Are you up-to-date?

The first issues of the “New England Journal of Medicine and Surgery, and the Collateral Branches of Science” were published in a letterpress in 1812 and featured a handful of articles. Now, medical articles are catered via e-TOCs, email, aheads of prints, PDFs, RSSs, Kindles, iPads, and soon Facebook, Twitter and Angry Birds. It would be very hard to actually dimension the impact of this tremendous access. The half life of new knowledge decreases dramatically as access to information becomes ubiquitous. From 1948 to the present, PubMed now provides instant access to 18 million journal citations. PubMed Central hosts 1.5 million full-text articles. And when you look at the trend over time, it points up like our fiscal deficit chart.

Potato-couch instant access: One of my mentors, who came to the US in the late ’60s for a fellowship training, described to me how marveled he was to have easy access to a full medical library and a copier. When he returned to his country to become a prominent subspecialist, he took several priceless boxes just full of photocopied articles he amassed during his training. Another colleague of mine told me that in his years as pediatric resident in the mid ’80s he used to ride a bus for about a half hour to go to the library at the medical school. Then it would take ages to find the reference, if it was there. Plus, you’d have to cough up some money for copies.

Email became popular while I was in med school, but I do remember searching Medline in those CD-ROMs or the huge index books. No matter how archaic it may seem today, that was the most fancy and updated way to go. The old folks may be saying “in our times, it was more about textbooks and a few leading journals.”

The Internet revolution profoundly impacted the medical sciences (and everything else) for the good. The original concept of anywhere-anytime-data repository was like love at first sight for PubMed and the Web. As journals made full-text available and you could print “as-is,” it became clear that real-time access was at the tip of your fingers.

How long does it take to become obsolete? Proven: by ignoring medical advances, we would go sour in a matter of a few years. We may damage patients or just deprive them from improved diagnostic and therapeutic options. From this view, CME credits can be seen as a painful requirement or as a bar set too low. I heard once that it would take less than 5 years to become obsolete. That may be even shorter for subspecialists.

How to stay afloat? In an indistinct order, and also to survive the information overload, these would be my tips:

Identify the core journals in your field, go to their websites and sign up to receive an electronic table of contents by email. If you don’t have an email address, you are officially obsolete.
Allocate time during the week to put your legs on your desk and read what you have pre-screened or to peruse your favorite journals.
Visit your professional association website regularly. For instance, pediatrics.org, pids.org, idsociety.org.
Attend national meetings to get the scoop and see what your peers are doing.
Familiarize yourself with library resources in your institution (they usually crave to show you what they have); if you have no affiliations to institutions, universities or professional societies, continue to enjoy life and post me your secret.

This topic is so fascinating that it should deserve more posts. If you’ve been through different times and trends, I’d love to hear your story or comments.

Until soon,
FL