NEJM figure preparation: resolution (300-1200 DPI), editable vector formats (AI/EPS/SVG), in-house medical illustration policy, and strict image integrity requirements.
license
CC-BY-4.0
compatibility
Python 3.10+, Pillow, Matplotlib
metadata
{"authors":"HITS","version":"1.0"}
NEJM Figure Preparation Guide
Overview
This guide provides the complete specifications for preparing figures for submission to the New England Journal of Medicine (NEJM). A unique feature of NEJM is that medical illustrations are created by NEJM's in-house illustrators working directly with authors — authors should NOT submit finished medical illustrations due to copyright considerations.
Figures can be inserted in text files (preferred) or uploaded separately
Medical Illustration Policy
IMPORTANT: NEJM's in-house medical illustrators will work directly with authors to create medical illustrations. Authors should NOT submit finished illustrations due to copyright considerations. The journal retains copyright on illustrations created by their team.
Figure Size and Dimensions
NEJM does not publish detailed size specifications in their public guidelines. General best practices:
Size figures appropriately for the intended column layout
Ensure all text is legible at final print size
Follow standard medical journal conventions
Color Mode
No explicit RGB/CMYK mandate in published guidelines
Follow standard practice: submit in RGB for online; journal handles print conversion
Font Requirements
Element
Specification
Preferred style
Sans-serif
Historical font
Univers (NEJM house font)
Alternatives
Helvetica, Arial
Ensure all text is legible at final reduction size
All patient-identifying information must be removed from images
This includes faces, names, medical record numbers, and any other identifiable information
defcheck_clinical_image_text(title, legend):
"""Validate text limits for NEJM Images in Clinical Medicine."""
title_words = len(title.split())
legend_words = len(legend.split())
issues = []
if title_words > 8:
issues.append(f"Title has {title_words} words (max 8)")
if legend_words > 150:
issues.append(f"Legend has {legend_words} words (max 150)")
if issues:
for issue in issues:
print(f"ISSUE: {issue}")
else:
print(f"PASS: Title ({title_words} words), Legend ({legend_words} words)")
returnlen(issues) == 0
Image Integrity and Manipulation Policy
PROHIBITED
Enhancing, obscuring, moving, removing, or introducing any specific feature within an image
REQUIRED
Brightness, color, and contrast adjustments must be applied uniformly to the entire image
Adjustments must not misrepresent any features of the original image
Best Practices
Maintain original unprocessed image files
Document all processing steps
Be prepared to provide raw data upon request
Python Quick Start: Full Validation
from PIL import Image
import os
defvalidate_nejm_figure(image_path, image_type='photo', stage='final'):
"""Full validation of a figure against NEJM requirements."""
img = Image.open(image_path)
issues = []
# 1. Resolution check
min_dpi = {'lineart': 1200, 'photo': 300}
required = min_dpi.get(image_type, 300)
if stage == 'review':
required = 150
dpi = img.info.get('dpi', (72, 72))
if dpi[0] < required:
issues.append(f"Resolution {dpi[0]} DPI below {required} DPI for {image_type} ({stage})")
# 2. Color modeif img.mode notin ('RGB', 'RGBA', 'L'):
issues.append(f"Color mode {img.mode} may not be ideal; use RGB or Grayscale")
# 3. Format check
fmt = img.format
vector_preferred = image_type != 'photo'if vector_preferred and fmt and fmt.upper() in ('JPEG', 'PNG'):
issues.append(f"Data visualizations: prefer vector format (AI, EPS, SVG) over {fmt}")
# Reportprint(f"=== NEJM Figure Validation ({stage}) ===")
print(f"Dimensions: {img.size[0]} x {img.size[1]} px")
print(f"DPI: {dpi[0]} x {dpi[1]}")
print(f"Color mode: {img.mode}")
if issues:
print(f"\nISSUES FOUND ({len(issues)}):")
for issue in issues:
print(f" - {issue}")
else:
print("\nAll checks PASSED")
print("\nREMINDER: Do NOT submit finished medical illustrations (NEJM creates these)")
print("REMINDER: Remove ALL patient-identifying information from images")
returnlen(issues) == 0
Key Concepts
In-House Medical Illustration
NEJM's most distinctive policy is that medical illustrations are created by their in-house illustrators working directly with authors. Authors should NOT submit finished medical illustrations. The journal retains copyright on illustrations created by their team. This applies only to medical illustrations — data visualizations and photographs are author-submitted.
Two-Stage Resolution Requirements
NEJM accepts lower-resolution figures during peer review to reduce submission friction. However, final publication requires full resolution: 1,200 DPI for line art and 300 DPI for photographs. Authors should prepare high-resolution originals from the start to avoid rework.
Patient Privacy in Clinical Images
NEJM enforces strict patient privacy requirements. All patient-identifying information must be removed from images, including faces, names, medical record numbers, and any other identifiable features. This is non-negotiable and applies to all clinical images regardless of consent status.
Decision Framework
What type of figure are you preparing?
├── Medical illustration (anatomy, mechanism)
│ └── Do NOT submit → NEJM illustrators create these
├── Data visualization (graph, chart, diagram)
│ ├── Vector source available → AI, EPS, or SVG (preferred)
│ └── Raster only → TIFF at 1,200 DPI (line art) or 300 DPI (photo)
├── Clinical photograph
│ ├── Patient identifiable? → Remove ALL identifying information
│ └── Ready for submission → TIFF at 300+ DPI
└── What stage?
├── Peer review → Lower resolution acceptable
└── Final publication → Full resolution required
Scenario
Format
Resolution
Special Considerations
Kaplan-Meier curve
AI, EPS, SVG
Vector
Editable format preferred
Clinical photograph
TIFF
300+ DPI
Remove patient identifiers
Histology image
TIFF
300+ DPI
Include scale bar
Flowchart or diagram
AI, EPS, SVG
Vector
Use Univers or Helvetica
Medical illustration
Do NOT submit
N/A
NEJM creates in-house
Images in Clinical Medicine
TIFF/JPEG
300+ DPI
Title max 8 words, legend max 150 words
Best Practices
Submit data visualizations as editable vector files: NEJM prefers AI, EPS, or SVG for graphs and diagrams. Vector formats allow their production team to make typographic adjustments
Do not submit finished medical illustrations: NEJM's in-house illustrators will create these. Submit reference sketches or descriptions instead
Remove all patient-identifying information: Strip faces, names, record numbers, and any identifiable features from clinical images before submission
Prepare high-resolution originals early: Although peer review accepts lower resolution, having 300+ DPI originals ready prevents delays during final production
Use Univers or Helvetica fonts: NEJM's house font is Univers; Helvetica and Arial are acceptable alternatives. Ensure all text is legible at final reduction size
Respect word limits for Images in Clinical Medicine: Titles must be 8 words or fewer; legends must be 150 words or fewer
Maintain original unprocessed files: NEJM may request raw data at any point during review or after publication
Common Pitfalls
Submitting finished medical illustrations: NEJM retains copyright on illustrations they create. Submitting finished artwork creates copyright conflicts
How to avoid: Provide reference sketches, descriptions, or rough drafts; NEJM illustrators will create the final version
Leaving patient-identifying information in images: Any identifiable features in clinical images can result in rejection and ethical concerns
How to avoid: Review all clinical images for faces, names, ID numbers, and other identifiers; blur or crop as needed
Using raster formats for data visualizations: JPEG or PNG graphs lose editability and may appear pixelated at print size
How to avoid: Export charts and diagrams as AI, EPS, or SVG from your plotting software
Submitting low-resolution line art: Line art requires 1,200 DPI — significantly higher than the 300 DPI for photographs
How to avoid: Export line art at 1,200 DPI or use vector formats that are resolution-independent
Exceeding word limits for clinical image submissions: Images in Clinical Medicine has strict limits (8-word title, 150-word legend)
How to avoid: Count words before submission; move detailed descriptions to supplementary text if needed
Pre-Submission Checklist
Before submitting figures to NEJM, verify:
Line art at 1,200+ DPI
Photographs at 300+ DPI (lower OK for peer review only)
Data visualizations in editable vector format (AI, EPS, SVG)
Photographs in TIFF format
Medical illustrations: NOT submitted (NEJM creates these in-house)
Sans-serif font used (Univers, Helvetica, or Arial)
All text legible at final print size
Images in Clinical Medicine: title ≤ 8 words, legend ≤ 150 words
