ImportancePublishing in health professions education (HPE) journals is an integral component of academic discourse and career progression. Research in this field is shifting to an open access (OA) publishing model.ObjectiveTo identify the characteristics and publishing models of HPE journals and explore potential associations between publication costs and journal metrics.Design, Setting, and ParticipantsThis cross-sectional study was conducted between September 20, 2023, and February 14, 2024, using the World Bank purchasing power parity (PPP) index to analyze relative costs of article processing charges (APCs). Data on journal characteristics, impact metrics, APCs, and waiver or discount were extracted from the National Library of Medicine, Scimago, Scopus, journal websites, and email correspondence with editorial staff of journals. All HPE journals indexed in PubMed, written in or translated into English, and with HPE as a core component of their mission were included in the analysis.Main Outcomes and MeasuresTwo-year impact factor, H-index, cite score, Scientific Journal Ranking, and APC.ResultsAmong the 51 journals included, 27 (53%) adopted OA-only and 24 (47%) adopted hybrid publishing models. The median (IQR) APC for all journals was $2820.00 ($928.00-$3300.00). Associations were observed between impact factor and APC (β coefficient, $386.84; 95% CI, $226.84-$546.84; P < .001) and between cite score and APC (β coefficient, $282.40; 95% CI, $148.12-$416.61; P < .001). Of 20 journal websites with information regarding fee waivers or discounts, 7 journals (35%) confirmed fee waiver or discount. The PPP index analysis of the top 39 countries publishing HPE research showed that the financial burden of meeting the median APC for publication was 1.94 to 10.26 times higher for authors from lower-income countries than for authors from the US.Conclusions and RelevanceResults of this cross-sectional study suggest that adoption by HPE journals of an OA publishing model was high but access to APC waivers or discounts was limited. These factors create barriers to equitable OA practices, necessitating concerted efforts, such as increasing transparency of publishing costs, implementing economic impact analysis, expanding waivers to eligible authors, and applying holistic impact factor scoring.
