In reply: I thank Drs. Bordage and Elstein for their letter. I understand their concerns about what might be interpreted as encouragement of dual publication of articles in the field of medical education. I agree that this should be avoided. There may be occasions, however, when dual publication can be justified, and this has been acknowledged by leading journals in the past. It should occur only rarely, and should not be seen as setting a precedent.
There were particular circumstances in the case of Dr. Friedman's manuscript that justified its publication in both the October supplement to Academic Medicine and Medical Teacher. A version of his paper was first given at the RIME Conference in Washington in October 1999 and, with other contributions to that meeting, was published in the October 2000 supplement of Academic Medicine. The Beer Sheva AMEE Meeting of August 26-29, 2000, had as its theme “Horizon Scanning in Medical Education: 2020 Vision,” and Dr. Friedman, together with two other contributors, looked at the impact of the new technologies on the future of medical education. The program was arranged such that the time allocated to the speakers to introduce their topic was kept to a minimum in order to leave as much time as possible for discussion. To allow this to happen, Dr. Friedman's paper, together with other plenary presentations, was published in the September (2000, vol. 22, no. 5) issue of Medical Teacher, and a copy was included in the conference packs, to enable participants to read the papers in advance of the scheduled session on the topic. In these special circumstances, it was considered important, after consultation with Dr. Friedman, the editor of Academic Medicine, and the editorial staff of Medical Teacher, to include the paper in this issue of Medical Teacher. Acknowledgement was made at the end of the article to its prior presentation at the RIME Conference, but at that time the article, which would appropriately appear in the RIME Proceedings supplement to Academic Medicine, had not been published.
I do not believe that a precedent for dual publication has been set. Journal editors will continue to use the practice only in exceptional circumstances, and with the full concurrence of all concerned.