Intended for healthcare professionals

Head To Head

Are international medical conferences an outdated luxury the planet can’t afford? Yes

BMJ 2008; 336 doi: (Published 26 June 2008) Cite this as: BMJ 2008;336:1466
  1. Malcolm Green, professor emeritus respiratory medicine, Imperial College
  1. 1London SW8 2EF
  1. malcolm{at}

Every year thousands of doctors and scientists fly to meetings at distant locations. Malcolm Green argues that this is no longer justifiable or necessary, but James Drife (doi: 10.1136/bmj.a351)believes face to face contact is hard to replace

Climate change is accelerating, and our propensity for releasing carbon dioxide and other greenhouse gases into the atmosphere is contributing massively. We owe it to our children and grandchildren to minimise our contribution to the acceleration, putting off the day when the environment becomes terminally unstable for human existence.1

For each of us to reduce our carbon footprint from 8 tonnes a year in the United Kingdom to the 2 tonnes that is our sustainable share is a task that is hard to conceive. But a journey of a thousand miles starts with but a single step, and doctors and scientists should be asking themselves how they can act.

Low energy light bulbs, improving the insulation of our homes, and driving less will contribute. But if we stop going to international conferences we can make a significant difference and be seen to be giving a lead. By finding new ways of communicating with our colleagues in other countries, we can save time, energy, and carbon emissions.

Unnecessary luxury

Why do we attend international conferences in such large numbers? One reason is to keep up to date in our specialty. We attend lectures, seminars, presentations, and plenary sessions, sitting in darkened rooms and listening to speakers talking to their slides, followed by a few questions. With modern technology speakers could be relayed from their home auditorium and we could just as well enjoy these sessions in darkened rooms in BMA House or in our own hospital or office. We could even ask questions if the session was in real time.

We also go to conferences to present our work to our colleagues and to obtain their feedback. Those who attend these sessions could instead join together in virtual networks, with people presenting their work by conference call or conference video or by virtual poster accessed through the internet. Sessions could be set up to link as many network participants as is desirable, with a chair to catalyse and control the discussions.

We go to conferences to meet our colleagues. Sometimes we spend time with collaborators or competitors from abroad, but often conferences are the opportunity to network with colleagues from the United Kingdom in a relaxed setting. Surely there should be ways of achieving this creatively on home territory. Collaborators from abroad could be linked by conference video while key people could arrange to meet offline occasionally.

Finally, it is argued that we go to conferences to see the sights and enlarge our horizons. But most conferences are in undistinguished conference centres, surrounded by impersonal hotels, and could be anywhere in the world. It is better to choose places to go on holiday for their own merit and stay at home for conferences.

Environmental impact

So would abandoning conferences make a material difference? Take the American Thoracic Society, a relatively small example of the genre. Every year, over 15 000 respiratory doctors and scientists, of whom about 3500 are from Europe, trek to some great location in the United States. Callister and Griffiths calculated that the carbon burden of flying delegates to and from the 2006 conference in San Diego was about 10 800 tonnes, representing some 100 million person air miles.2 For the American Cardiac Society meeting, attended by 45 000 people, the total would be over 300 million person air miles. If there are, say, 20 medical conferences a year in the US and we add in conferences in Europe, Asia, and Australasia, the impact from travel to conferences would be at least 6 billion person air miles a year or 600 000 tonnes of carbon. This equates to the sustainable carbon emissions for around half a million people in India3 or the carbon dioxide absorbed by 120 million mature trees covering 120 000 hectares of rainforest.4 Add in the energy costs of huge hotels, enormous conference centres, and all the attendant activities, and the environmental impact becomes mind boggling.

Can alternatives work?

Is it realistic to expect people to attend virtual conferences? This would require a new mindset in which comfortable facilities would be provided and discussion with other colleagues facilitated. The excitement of a foreign visit might be lacking, but the easy practicalities of a trip to London or regional hub could compensate. There would be no jet lag, no interminable waits at airports, no lost luggage, no weekends away travelling.

Could conferences be as good at distance? The answer is a resounding yes. Organisations such as oil companies, financial institutions, and inter-governmental bodies have regular and highly successful conference calls and videoconferences. Some are so vivid that in the heat of discussion members forget they are separated by oceans. At a recent transatlantic conference a participant in New York asked his colleagues if they would like coffee and several hands were raised in London. Teenagers communicate with each other all over the world by VOIP (voice over internet protocol), with or without video links, using only their home computers. Surely we could follow their example?

There would be costs associated with setting up virtual conferences, but these will be much less than those of flying people around the world, staying in expensive hotels. Our grandchildren will view with amazement our profligacy and inefficiency in flying across continents in great clusters to exchange information. Huge international conferences will be as outdated and unsuitable for a modern world as the dodo, the fax machine, carbon paper, and the horse drawn carriage. We must be bold and act now to plan and welcome the new world of information transfer.


  • Competing interests: MG attended international conferences for 30 years.


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