In Pakistan there are very few experts in different fields of medicine and science and it has been observed that competent clinicians are not god reviewers and many good reviewers are not good clinicians or academicians.

Very few know how to review article therefore to pick good reviewers one has to adopt a-hit and try method.

Many reviewers know that there are deficiencies in the paper but do not know to compose and there are deficiencies in the paper but do not know how to compose and pen them.

Some reviewers are even informing the authors or colleagues once they receive the paper and try to show the author or the colleagues their power.

Despite an obvious conflict of interest they accept an article to review and occasionally they reject a study with or withdraw giving valid reasons but will themselves do a similar study later.

These peers even accept papers under pressure or obligation especially if they are from their seniors or from people they know, despite their preoccupations and time limitations the peers disregard the time limit and take a long time to review.

Often the peers give an excuse of loosing the manuscript when reminders are sent to them to send their comments.

Once they send their comments they do not keep a record of their previous comments for 2nd review.

Despite all these deficiencies and shortfalls the peers are indispensable and required by each peer reviewed journal.

The way forward to overcome the deficiency of peer/reviewers in Pakistan we should have training of trainers, share good review with other reviewers, use younger generation as second reviewers, emphasize to them that they should give comments in a way as to how get this manuscript accepted.

Acknowledge reviewers on and off by sending letters of support and including them in the editorial board.

Manuscript Peer Review Process