Governance of AI Writing Tools: A New Priority for Medical Journals

Generative artificial intelligence (AI) - large language models (LLMs) and related tools- has rapidly moved from novelty to ubiquity in academic writing. In less than three years these systems have begun to assist manuscript drafting, editing, literature summarisation and even figure generation. Their speed and fluency promise to lower barriers to publication, improve clarity for non-native English speakers, and accelerate dissemination. At the same time, unchecked use of these tools threatens core principles of scholarly communication:accountability, accuracy, reproducibility and trust. Medical journals now stand at a crossroads: adopt and govern AI to preserve integrity and accessibility, or risk erosion of the scientific record by inconsistent,opaque practices.1-5