As a medical researcher at Harvard, Mark Shrime gets a very special kind of spam in his inbox: every day, he receives at least one request from an open-access medical journal promising to publish his research if he would only pay $500.

Mark Shrime

“You block one of them with your spam filter and immediately another one pops up,” Shrime, an MD who is pursuing a PhD in health policy, tells me.

These emails are annoying, for sure, but Shrime was worried that there might be bigger issues at stake: What exactly are these journals publishing and who is taking these journals to be credible sources of medical information?

Shrime decided to see how easy it would be to publish an article. So he made one up. Like, he literally made one up. He did it using www.randomtextgenerator.com. The article is entitled “Cuckoo for Cocoa Puffs?” and its authors are the venerable Pinkerton A. LeBrain and Orson Welles. The subtitle reads: “The surgical and neoplastic role of cacao extract in breakfast cereals.” Shrime submitted it to 37 journals over two weeks and, so far, 17 of them have accepted it. (They have not “published” it, but say they will as soon as Shrime pays the $500. This is often referred to as a “processing fee.” Shrime has no plans to pay them.) Several have already typeset it and given him reviews, as you can see at the end of this article. One publication says his methods are “novel and innovative”!. But when Shrime looked up the physical locations of these publications, he discovered that many had very suspicious addresses; one was actually inside a strip club.

When Shrime looked up the physical locations of these publications, he discovered that many had very suspicious addresses; one was actually inside a strip club.

Many of these publications sound legitimate. To someone who is not well-versed in a particular subfield of medicine–a journalist, for instance–it would be easy to mistake them for valid sources. “As scientists, we’re aware of the top-tier journals in our specific sub-field, but even we cannot always pinpoint if a journal in another field is real or not,” Shrime says. “For instance, the International Journal of Pediatric Otorhinolaryngology is the very first journal I was ever published in and it’s legitimate. But the Global Journal of Pediatric Otorhinolaryngology is fake. Only someone in my field would know that.”

What angers Shrime more than anything is that fake journals seem to target doctors and researchers in developing countries for whom $500 is an enormous sum of money. “When you dig into these publications, it’s clear that the vast majority of authors on their table of contents come from lower-income countries,” he says. “They’re preying on people who aren’t able to get into the mainstream medical journals because they come from a university that nobody recognizes or they have some other scientific disadvantage.”

There is a government agency, the National Library of Medicine, that creates an official list of approved medical journals called PubMed. However, Shrime says, it can sometimes take a while for publications to be indexed. Eighteen months ago, The Lancet, one of the most respected medical journals in the world, launched several new publications like The Lancet Respiratory Medicine and The Lancet Global Health; they have only just been included in PubMed.