Abstract:The challenge of publishing internationally for non-native English speakers (NNESs) is substantial, although there are conflicting accounts as to how NNES-authored texts fare in English-medium journals and the nature of the criticism levied at these texts. Collaborators from a wide variety of backgrounds and skill sets may contribute to these texts, and the aspects they focus on differ based on their profile. One of these aspects, rhetorical appropriateness, is of interest to the study of NNES writing because of difficulties authors have in adapting to the discourse-level features of English-medium academic texts. This article presents a multi-year research project exploring the rhetorical characteristics of writing produced by 10 NNES academics seeking to publish in international biomedical journals. Using a text-historical approach, the study traces the arc of 10 different research articles across multiple drafts, analyzing the processes and agents behind these drafts and the feedback received from target journals. Focusing on rhetorically significant changes made across different drafts and comments concerning linguistic issues, this paper seeks to further the understanding of English as a lingua franca within written discourse in the field of biomedicine. One text history is presented to exemplify the methods.