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Writing a manuscript can be intimidating, but it's an essential skill that can be honed with practice. In "How to Write Better," I discussed some technical aspects of writing.1 This follow-up article focuses on starting your writing journey, establishing an effective writing routine, and mastering the iterative writing process. I present actionable strategies and illustrate these principles with clear examples from my experiences. Whether you're a novice or a seasoned writer, I hope this guidance inspires you to write more. One of the most common misconceptions about writing is that great writers are born with innate talent. In reality, great writers are made through consistent practice. Writing helps you develop your voice and refine your style. Writing regularly keeps your mind engaged in the writing process. The more you write, the better you write. Any form of writing counts, and you can practice your writing while being productive. I learned to write by writing editorials, case reports, short clinical reviews, and Op-Eds for local news organizations.2 Writing these types of shorter articles will help you build the skills and discipline necessary to tackle larger projects with less worry.3, 4 It can be hard to just sit down and write. However, don't fall into the trap of waiting till the mood strikes you. If you're not in the mood, you need to set it. Develop a routine that primes you to write and identify the conditions under which you write best. Leverage this structure for your writing sessions. For instance, if listening to music while sipping tea gets you in the mood to write, start each writing session with those activities. If you prefer writing in short bursts amid a busy day of meetings, schedule 30-min writing blocks. If a quiet, distraction-free environment is more conducive to your productivity, consider libraries, co-working spaces, or writing at home whenever (if ever) it's quiet. If a bit of background noise helps you focus, find a coffee shop with the right level of hustle and bustle. Over time, you may find that you experience a Pavlovian desire to write when you start your routine under your preferred conditions. I generally write best when I block out larger chunks of time (i.e., 3–5 h); the noise level and the surrounding activity matter less to me. I typically spend more than half of that time thinking about what I'm going to write. I start by sitting in front of my computer with a blank page open on the screen, a notebook in front of me, and a pen in hand. I'll run through ideas in my head and occasionally scribble some words on paper. If I'm stuck, I may write, "What am I trying to say?" on the paper before me as a prompt to organize my thoughts. I'll begin typing when I have a general sense of what I want to convey. Once I have written a few paragraphs, I carry a printed version with me and use brief moments of downtime (e.g., my dentist's waiting room, soccer halftime) to do a little self-critique, as described below. Finding time to write in the context of our other responsibilities can be challenging. Clinical schedules, teaching sessions, committee service, and other activities compete for time. For these activities, there are also others, whether division directors, colleagues, or trainees, to hold us accountable, while in writing, we're usually only accountable to ourselves. No wonder it's easy to let writing fall by the wayside. Blocking out dedicated writing time in your schedule can help keep you on track to write regularly. The act of scheduling writing on your calendar creates commitment, which makes it easier to follow through. For self-accountability, it's important to treat this time as nonnegotiable, just like any other important commitment. Dedicated writing time allows you to create a routine and signals to your brain that it's time to write. Consistency is key, whether it's every morning, a few evenings a week, or even a few hours every few weeks. As with exercise, when I'm writing regularly, I crave it and make time to write. Manuscript writing is inherently a solitary task, but that doesn't mean you have to do it alone. Sharing your progress, discussing challenges, and celebrating milestones with others can make writing more enjoyable and less isolating. Working alongside other writers can also introduce you to new ideas, perspectives, and approaches. This community of fellow writers can enhance your progress by providing motivation, support, and accountability. Writing partners and peer mentorship groups can meet in person or virtually.5 These partnerships require participants to coordinate their schedules, which naturally leads to blocked writing time. Larger academic programs have also leveraged writing retreats to advance scholarship while building community.6 Single-day retreats can easily be integrated into the work week, while multiday retreats require some planning and a small financial investment. As you develop your writing group, keep in mind that longer writing blocks (e.g., 90 min) may work better early in the day when energy is higher, and shorter writing blocks (e.g., 45–60 min) may work better in the afternoon as focus wanes.6 The blank page can be daunting, but the most important step in writing is simply to start. Get some words on paper. They don't have to be good; they just have to be words. They may not feel perfect or even good, and that's okay. When you focus on putting words on paper instead of worrying about whether they're any good, you capture fresh and unfiltered ideas. This process can help clarify your thoughts and lead to new insights. The goal of a first draft isn't to produce a masterpiece but rather to create a scaffolding upon which to build. If you're sitting there staring at a blank page, reflect on what I occasionally say to my mentees, "I can't edit what you haven't written." I begin writing by creating a document listing the major manuscript headings: Introduction, Methods, Results, and Discussion. I start with this step because it helps me overcome the inertia of getting started. When I return to the manuscript later, I've already started writing, allowing me to focus on continuing to write rather than attempting to start. I usually tackle the methods section next. The structured subheadings (e.g., study design, setting, participants, interventions) are useful writing prompts. I can complete this section and circulate it to the team for review before the study is finished. For me, the rest of the manuscript comes together in a less regimented manner. I focus on writing different sections or creating tables and figures depending on my mood. Embrace the iterative nature of the writing process. View each draft as an opportunity to refine your work and move closer to a polished and cohesive final piece. What I might refer to as a first draft is usually the result of me repeatedly rewriting each paragraph after self-critique. However, if you find yourself stuck, it can be helpful to bounce some ideas off a colleague. I never number my manuscript drafts as "version 1" or "version 2"; instead, I label each version by date, starting with the year (e.g., Write More 2024-07-15), so my different manuscript versions sort sequentially. I save these different versions so that I can revisit deleted phrases, paragraphs, or ideas if necessary. If I make substantive changes on the same day, I add sequential letters to the date (e.g., Write More 2024-07-15a). I share this quirk to emphasize the dynamic process of writing where there is no definitive first or second or, dare I say, final version, but rather a living document that continuously evolves. Learning how to critique your own writing is an essential skill. You shouldn't do this while you're writing; otherwise, you'll hamper progress. However, you shouldn't wait until you have a complete draft to review it with a critical eye. The key is to find a balance between writing and self-critique. For example, you might review and edit your work near the end of a writing session or whenever you're stuck and unsure what to write next. This may feel awkward at first but, over time, it becomes second nature. To critique my writing, I print out what I've written and read it from a reader's perspective. This shift in mindset is beneficial because now I'm too focused on trying to understand what I've written to worry about writing. With a pen in hand, I'll ask myself whether each paragraph logically flows from the preceding one. I'll often write the theme of each paragraph in three to four words in the left margin to help me in this process. I then concentrate on individual paragraphs, mapping the ideas in each sentence to determine whether they connect in a meaningful sequence. This step helps me understand whether the paragraph makes sense and identifies redundancy. We all get attached to sentences or phrases we love. Sometimes we must let them go to serve our larger goal of writing well (Figure 1). Feedback is an invaluable part of the writing process. You are better off receiving the toughest feedback before the manuscript has been submitted; it makes the peer reviewer comments seem easy to address in comparison. Of course, your co-authors and mentors will review your manuscript. Also, seek out others who can provide constructive criticism. Colleagues who are not involved in the work can offer perspectives and insights you might not have considered. Do not take any comments personally. Those who provide constructive feedback care enough about you—and your work—to devote their time to helping you improve it. And don't be flustered by divergent comments. Different reviewers may have different opinions, so you should weigh their suggestions and decide what works best for the manuscript. One of the biggest obstacles to productive writing is the pursuit of perfection. However, the notion of perfection is at odds with good writing. The writing process is messy, and striving for perfection causes frustration and procrastination, hindering progress. Additionally, the path from manuscript start to finish is not linear, making progress sometimes difficult to assess. Our colleagues and mentors can help us step back and take a broader perspective to evaluate progress. We must also be prepared to accept that our final version won't be perfect. Scientific writing isn't poetry; its purpose is to communicate a message clearly, and there are many ways to do that effectively. For those with a background in literature, this perspective might help you let go of the need for artistic phrasing, elaborate vocabulary, or striving for that ever-elusive "perfection." The key is recognizing when it's worthy of being submitted. To paraphrase French writer and philosopher Voltaire, perfect is the enemy of done. In summary, writing can be difficult. Don't worry about producing a polished manuscript. The goal is progress, so write more, worry less, and embrace the iterative process. The authors declare no conflict of interest.
Samir S. Shah (Mon,) studied this question.
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