Nature Medicine cover letter: what should authors include?

Nature Medicine lists a cover letter as a required part of the initial submission package. That makes it more than a formality, but it does not need to become a second abstract or a long account of the whole project.

The journal’s current submission guidance gives the cover letter a focused job: explain why the work matters and why it belongs before Nature Medicine’s broad readership, then disclose several details that help the editors handle the manuscript correctly. This checklist turns those source requirements into a practical drafting and final-review sequence.

It is a preparation guide, not a promise of editorial interest or acceptance. Nature Medicine’s live instructions control, and authors remain responsible for the manuscript, declarations, and submission decision.

Start with the cover letter’s two core questions

Nature Medicine says the cover letter should explain:

1. The importance of the work
2. Why the work is appropriate for the journal’s diverse readership

Those points are related, but they are not identical. “Why is this work important?” asks authors to identify the problem addressed and the contribution made. “Why is it right for this readership?” asks why the paper should matter beyond a very narrow specialty.

A practical opening can answer both questions in a short paragraph:

• Name the research problem or clinical need without overselling it.
• State what the study contributes, using the same scope and level of certainty as the manuscript.
• Explain the relevance to Nature Medicine’s readership in concrete terms.

Avoid turning the opening into a claim that the paper is certain to change practice, policy, or patient outcomes unless the manuscript itself supports that conclusion. The cover letter should frame the work accurately, not enlarge it.

Keep the summary aligned with the manuscript

Nature Medicine’s cover-letter guidance does not ask authors to reproduce the abstract. A brief study summary may help establish importance and fit, but every factual statement should agree with the submitted paper.

Practical interpretation: after drafting the letter, compare its description of the study with the manuscript title, abstract, primary outcome, central result, and conclusion. Check especially for:

• A population or setting described more broadly in the letter than in the paper
• A secondary result presented as the main finding
• Causal language where the study design supports only association
• Claims about novelty or impact that are not established in the manuscript
• Different participant numbers, study dates, or outcome descriptions

The cover letter is often written last, which makes it an easy place for an older description of the project to survive. Treat it as part of the same controlled submission package as the manuscript.

Disclose related manuscripts under consideration or in press

Nature Medicine asks authors to disclose details of related manuscripts that all authors have under consideration or in press elsewhere.

This section should be direct. Identify the related work clearly enough for the editors to understand its relationship to the submitted manuscript. Do not leave the disclosure implicit in the study summary.

Practical interpretation: before finalizing the letter, ask every coauthor whether a related manuscript is under consideration or in press. Reconcile the response with any related-work statements elsewhere in the submission. If there is nothing to disclose, use a plain statement rather than leaving the editors to infer that the issue was checked.

This checklist does not determine whether two manuscripts are sufficiently related to require disclosure. Authors should apply the journal’s current policies and ask the journal when the boundary is unclear.

Note any prior discussion with a Nature Medicine editor

The journal asks authors to say whether they have had prior discussions with a Nature Medicine editor about the work described in the manuscript.

If there was a discussion, identify it accurately and briefly. If there was no prior discussion, say so plainly. Do not imply an invitation, endorsement, or level of interest that the correspondence did not establish.

Practical interpretation: verify the editor’s name, the approximate date, and the nature of the discussion against the original correspondence. Keep the source email available to the corresponding author during submission in case the portal asks for related information.

Handle double-anonymized review information correctly

Nature Medicine offers double-anonymized peer review. When authors choose that route, the journal says author affiliations and contact information should appear in the cover letter instead of the manuscript file.

That creates a simple but important file-separation check:

• The cover letter contains the required author affiliation and contact details.
• The manuscript file has been prepared according to the journal’s double-anonymized review instructions.
• Other filenames and submission materials do not accidentally reveal information that the journal tells authors to remove.

The cover letter itself is not seen by peer reviewers, according to the journal’s guidance. Still, authors should follow the complete double-anonymized review instructions rather than relying on the cover letter alone.

Practical interpretation: make an author-identity inventory before upload. Check the title page, headers, acknowledgments, file properties, figure labels, supplementary files, and filenames against the journal’s current instructions. This is an organizational review, not a guarantee that a manuscript is fully anonymized.

Decide whether to suggest or exclude reviewers

Nature Medicine makes reviewer recommendations and exclusions optional. Authors may provide the name and institution of reviewers they would like to recommend and may identify people they would like excluded, with a reason.

If you use this option:

• Verify each person’s current name and institution.
• Follow the journal’s policies on appropriate reviewer suggestions and conflicts.
• Give a concise, factual reason for an exclusion.
• Keep optional reviewer information separate from the explanation of the paper’s importance.

Do not invent a relationship, conflict, or qualification. If you do not have appropriate suggestions or exclusions, the cover letter can omit this optional section.

Check the cover letter against the rest of the initial package

Nature Medicine’s preparation page lists three initial-submission components:

• The manuscript file, including Methods, figures, and Extended Data when applicable
• The cover letter
• Optional Supplementary Information

The manuscript file must contain the author information unless double-anonymized review is selected, a detailed description of the findings with enough methods and materials for expert replication, and a reference list. The journal allows up to ten optional Extended Data display items. Supplementary Information should be relevant to the paper’s conclusions and is sent to peer reviewers with the manuscript.

The cover letter should not carry information that belongs only in a required manuscript section or supplementary file. Its job is editorial framing and the specific disclosures in the journal’s guidance.

Practical interpretation: use a final package table with one row for each required item and one owner responsible for checking it. Confirm that the cover letter, manuscript, supplementary files, and submission-system fields use the same title, author list, study description, and disclosure position.

A concise final checklist

Before uploading the cover letter, confirm that it:

• Explains why the work is important without overstating the evidence
• Explains why it is appropriate for Nature Medicine’s diverse readership
• Uses study details that match the current manuscript
• Discloses related manuscripts under consideration or in press
• States whether any prior discussion with a Nature Medicine editor occurred
• Includes author affiliation and contact information when double-anonymized review is selected
• Gives accurate reviewer recommendations or exclusions only when the authors choose to provide them
• Avoids claims of editorial endorsement, guaranteed impact, or acceptance

Then open Nature Medicine’s current Submission Guidelines and Preparing Your Material page one more time. Journal instructions can change, and the official source—not a saved checklist—should control the final submission.

Keep the preparation boundary clear

Articlo can help format author-provided content to stored journal requirements and organize a preparation package. It does not write research, verify references, determine disclosure obligations, or guarantee acceptance. Authors should review every final file and make the submission decision themselves.