final exam. In our closed off world in the corner of the state, the 150 miles to the main campus seemed closer to 1500. Because of our social media connections to our classmates and technology, our access to the faculty lectures at the main campus made it feel almost as if we were there.
Early in residency, I missed a particular afternoon didactic lecture from one of our faculty. It was a lecture that I had planned to attend and especially wanted to see. I was rotating on the medical intensive care unit, and, typically for many days, resuscitation necessarily came before education. Knowing it was the policy and practice of our program to record the lectures and place them on an online service the campus had, I went about trying to access the lecture later that week. Despite my confidence that technology would once again come to my rescue, my attempts to access the lecture were as frustrating as they were futile. The technology had simply not been developed well enough to provide for the needs of residents. One of my colleagues could have“ live tweeted” the lecture to an audience around the globe if they had wished, using only a personal cell phone and social media account. But when it came to an institutional or professional level solution to an educational problem, we had failed to treat the underlying cause of a systemic problem.
Our profession has always taken great pride in the care of patients: the guardianship of their concerns, their wellbeing, and our honor-bound relationship. At the same time, we are also obliged to teach one another to care for patients. We teach by example and by sharing the stories that are often humbling in the lessons they have taught us. This somewhat dichotomous mandate has been protected in large part over the centuries by the insular nature of medicine. Historically, a person would have given serious pursuit to learning the profession of medicine before such stories would be shared or be otherwise accessible. Our best kept secrets and professional teachings have been guarded by the rigor required to pursue our profession, for who else besides ourselves understands the profound experience of seeing humanity lain as plainly as we are privileged to?
Without question, we live in the most connected era in history. The last 20 years have completely altered the manner in which we communicate, and we owe a great deal of this to social media. From humble beginnings in internet chat rooms to the pioneering efforts of companies such as MySpace, Facebook, Google, Twitter, Tumblr and hundreds of others, we now have an ability to find and connect with others of like mind: this is unparalleled in human history. We have the opportunity to seek out new ideas, information, research and materials that even our most revered and formidable heroes of medical education could scarcely have fathomed. Prior to the last five years, social media has been inadequately utilized for medical education for many reasons: our culture, our often conservative natures and the sight of career-ending social media mishaps playing in front of our eyes, writ large in the traditional media. As a profession that prides itself on keen observation, we have nearly overlooked what may be one of the greatest opportunities in modern history to reduce human suffering through the education of physicians the world over.
These are not merely hindsight observations and critiques from a younger generation. It is a call for aid in developing and managing the largest paradigm shift in medical education since Osler brought teaching to the bedside. In Emergency Medicine and Critical Care Medicine, I discovered that there exist large, free, online resources for any trainee who wants to learn. Frustrated by my experience in reviewing lectures in residency and inspired by these pioneers and their movement called Free Open-Source Medical Education( FOAMed); I helped create the first university supported Internal Medicine FOAMed resource: Louisville Lectures. We have created a comprehensive curriculum and begun taking our faculty’ s didactic lectures and placing them online, free of charge for anyone who wishes to learn. No matter where you are in the world, if your medical center is lacking in education on a medicine topic from an expert, they can find it on the Louisville Lectures website.
Social media in medicine is not a faceless sea of user names and Twitter handles. It allows us a personal connection with those we teach and affords us the opportunity to continue our profession’ s ethos of extending a helping hand to colleagues in need of guidance and advice. A physician reached out to us asking for help because when he returns to his village in rural Pakistan he was overwhelmed by patients with various complaints of back pain, and needed a way to triage who could be treated, which cases might not be real, and who actually needed his limited supply of opiate pain medication. The next week we were able to publish an excellent lecture on back pain from one of our former Chief Medical Residents who is a doctor of Osteopathic Medicine, who is now on the faculty of a major regional academic medical center.
The world of medical education is evolving rapidly and the world’ s experts in medical education are needed to support this movement and innovate with us. As ever in our profession, this path is perilous. These decisions with regard to how to best utilize social media are difficult. The opportunity is most fleeting; if we fail to embrace this new educational paradigm, we may doom our profession to stagnation. On behalf of my generation of physicians and those who will come long after, I ask you to help us, as a profession, to view the tools of social media as an opportunity to uphold our oath: to teach our art freely, without reward and to help the care of our patients.
Dr. Burk is the Chief Medical Resident for the University of Louisville Division of Internal Medicine as well as Founder and Managing Director of LouisvilleLectures. org.
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