Use of images in manuscripts


1. Scope of this policy
2. Inserting and labelling images
    2.1 Uploading images
    2.2 Labelling images
    2.3 Image series
    2.4 Visual abstracts
3. Image Quality
4.Copyright and licensing
    4.1 Images for which you hold the copyright 
    4.2. Use of other people’s images
          4.2.1 Images in the public domain
          4.2.2 Creative Commons licensing
          4.2.3 Images taken from previously published academic work
          4.2.4 Use of stock photos
          4.2.5 Fair use principles
          4.2.6 Images from social media
    4.3 Images you have created which are adapted or altered from someone else’s work
5.Ethical concerns
    5.1 Image manipulation
    5.2 Use of images which contain recognisable individuals
6.Reuse of images published in MedEdPublish

1. Scope of this policy

This policy covers the use of all images submitted as part of a manuscript to MedEdPublish, whether these are graphs/charts, photographs, illustrations or any other kind of visual aid. We refer to these as ‘Figures’ in the journal. We acknowledge that the use of images can significantly enhance the quality of a published article, however the use and reuse of images raises a number of issues for the journal, and we ask all authors to adhere to the following guidelines.

There are two main reasons for using images in your work: firstly, for the purposes of research, scholarship, criticism or comment (i.e. the image is part of your data or analysis); and secondly, to add visual interest and reinforce key points in your argument (e.g. in an opinion piece or ‘twelve tips’ article). In both cases, you need to be aware of copyright law, but, in the second, there is no defence under ‘fair use’ principles, and the image should not be used unless you are absolutely certain of its copyright status. 

2. Inserting and labelling images

2.1 Uploading images

Images should be uploaded using the ‘image uploader’ feature. They should NOT be copied and pasted directly into your manuscript submission, and we strongly recommend that you resize your image before uploading it, as changing the display size of your image will alter its resolution (see section 3: Image Quality).

Accepted file formats are .png and .jpg, and file size should not exceed 5Mb. There is no limit to the number of figures you are permitted to use in a manuscript.

Tables should not be uploaded as images.

2.2 Labelling images

Any images, including charts or illustrations, must be labelled as ‘figures’ and numbered in the sequence they appear in the text. All figures should be referenced in the body of the text.

Figure headings should not appear on the image, but should be entered as text directly above the image. Headings should ideally be informative enough to allow readers to interpret the content of the figure even if they have not read the text.

If the image requires a citation, this should appear in the body text directly under the image, as well as in the reference list. Please do not include your citation as part of the image as it cannot be read by electronic scanning software.

2.3 Image series

If you wish to display a series of images under the same figure heading (for example a set of graphs showing temporal progression), we recommend creating a composite image file rather than uploading individual images. This ensures your figures will display exactly as intended. Numbers or letters to identify each image may be inserted into the image.

2.4 Visual abstracts

We encourage the use of visual abstracts, which provide a concise, pictorial summary of the main findings of your article. You may upload a visual abstract into the abstract field of your article as a single image which meets our guidance on quality, file size and image format. Where a visual abstract has been provided, we may use this in any promotional posts on social media.

Visual abstracts should be able to be understood as a stand-alone summary of your work, but you may also provide a traditional, written abstract if you wish.

3. Image Quality

Images should be of high quality. They must not be stretched or skewed, and image files should be cropped as close to the actual image as possible. Layers should be flattened.

To meet standards required by some indexing services, resolution must be at least 300 dpi for photographs or graphics with no text, and 500-1200 dpi for images containing text. You can find the resolution of your image in Windows by right-clicking on the file, selecting ‘Properties’ and then ‘Details’ (see Figure 1). From a Mac, select the image and choose ‘get info’ and then ‘more info’. 72 dpi web-quality graphics should be avoided, and images in which colours are not realistic, text is illegible, or images are pixilated are not acceptable.

Note that resolution is measured in pixels (dots) per inch, and changing the image display size will alter its resolution. We strongly recommend that you resize your images before uploading them rather than altering the display size by stretching the image in the manuscript submission form.


Figure 1: Finding your image properties in Windows

4. Copyright and licensing

‘Copyright’ provides legal protection for authors of original work. The copyright belongs to the author but may be transferred or licensed to a third party, such as a publisher.

Legally, we cannot publish images where you do not hold the copyright unless:

  1. It is a public domain image (section 4.2.1). OR
  2. Explicit permission has been granted by the license holder (sections 4.2.2- 4.2.4), OR
  3. Use of the image is clearly covered under ‘fair use’ principles (section 4.2.5).

If you use any images in your manuscript, we ask you to acknowledge the source in the ‘Acknowledgements’ section.

4.1 Images where you are the copyright holder

If you are using photos that you took yourself or charts/diagrams/illustrations that you created yourself, it is best practice to state that you are the creator/owner of the image in the Acknowledgements section. For example, ‘Figure 1. Source: the author’. If you are reproducing an image that you have previously published elsewhere, you should check any licensing agreement you entered into carefully to ensure it permits you to republish the image (see section 4.2.3).

4.2 Use of other people’s images

All images published since 1989 are considered ‘copyright’ from the date of first publication, even if they do not carry the copyright logo ‘©’. Copyright law varies between countries and usually both the law of the country where the work was published and the law of the country where the work is being republished are considered, so whichever provides the highest degree of protection will apply.

To avoid lawsuits, there are some general principles that authors should follow when reusing previously published images.

4.2.1 Images in the public domain

Public domain images are images whose copyright has expired, been voluntarily relinquished, or never existed. Just because an image is publicly available does not mean it is in the public domain.

Images for which copyright has never existed include common icons such as male/female, no smoking, musical notes, astrological symbols, etc. These can be freely used or incorporated into your work.

The Berne convention sets out some general principles for the duration of copyright, which suggest that as a minimum, work is protected for 50 years after the author’s death, or, if the author is anonymous, 50 years after its first publication. Many countries have considerably longer protected terms, and these are often extended if the work has high commercial value. Where copyright has expired, the work will usually be marked with a ‘public domain’ logo (Figure 2).


Figure 2: Public domain "copyright-free"

Many museums and art galleries have voluntarily relinquished copyright on works they hold in order to make them public domain. Some authors also gift their work to the public. Such work may be licensed under a CC0 “no rights reserved” (Figure 3) license and can be used freely.

Figure 3: CC0 "no rights reserved"

Anyone can apply a ‘public domain’ logo to any work and it is your responsibility to ensure that any images you use which are marked as ‘public domain’ are, in fact, in the public domain.

4.2.2 Creative Commons licensing

Images licensed under Creative Commons may be used provided they are properly attributed. If the license states ‘no derivatives’ (ND) then the image may not be modified. If it states ‘share alike’ then the original terms of the license must be applied to any modified versions.

You should provide both the source of the image and the license that applies to it in the acknowledgements section of your manuscript. Anyone can claim to be the author of an image on the internet, and it is your responsibility to ascertain as far reasonably possible that the image is genuinely licensed for reuse. Signs that an image does not belong to the person who licensed it include a company watermark or logo superimposed on the image and/or the use of a copyright symbol © and the original author’s name.

4.2.3 Images taken from previously published academic work

Most work published in books or journals is covered by copyright law, and the author usually ‘assigns’ or ‘transfers’ their copyright to the publisher. If you wish to reproduce an illustration, you will need permission from the copyright holder. Most journals have a very straightforward online form to apply for this permission, and for reuse of a single image in an academic work there is often no fee. You will be provided with an explicit statement of what the permission covers and how it should be acknowledged, and this statement must be included in the ‘Acknowledgements' section of your manuscript.

4.2.4 Use of stock photos

Stock images are professional quality images which are licensed for reuse. They are usually curated by an agency and include: public domain images, which can be freely reused; royalty-free images, where the user purchases a license to the image and can reuse it as many times as they like; and rights-managed images, for which a license is granted for a single use of an image for a specified purpose. You are free to use stock images in your work provided you have paid any required license fees. To avoid any potential copyright disputes, you are requested to acknowledge the source of any stock images you have used – e.g. ‘Figure 1. Source: Shutterstock”

4.2.5 Fair use principles

‘Fair use’ (‘fair dealing’ in the UK) is a legal exception to copyright law which allows reproduction of portions of copyrighted work for public benefit, for example in teaching, scholarship and research. This means that in principle you can use copyrighted material as ‘data’ and quote from it to support your analysis. In legal disputes over fair use, there are four principles which are usually considered:

  1. the nature of the original work;
  2. the public interests served by reusing it;
  3. how much of the work has been reproduced, and
  4. the effect on the value of the original work.

Fair use can be difficult to apply to images as it is unlikely that it would be useful to reproduce only small portions of a photo or image. Decisions as to whether copyright breach has occurred would be made on the basis of the contribution to the public good and whether the use significantly devalues the original work. If in doubt, you should avoid using the image. You should state in the acknowledgements section of your manuscript that you have reproduced the image under fair use principles.

Fair use extends to reusing branded images or corporate logos, however these may also be trademarked, and care should be taken not to alter or deface them in any way, or to use them in a way that could affect the brand owner – for example, by suggesting they endorse your work or creating a false association with another company.

4.2.6 Images from social media

While posts and images shared to social media are often shared publicly, they are not public domain images. Authors of content on Twitter, Facebook and YouTube retain the copyright to any material they have created, including both text and images, and their posts should not be reused as images without explicit permission. Using such content as ‘data’ is generally permitted under fair use principles, and it would, for example, be permissible to use quotes from the material in the same way as you might quote interviewees, but not to reproduce the original posts without permission of the poster.

In addition, if an image shows any identifiable individuals their permission must be sought before reusing the image. See section 5.2.

4.3 Images you have created which are adapted or altered from someone else’s work

Simply redrawing or recreating someone else’s figure does not count as an alteration – the work is still protected by copyright law and you should follow the guidance in section 4.2.

Altering or amending a previously published figure, chart or illustration yourself by adding your own data or interpretation of the work is equivalent to drawing on any other academic source to develop the argument you are making. You should acknowledge the source material as a citation in the normal way, stating ‘Adapted from … under the image’. You should also state in the acknowledgements section that you created the figure yourself but that it was based on their work. Failure to cite the original author is a form of plagiarism and could lead your article being retracted.

Note that some images, such as trademarks or images associated with proprietary brands, may not be altered even for research purposes. It is your responsibility to check that the original image was published under a copyright license that permits this kind of adaptation, that you have permission from the copyright holder to adapt the image and/or that your adaptation would be permitted under ‘fair use’ principles.

5. Ethical concerns

5.1 Image manipulation

Deliberate and unacknowledged manipulation of images to mislead readers about the strength of your data or conclusions constitutes data fabrication and is a form of research misconduct. This could include, but is not limited to: obscuring or removing parts of an image; introducing new elements into an image; digitally enhancing parts of an image; moving parts of an image.

There are instances (as described in section 4.3) where it is perfectly acceptable to use an altered version of a previously published image, provided the original source is properly acknowledged. In most cases, it is better to create your own new image than to make alterations to the original image, but it is permissible to alter the original: if it was published under a Creative Commons license permitting modifications; if you have good grounds for doing so under ‘fair use’; or if the modification is made to protect identifiable individuals. Such alterations must be clearly indicated and justified in the text of your article (e.g. Figure 1 was modified to protect participant anonymity).

We will not publish articles where fraudulent image manipulation is suspected, and if it is discovered after publication, it may constitute grounds for retraction. If you have used a manipulated image, the editors may request to see the original image, and you should be able to describe exactly what modifications were made, and which tools were used to make them.

Further information is available in our editorial policy

5.2 Use of images containing recognisable individuals

Individuals own the rights to their own images and these may not be distributed without their explicit permission. If permission cannot be obtained (for example because the person was accidentally captured and cannot be traced), the image must be suitably anonymised, for example by pixilating or masking faces). It is at the editors’ discretion whether such images are considered suitably anonymised to allow publication. If permission is sought and refused, the image should not be used even if it is de-identified. Use of identifiable images without permission can be grounds for retracting an article.

In addition, if your research involved analysis of images containing identifiable individuals, we would normally expect informed consent to have been sought.

Further information is available in our policy on protection of research participants

6. Reuse of images published in MedEdPublish

All articles published in MedEdPublish are licensed under a CC BY-SA 4.0 license and you do not need permission to reuse or modify any of the article content including original, author-created images, provided you acknowledge the original author, article and journal, and are explicit about any modifications you have made. Your adapted image must be licensed under the same CC BY-SA license. This license does not extend to third-party images that have been included in articles, to which the original copyright licensing terms apply. You must check the image source before reusing it and, if you are in any doubt, contact the author of the article and/or the original creator of the image.

You may not reuse the MedEdPublish logo, the AMEE logo or any third party logos published on the site without explicit permission from the copyright holder. Should you wish to use the MedEdPublish logo or the AMEE logo please contact [email protected]. Queries regarding third party logos should be directed to the third party in question.