- Richard Smith, chair
- 1Patients Know Best, Cambridge CB4 0WS, UK
Fraser and Dunstan (doi:10.1136/bmj.c6815) show that even within a narrow specialty it is impossible to keep up with published medical reports.1 Trainees in cardiac imaging reading 40 papers a day five days a week would take over 11 years to bring themselves up to date with the specialty. But by the time they had completed that task, another 82 000 relevant papers would have been published, requiring another eight years’ reading. And this analysis assumes that trainees need to know about cardiac imaging only, whereas they surely need to keep up with other areas of medicine and healthcare. The authors conclude that it is impossible to be an expert⇓.
This problem is not new. Dave Sackett, the “father” of evidence based medicine, found some 20 years ago that to keep up to date in internal medicine it was necessary to read 17 articles a day 365 days a year.2 He also found that the median time spent reading by newly graduated doctors was zero, while for senior consultants it was 30 minutes, with 40% reading nothing.2
Some 10 years ago I asked around 100 doctors how much of what they should read to do their job better they actually read. About 80% said less than 50%, and 10% said less than 1%.3 More than half felt guilty about this, and when asked to describe in one word how they felt about their information supply it was mostly negative (impossible, overwhelmed, crushed, …