Madam, we have read "Readers are leaders in
publishing"1by Ejaz et al with interest. They have highlighted an
aspect that is generally not emphasized at the undergraduate and
post graduate medical education system in Pakistan. But this
problem is not limited to Pakistan alone. Even in the USA
residents and consultants report that they did not read as much as
they would like to read.2Most of them were rarely able to
completely read the most relevant journals in their field and only
scanned the table of contents and read the most important
Based on our experiences as residents and then faculty
members in our respective fields we would like to point out the
determinants of poor reading habits in Pakistani doctors and
suggest some remedial measures.
?Supervisors and faculty are a source of guidance and
inspiration for the medical students and residents. With hundreds
of medical journals available in every field of medical science it
becomes very difficult for them to decide the best option for
reading. It is absolutely necessary that teaching faculty
themselves are in the habit of reading and are able to guide
medical students and young doctors on reading the right kind of
journal and articles.
?Journal club meeting (JCM) is a powerful educational
tool and has played an active role in medical education for over
a century.5JCM helps in dissemination of knowledge, promoting
evidence based medicine, discussion of recent advances,
improvements in critical appraisal skills, better understanding of
bio-statistics and improved reading habits.6,7JCM is not a
regular feature in most of the training programs in Pakistan. The
medical reading culture in the country can be improved by
conducting regular JCM lead by the residents and facilitated by
the supervisors and faculty.
?Another hindering issue towards medical reading is the
problem with full text access of articles in Pakistan. Hundreds of
medical journals are available online, but most (if not all) of the
highly cited and scientifically sound journals (e.g. British
Medical Journal, Lancet, Clinics of North America series,
Journals published by American and British Medical
Associations, Nature Journal series etc.) require a subscription to
access the full text. The subscription cost of these journals is in
hundreds of US dollars (1 USD= 91 PKR) and even a single
article may cost up to 60 USD (Pak Rupees 5460). This is
financially not feasible for a young doctor or resident who are in
their early stages of career development. This issue can be
addressed by buying an institutional subscription to the journal
518J Pak Med Assoc
Table: A list of useful, award winning medical blogs and websites on a diverse range of topics.
S/No Name of the BlogWeb addressBrief Description
3.Clinical Cases and Images http://casesblog.blogspot.com/
7.Covert Rationing Bloghttp://covertrationingblog.com/
9. Dr Shock MD PhDhttp://www.shockmd.com/
Website by Dept. of Medicine, New York University, with posts on clinical
examination, clinical case reviews and journal reviews.
A comprehensive blog covering all aspects of medical education, medical
technology, e-learning and virtual medicine.
A comprehensive and up-to-date blog of internationally recognized
collection of clinical teaching cases and images.
An Emergency Department Intensivist from New York City writes
interesting issues for other clinicians in the field. The blog also features
podcasts discussing procedures, checklists, and other practically useful
knowledge for others rescuing people in the ER.
A blog maintained by an ER physician, focusing on the grace, passion, and
sadness ongoing daily in ERs everywhere.
A group blog about geriatrics and palliative care and features evidence-
based reviews with frequent updates.
A blog by a former professor of medicine and a longtime practitioner,
researcher and author in the fields of cardiology on the persistent and often
unavoidable issue of health care rationing.
Written by a multiple sclerosis patient. This site covers research news,
lifestyle issues, and the complexity of living with multiple sclerosis.
Blog by a practicing psychiatrist with a passion for medical education and
research into the treatment and neuroscience of depression.
How to improve medical reading in Pakistani doctors?
Letter to the Editor
or medical database which will benefit all the Health care Download full-text
professionals (HCP) in a medical institute or setting up the
Higher Education Commission (HEC) Digital library.8In
addition we have found that writing an email to the
corresponding author requesting for a PDF article reprint is
another useful alternative.
? Useful academic habits like medical reading and
writing are more likely to gain acceptance if they are associated
with academic incentive. This can be in the form of a young
researcher award from the medical school that should help
medical students develop interest in this area. This can be given
each year or at the end of medical school during the convocation
ceremony. Regular workshops on research methodology with
small feasible projects at hand can be another useful strategy.
This should also be part of the internal assessment. Seminars and
conferences should be arranged so that the students get adequate
opportunity to share their work along with the experienced
faculty to polish their skills of medical writing.
?As rightly pointed out by the Authors, the HCP should
not restrict their medical reading to their respective subject alone.
Medical education, biomedical ethics, responsible research, and
biostatistics are now intermingled with every branch of medical
science and have transformed the practice of medicine in the last
four decades. There are journals dedicated to each of these
subjects and it is necessary to learn more about these aspects too.
? HCP should not consult medical journals alone to
improve medical reading. The health sections of leading global
newspapers, medical websites and academic blogs (Table) are
also an important form of acquiring new knowledge in different
fields of medicine. They often present a diverse and different
point of view that sometimes cannot be found in the scientific
journals. Discussion on important medical topics is often
answered by different HCP around the globe thus adding to the
overall pool of knowledge.
Fareeha Farooq,1Farooq Azam Rathore2
Park View Town, Park Road, Islamabad,1Department of Rehabilitation
Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi.2
Corresponding Author: Farooq Azam Rathore.
1. Ejaz K, Naqvi H. Readers are leaders in publishing. J Pak Med Assoc 2012; 62: 303.
2. Burke DT, DeVito MC, Schneider JC, Julien S, Judelson AL. Reading habits of
physical medicine and rehabilitation resident physicians. Am J Phys Med Rehabil
2004; 83: 551-9.
3. Saint S, Christakis DA, Saha S, Elmore JG, Welsh DE, Baker P et al. Journal reading
habits of internists. J Gen Intern Med 2000; 15: 881-4.
4. Burke DT, Judelson AL, Schneider JC, DeVito MC, Latta D. Reading habits of
practicing physiatrists. Am J Phys Med Rehabil 2002; 81: 779-87.
5. Linzer M. The journal club and medical education: over one hundred years of
unrecorded history. Postgrad Med J 1987; 63: 475-8.
6. Ebbert JO, Montori VM, Schultz HJ. The journal club in postgraduate medical
education: a systematic review. Med Teach 2001; 23: 455-61.
7. Kleinpell RM. Rediscovering the value of the journal club. Am J Crit Care 2002; 11:
8. Digital Library. Higher Education Commission of Pakistan. (Online) (Cited 2012
March 8). Available from URL: http://www.digitallibrary.edu.pk/eligibility.html.
Vol. 62, No. 5, May 2012519