Looking beyond, around and within cultural differences and dialogues across the open access ecosystem

‘Where is it indexed?’ or ‘what's its impact factor?’ have been, for decades, typical questions researchers ask themselves when choosing a journal to disseminate their work. In the last few years, new questions have popped up: ‘is it open access?’, ‘is it compliant with my institution's mandates?’, ‘does it charge an APC (article processing charge)?’. Worryingly, a follow-up question is, all too often, ‘can I afford it?’.

We were reminded of these dilemmas by a recent Medical Education article, where Han and Kumwenda highlight, but also question, the claim that online education has been ‘touted for promoting equity and inclusivity’.¹ The authors acknowledge notable progress and efforts in providing open and equitable access to medical education globally, but they also highlight concerns about its potential to perpetuate—and even exacerbate—inequalities between well-resourced, or Global North, and under-resourced, or Global South regions. An analogous argument can be made when it comes to discussing access to scholarly articles.

The belief that removing—or better yet, not even building—the subscription paywalls that block access to scientific articles would make knowledge globally available was one of the starting points of the open access movement more than two decades ago.² While it certainly remains a necessary condition for the democratisation of knowledge, this seems like an overly optimistic simplification given the current state of the scholarly publishing landscape. The model known as ‘gold open access’, where articles are immediately made publicly available on a journal's website, has, for the most part, come to be equivalent with increasingly costly fees for authors, effectively reducing the spectrum of scholars who can afford them and therefore excluding a sizeable proportion of researchers from the most prestigious, internationally visible publication venues.

In a recent discussion about where to submit an article on physicians' use of social media,³ LC, an Argentinian early career researcher, explained to LM, a full professor based in the United States, that this model, however, is not—and needs not be—the norm or the only possible implementation of open access. In regions such as Latin America, community-driven, non-commercial open access is the norm rather than the exception.⁴ For example, a recent survey of Latin American scientific journal editors (n = 342) reported that 91% of the respondents' journals are open access, and 88% do not require authors to pay APCs.⁵

So, for LC, targeting a diamond open-access journal (i.e. no fees for readers, no fees for authors) was the norm, whereas LM had been conditioned to accept the author pays model to ensure access, which can be prohibitively expensive; in 2023, the median APC for gold open access was $2000.⁶ This cross-cultural difference presented a quandary about where to submit our manuscript. We wanted to ensure that we both were comfortable with our decision and confident that we could reach our desired audience of readers.

Starting from the shared belief about the importance of open access helped our discussions, but we quickly realised that selecting a journal was complicated. To help us decide, LC compiled a spreadsheet of target journals and their APCs. Because our study was set in the United States, we focused on journals that were global versus regional in nature and found that the fees were at or above the $2000 median APC cost.⁶ While in this case we were fortunate to have grant funds to cover such fees, LC raised an important point: the expenses for publishing just one paper were well above the average salary of a researcher in her home country, where public investment in science, health and education is being cut at unprecedented rates, endangering the sustainability of entire research areas and the very livelihoods of many Argentinian scientists.^{7, 8}

In light of our dialogue, these journal titles were unacceptable to both of us. In the end, we leveraged the option to preprint our manuscript, thus making it freely accessible in its pre-peer review form (for more on preprints, see Maggio & Fleerackers⁹) and then submitted to Medical Education. Our decision hinged on wanting to reach medical educators, but we also selected this journal because it not only allows preprints but also allows authors to post the accepted version of their article 12 months after publication to freely accessible locations such as the author's homepage and institutional repository (Sherpa Romeo).

In health professions education, authors have increasingly become interested in publishing their work via open access.^{10, 11} However, in APC-based models, cost is a deterrent for under-resourced researchers.¹² This suggests that authors look beyond their current context and consider global models to transform not only the expensive and exclusive APC path to open access but also their own publishing practices. Moreover, authors should look around at their colleagues and be mindful of their backgrounds, cultural and disciplinary differences. Finally, authors should look internally at their author teams to ensure that all collaborators feel empowered to question publishing decisions (e.g. regarding a journal's licence sharing permissions, to pay an APC or not, to deposit a preprint) and feel confident that their voices will be heard.

Lucía Céspedes: Conceptualization; writing—original draft; writing—review and editing. Lauren A. Maggio: Conceptualization; writing—original draft; writing—review and editing.

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.