A recent letter to the editor in the Canadian Medical Association Journal (CMAJ) highlighted a potential opportunity to increase access to subscription-based journals for individuals in low and middle-income countries. It turns out that a few journals give their peer reviewers’ free journal access or a free subscription as a thank you gift for their effort.

How widespread is this policy in the medical publishing world?

Unfortunately not very. Of the 21 journal editors contacted (including CMAJ, Lancet, BMJ, JAMA, etc.), only three actually provide reviewers with free journal access. The gift ranges from a 3-month (Lancet) to a 12-month subscription (BMJ and the Journal of Intellectual & Developmental Disability).

On the positive side, 20 out of the 21 journals were members of the Health InterNetwork Access to Research Initiative (HINARI), the World Health Organisation’s programme to provide free or low cost online access in the developing world to scientific research. This is encouraging, but HINARI is not perfect and many are still left without access.

For example, a BMJ Rapid Response highlighted that health care workers in middle-income countries such as Malaysia are often caught in the middle. Too rich for aid but not wealthy enough to afford the high cost of journal subscriptions.

However, despite the fact that most original research relevant to low and middle-income countries is open-access, the majority of the education articles, clinical reviews, news pieces and commentaries are still often behind firewalls that require payment.

The move for more open-access journals is encouraging. For example, the Howard Hughes Medical Institute, the Max Planck Society and the Wellcome Trust will be launching eLife, a new open access journal later this year.

Why don’t more journals provide peer reviewers with free subscriptions? Not only is it a symbol of appreciation for the hours of gratuitous time altruistically invested but it could be used to help others. Likely there is no pressure or demand for it. The majority of peer reviewers are already at academic institutions with subscriptions.

Has this happened to you before? What have you done with this free gift? Although few journals seem to be endorsing this policy, it may serve as a small way to increase access to those who otherwise do not have it.

In the future, if you review an article for the BMJ, the Lancet or the Journal of Intellectual & Developmental Disability (or other journals that provide free subscriptions after peer reviewing), rather than deleting the email consider who might benefit.

If you review for a journal that does not, ask the editor why not?

A couple of weeks ago, I spent the evening in London, with three other doctors, talking to sixth-formers from “non-traditional backgrounds” (a euphemism for low socio-economic status) about studying medicine. A friend from medical school organised this careers event on behalf of Teach First, an independent charity that aims to broaden access to education. These were 16- and 17-year olds achieving high grades despite being in inner-city schools, where their peers were not pursuing A-levels, let alone higher education.