As of April 15, 2013, the Singapore Medical Journal has instituted an Article Processing Charge (APC) of SGD 100.00 on all online submissions. Since its inception in 1960, the SMJ has been freely accessible to the medical community, with no submission, publication, page or colour charges levied on its authors. However, due to the rising costs of peer-review administration and publication, this is no longer viable. The APC is thus a means by which the Journal can continue to publish quality articles whilst maintaining a sustainable model for open access publication.