystrophy…” In writing, it is best to say what you need to say and get on with it.3 A similar danger is explaining to the reader what they should understand independently. Examples of this are “This was a sad patient encounter.” “You should be angry at this injustice.” Let the material speak for itself and trust the reader to draw the intended conclusions.5

The last pitfall is confusing your work line with the subject matter.1 When we immerse ourselves in a subject, it is easy to think people care about the day-to-day of it, but they don’t. So starting a paragraph with “In recent years, more physicians are becoming interested in…” The writing is more engaging if we skip that part and say what is so interesting.

I hope you will read this to improve your medical writing skills. I am sure there are instances throughout this edition where I contradict myself by doing the opposite of what I state as a best practice. Like everyone else, I am still learning and will continue to do so. But the spirit of the law is what is important, and hopefully, you saw something of yourself here and will use it to improve your next draft.

As always, thank you so much for learning with me!

References

1.     Pinker S. The Sense of Style: The Thinking Person’s Guide to Writing in the 21st Century. Penguin Books; 2015

2.     Association AMW. Medical Communication: Essential Skills for Success. Accessed April 28, 2025. https://info.amwa.org/medical-communication-essential-skills-for-success.

3.     King S. Stephen King on Writing a Memoir on the Craft. SIMON AND SCHUSTER; 2000.

4.     Sword H. Air & Light & Time & Space: How Successful Academics Write. Harvard University Press; 2018.

5.     Zinsser W. On Writing Well. Harper Paperbacks; 2016.

6.     Herron C. How to Transform Your Scientific Writing to Maximize Your Impact. Redwood Ink; 2025. Accessed March 24, 2025. https://redwoodink.ewebinar.com/webinar/19501/join/13673944.

7.     This webinar has been referenced with the permission of the creator.

8.     Marchington JM, Burd GP. Author attitudes to professional medical writing support. Current Medical Research and Opinion. 2014;30(10):2103-2108. doi:10.1185/03007995.2014.939618

9.     Collier R. A call for clarity and quality in medical writing. Canadian Medical Association Journal. 2017;189(46). doi:10.1503/cmaj.171265

10.  Kahneman D. Thinking, Fast and Slow. Penguin Books; 2024.