Gary Burd, PhD, ISMPP CMPPTM, Caudex; Aya Takemoto Tokaji, ISMPP CMPPTM

ISMPP membership in Japan has been growing in recent years, underlining the increasing importance of publications planning and execution in a country with potentially unique education needs regarding available treatments to better patients’ lives. Japan has a reputation for being culturally different from other parts of the world, and global publications teams can have a lack of understanding of how best to approach this cultural difference. Misunderstandings can be experienced in delivery of training, methodologies for audit trails, appropriate author interactions, use of publications tracking software, and meeting journal expectations in the peer-review process. As medical publication professionals with experience working on a number of publication projects supporting Japanese affiliate teams and global pharma companies headquartered in Japan, there are various learnings to share with fellow colleagues.

Cultural Expectations in Japan

Japan has distinctive cultural expectations that are rooted in tradition and meaning in Japan; awareness of these can enhance interactions.

  • In business, Japanese people tend to be more formal, but formality in this instance is merely a more obvious manifestation of general good business etiquette: politeness, sensitivity to others, and good manners. This shouldn’t be so different to business etiquette elsewhere, but it can seem more obviously on display.
  • Communication is more subtle and nuanced, so people with a more direct approach to communication may have to calm themselves a little, or politely question further to get a true meaning. Face-to-face business meetings are the lifeblood of business relationships in Japan, as nuances can be difficult to ascertain without associated body language; teleconferences are, therefore, sometimes difficult for all participants to interpret.
  • Hierarchy is very important to the Japanese and showing due deference to high-status individuals is important so as not to upset or disrespect someone. This means that leadership can be by seniority and expert recognition, not necessarily by action, and that group verbal interactions are something that the Japanese try to minimize in order to avoid the risk of offense. Japanese culture values highly the concept of “Face (mentsu, or taimen),” which refers to one’s social standing and reputation. “Losing face” implies the circumstance where someone gets embarrassed in front of others, which can have long-term implications for one’s social standing; colleagues try to avoid this situation as much as possible.

It would help medical publication professionals to be acquainted with these cultural expectations when working with authors and colleagues in Japan, and adjustment of practices can help with engaging successfully.

Managing Publication Needs in Japan

Several examples of publication needs experienced in Japan and suggestions of how these might be approached to maintain cultural sensitivities are provided below.

Training on Good Publication Practice (GPP) in Japan is best delivered with a two-tiered approach, as there are a number of people with limited awareness of the guidelines. Basic training should be offered in Japanese in a classroom-style setting with supporting written materials and opportunities to ask experts any questions, following a traditional teacher–student format. A Japanese translation of GPP3 would help with training in the future. For more practiced publication professionals with experience in global interactions, networking events where ideas can be shared are more appropriate. ISMPP has held two live meetings in Japan focused on the educational needs of the Asia-Pacific region, which included sessions on GPP. ISMPP CMPPTM certification is becoming more well-known and seems to be a very beneficial part of any training on GPP and publications planning; there is a need to explain the requirements of CMPP certification in detail to help understanding of some of the nuances.

Implementing global requirements locally in this age of global development means that all company-sponsored publications should follow the international guidelines and local rules without exception. Japanese companies embraced global methods quickly as most are under pressure to globalize their business and, given its culture to observe rules, most have now adopted procedures for systematically planning publications. Some global companies have internal approval and review processes that are more rigorous than what is considered common in Japan. The global publications team needs to take time and effort in explaining the requirements to its Japanese colleagues; publication managers and agency support are gaining recognition as ways to facilitate explaining these requirements.

Author reviews need to very carefully navigate the hierarchy that exists in Japan to make sure that offense is not caused. This means that authors may need to be engaged at every draft in two stages: the first stage being a conversation with the lead author and the senior author, and the second stage being a review by all authors. Conversations with co-authors need to be clear that they really do need to contribute to the review, as there is the potential for co-authors to defer to senior colleagues. Publication managers can play an intermediary communication role between authors to limit direct confrontation. The challenge associated with these methodologies is that they can be time consuming, which can impact budgets and project timelines, so it is important to plan ahead.

Publications management software is not extensively used in Japan, but healthcare professionals are becoming more comfortable with its implementation. The challenges faced include publication managers having unrealistic expectations of what the software can achieve for them, the one-size-fits-all templates not easily allowing for nuances that may be required with individuals, and the fact that sub-reviews that may be necessary are not easily built into the software. However, with greater experience and increased potential for customization, publications management software can be a useful tool for Japanese publication professionals and authors, as well as global teams managing publications with Japanese authors.

Addressing comments from journal peer reviewers from international journals can lead to different perspectives on how best to proceed. Common questions include understanding what the peer reviewers are actually asking for, as their language can sometimes be unclear even to a native English speaker. Another example includes conflicting comments or requests that are unachievable, such as asking for additional analyses that are unavailable. To help alleviate some of the stresses in preparing a thorough response, publication professionals can ask for help from experts who have responded to peer reviewers many times before, have the authors discuss solutions to difficult comments together, and explain that presenting a rationale for not being able to address a comment is permissible.


In all, the methods and practices employed globally are harmonizing, and this includes in Japan. Each generation of physicians, authors, and publication professionals who are technology savvy and who have experience in dealing with colleagues internationally brings the shared understanding of the needs more into focus for everyone. It is important that ISMPP, its members, and all publication professionals continue to lead the way with GPP, from a global and local perspective. Initiatives that share experience, including working together on projects across countries, will only improve the publication practices for all involved.

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