Peer review is the process by which journals scrutinize and regulate the quality of content they publish, by inviting experts in the field (peers) to review and comment on manuscripts received.

The peer review process of Sierra Leone Journal of Medicine goes through the following steps:

1. Submission of Manuscript: The corresponding author submits the manuscript to the journal. This is usually via the journal’s online submission system. Occasionally, the journal accepts submissions by email. The journal may ask authors to suggest potential reviewers, but the journal is not constrained to use the suggested reviewers.
2. Assessment by the Editorial Staff: The purpose of this assessment is to make sure that the submitted manuscript follows the journal’s Author Guidelines. The quality of the paper is not assessed at this point.
3. Assessment by the Editor-in-Chief or the Editor: The Editor-in-Chief or the Editor check that the paper falls within the scope of the journal.
4. Editor-in-Chief or the Editor assigns an Associate Editor: Associate Editors assess the manuscript to see if it is sufficiently original and interesting. If not, the paper may be rejected without being reviewed any further.
5. Invitation to Reviewers: The Editor-in-Chief sends invitations to three peer reviewers, who are experts in the field.
6. Response to Invitations: The potential reviewers consider the invitation against their own expertise, conflicts of interest and availability, and may then accept or decline. The journal will ask those who decline to suggest alternative reviewers.
7. Actual Peer Review: The reviewer conducts the peer review according to the guidelines in the Journal’s Guideline to Reviewers which is made available to the reviewer. The review is then submitted to the journal, with one of the following recommendations: (a) accept without revision (2) accept with minor revision (3) accept with major revision (4) resubmission or (5) rejection.
8. Associate Editor Evaluates the Reviews: The assigned Associate Editor considers all the returned reviews before making a final recommendation to the Editorial Board. If the reviews differ widely, the Associate Editor may recommend invitation to an additional reviewer so as to get an extra opinion before making the final recommendation.
9. The Decision is Communicated to the Authors: The Editor sends a decision email to the author including any relevant reviewer comments.
10. The Authors Respond to the Decision: In the case of minor revision, the Associate Editor can assess and make appropriate recommendation. For major revision, the manuscript is sent back to the reviewer with the changes made by the authors highlighted. The reviewer will reassess the document and send his or her recommendation back to the editorial office. The document goes through steps 8 downward again; culminating in a final decision, which is recommended to the Editorial Board

The Final Decision is Communicated to the Authors.