This article was migrated. The article was marked as recommended. Medical education publishing is growing rapidly, with both increasing demand for publication space and increasing space availability. The increasing speed of publication, variable degrees of manuscript checking and increasing accessibility pose some challenges to compliance with ethical guidelines for academic publication. In this paper we review the literature and the websites of journals that publish medical education content and present a contemporary view on issues that should be considered by authors, reviewers, editors and readers of medical education publications. Based on this analysis, we present guidance on how to meet desired ethical standards when writing particular categories of manuscripts. Relying on self-judgement of the ethical status by authors may no longer be acceptable. The need to meet ethical guidelines in publishing must be balanced with the desire for freedom of speech and avoidance of editorial bias. Our intention is to provoke discussion and learning within the medical education community of practice.