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BMJ 2011; 342 doi: (Published 06 April 2011) Cite this as: BMJ 2011;342:d2182
  1. Jerome P Kassirer, distinguished professor, Tufts University School of Medicine, Boston, Massachusetts, and visiting professor, Stanford University, Palo Alto, California
  1. jpkassirer{at}

Scant attention was aroused by the results of a small study that many might applaud but that I perceive as alarming. A survey of nearly 200 junior doctors in internal medicine showed that more than three quarters read the medical literature in response to a specific patient encounter. And nearly 95% consider electronic textbooks the most effective source of knowledge (Medical Teacher 2010;32:773-5, doi:10.3109/01421591003692698). Similar observations are reported among medical students (Academic Medicine 2006;81:489-94, doi:10.1097/01.ACM.0000222273.90705.a6).

A reason to applaud is that rapid access to authoritative information can benefit the care of patients. A reason for concern is that the information being sought is narrowly restrictive. The survey findings bolster an informal appraisal that I have made over several years: that nearly all medical students and junior doctors use electronic textbooks to look for patient related information. Indeed, they are simply trying to solve a highly specific problem by using purposeful, targeted searching and focused retrieval of information, which is generally what they were taught to do in medical school. They rarely just browse for medical information.

Browsing, in contrast, does not focus on answering …

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