Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What’s the best way to keep up with medical literature?

Paul Bergl, MD
Education
October 23, 2013
Share
Tweet
Share

As a resident, probably the most common piece of feedback one receives is, “Read more and expand your clinical knowledge base.” This critique is a standard and generic piece of feedback to encourage the younger generation to never quit in the endless pursuit of knowledge. As our erudite attendings know, medical knowledge always evolves and often reverses course. Thus, the trainee is reminded to establish the habit of keeping up on the literature early in his or her career.

Indeed there is merit to following the literature vigilantly. Recently, Vinay Prasad et al. published on “medical reversals” in Mayo Clinic Proceedings. In their analysis, they reviewed a decade’s worth of original articles in the New England Journal of Medicine. The authors found that more than 100 original articles had overturned previous guidelines or accepted practices. Notable examples — some of which are now old news — included the following:

  • The standard teaching of CPR with rescue breaths was reversed by well-designed trials showing that adequate compressions were the main objective in CPR.
  • KDOQI guidelines in 2000 were updated to reflect a target hemoglobin between 11 and 13 g/dL in patients with CKD. These recommendations were subsequently refuted on the basis of randomized control trial of epoetin alfa that demonstrated no major benefits and increased risk.
  • Rosiglitazone was introduced in 1999 as a treatment for type 2 diabetes mellitus based on its ability to lower hemoglobin A1c. However, a meta-analysis in the New England Journal of Medicine later concluded this drug was associated significantly with cardiovascular death.

The list goes on and can be found in the article’s supplementary materials. If you’re inspired by Prasad’s findings, you ought to make every effort to “read more” and “keep current.”

Then again, maybe better advice for trainees would be, “Read when you can, but don’t worry if you end up falling a few years behind in the literature.” Sure, a revolutionary medical practice might arise, but even residents are unlikely to be so tuned out to the world that they won’t hear about the latest breakthrough somewhere. New treatments will surface; new drugs will be manufactured. The trainee may want to see a novel therapy survive a few years of validation in real clinical practice before stepping out onto a limb of uncertainty. If one aggressively tracks every advance in medicine, one also runs the risk of adopting a practice that later proves more harmful than anticipated.

At least one recently published article speaks in favor of this more lax approach toward the literature. As Paul Mueller highlighted in a Journal Watch article, many meta-analyses add very little to the growing body of medical literature except growth of the body itself. If you haven’t read a meta-analysis on the pharmacotherapeutic options for fibromyalgia or supplements to prevent colon cancer in the last handful of years, don’t worry: The article you read in 2009 had most of the same studies. A more rational approach might be to pull meta-analyses on an as-needed basis rather trying to stay ahead of the barrage of articles published weekly.

So what’s the best strategy for a trainee? I personally favor a “headlines, tweets, and abstracts” approach — not only for the time-strapped resident but for myself too. Skim a few journals each month, and subscribe to essential Twitter and RSS feeds. You might hit the right balance of staying current and staying above the fray.

Paul Bergl is an internal medicine physician who blogs at Insights on Residency Training, a part of Journal Watch.

Prev

Emergency departments will remain a safety net for decades to come

October 23, 2013 Kevin 6
…
Next

Finding out the price of health care should be a realistic expectation

October 23, 2013 Kevin 7
…

Tagged as: Residency

Post navigation

< Previous Post
Emergency departments will remain a safety net for decades to come
Next Post >
Finding out the price of health care should be a realistic expectation

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Paul Bergl, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Teaching doctors: Learning to learn in new ways

    Paul Bergl, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Will resident autonomy disappear completely in the future?

    Paul Bergl, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Prevention, detection, and treatment of cancer has become more nuanced

    Paul Bergl, MD

More in Education

  • How dismantling DEI endangers the future of medical care

    Shashank Madhu and Christian Tallo
  • What’s driving medical students away from primary care?

    ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD
  • In the absence of physician mentorship, who will train the next generation of primary care clinicians?

    Kenneth Botelho, DMSc, PA-C
  • The moment I knew medicine needed more than science

    Vaishali Jha
  • A faster path to becoming a doctor is possible—here’s how

    Ankit Jain
  • Medical students in Korea face expulsion for speaking out

    Anonymous
  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
  • Recent Posts

    • Rediscovering the soul of medicine in the quiet of a Sunday morning

      Syed Ahmad Moosa, MD | Physician
    • An introduction to occupational and environmental medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Does silence as a faculty retention strategy in academic medicine and health sciences work?

      Sylk Sotto, EdD, MPS, MBA | Conditions
    • Why personal responsibility is not enough in the fight against nicotine addiction

      Travis Douglass, MD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Alzheimer’s and the family: Opening the conversation with children [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
  • Recent Posts

    • Rediscovering the soul of medicine in the quiet of a Sunday morning

      Syed Ahmad Moosa, MD | Physician
    • An introduction to occupational and environmental medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Does silence as a faculty retention strategy in academic medicine and health sciences work?

      Sylk Sotto, EdD, MPS, MBA | Conditions
    • Why personal responsibility is not enough in the fight against nicotine addiction

      Travis Douglass, MD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Alzheimer’s and the family: Opening the conversation with children [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What’s the best way to keep up with medical literature?
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...