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Editorial: Editorials Graduate Medical Education on the World Wide Web

Nemergut, Edward C. MD

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doi: 10.1213/ane.0b013e3181ace68d
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“Education is not the filling of a pail, but the lighting of a fire.”

—William Butler Yeats

The International Anesthesia Research Society (IARS) was founded in 1922 “to foster progress and research in all phases of anesthesia.” Implicit in this statement is the understanding that the value of a medical society rests not in the number of printed journals that make their way around the globe each month, but in its ability to enhance the progress of medicine. Keeping with that broad mission, the IARS, in combination with Anesthesia & Analgesia, will be the first major medical journal to sponsor an online multimodal toolkit specifically designed to advance graduate medical education (GME) in anesthesia:

It is the hope of the editorial board that will not only enhance the traditional paradigm of scientific journalism, but also revolutionize GME itself. creates a unique method for resident physicians to discover and appreciate the primary medical literature. It also allows residents to cooperate and collaborate while providing Program Directors with a tool to document core competency activities for Accreditation Council for Graduate Medical Education (ACGME)-mandated learning portfolios. can roughly be divided into 2 overlapping components, a Journal Section and a Wiki section.

Journal Section

The Journal Section is intended to help resident physicians learn from the primary literature, with a focus on Anesthesia & Analgesia. The centerpiece of the Journal Section is the “Featured Article.” Each month, the editorial board will select an article from the current Anesthesia & Analgesia issue. Anesthesia & Analgesia is a comprehensive journal, encompassing anesthesia and analgesia (of course) as well as critical care, pain medicine, perioperative medicine, experimental neuroscience, medical economics, and occasional forays into the philosophy of science and medical ethics. Selecting high-quality articles from this potpourri of diverse papers will be a simple task. Residents will be invited to read the featured article and listen to an interview with one of the article’s authors. During the interview, the author will discuss the specifics of the article as well as general topics geared towards improving each resident’s appreciation of basic or clinical research. For example, the interview might include a discussion of why a given statistical test was employed by the authors, or why particular subjects were chosen or excluded from the study. Each month’s interview will be available as a podcast to which anyone may subscribe and listen.

After listening to the podcast and reading the article, residents will be able to login to the Anesthesia & Analgesia GME page using their IARS/ Anesthesia & Analgesia password and answer 5 questions in order to demonstrate their mastery of the topics discussed (similar to the Anesthesia & Analgesia Continuing Medical Education (CME) section). Like the CME section, after demonstrating proficiency, a resident will receive a printable certificate that will specify which ACGME core competencies were addressed in the article and interview. The certificates can be put in each resident’s ACGME-required learning portfolio.

In addition, the journal section of will feature an “Ask the Experts” podcast interview each month. During this interview, an “expert” on a specific topic (typically a member of the Anesthesia & Analgesia editorial board) will respond to presubmitted resident questions. These “Ask the Experts” podcasts will make international expertise on fundamental or timely topics directly available to IARS members every month.

Anesthesia & Analgesia Wiki Section

The second component of is a “wiki” that aims to cover all aspects of anesthesiology, critical care, pain medicine, and perioperative medicine. For the uninitiated, a wiki is a website designed to enable anyone who can access it to contribute or modify its content. The Anesthesia & Analgesia wiki facilitates worldwide interaction and thoughtful collaboration among residents, faculty, scientists, and regulators.

In general terms, the wiki can be considered an encyclopedic anesthesia textbook, which is continually updated by its own readers. Information is instantaneously integrated and incorporated into the knowledge base, permitting physicians to extrapolate and bridge data and knowledge from various medical topics. Controversial topics are actively discussed, and typically thoughtful threads are pursued while baseless speculation is discouraged by the collective wisdom. Most importantly, the wiki allows anesthesia residents to take an active role in their own education by writing new content and actively sharing their knowledge with other physicians. The process compels residents to take charge of their own education, and by doing so, improve the education of others. This reminds residents that they are one of a community of physicians and that a community needs the citizenship of all its members to prosper.

Can multiple unpaid authors and editors really create something that is both accurate and useful? The answer is an unequivocal “yes.” The skeptic reader is referred to Nature for an objective comparison of Wikipedia (the world’s most famous wiki, on which was modeled) and Encyclopedia Britannica.1

The cost of these services is modest: an IARS membership. For United States residents that is $40/year, which roughly defrays the cost of mailing the printed journal. For non-residents, IARS membership increases to $140/year. IARS membership, of course, also includes the printed Anesthesia & Analgesia, on-line Anesthesia & Analgesia, the on-line (and excellent!) Anesthesia & Analgesia CME program offering 24 hours of category 1 credit every year. It’s not free, but it is as good a bargain as physicians get anywhere.

The goal of is identical to that of Anesthesia & Analgesia itself, improving patient care. Although the focus will be on resident education, we expect all IARS members will participate, and benefit, from this new initiative. Indeed, medical students, basic scientists, and physicians from other disciplines are likely to benefit from this program as well. is not “done.” Indeed, we don’t intend to ever finish it. That is how a “wiki” works. It is forever dynamic and changing, just like the medicine itself. But you can go there today and probably learn something. Or better yet, help someone else learn something.

We hope you are sufficiently intrigued to spend some time exploring We hope, even more, that it lights your fire.


1. Giles J. Internet encyclopaedias go head to head. Nature 2005; 438:900–1
© 2009 International Anesthesia Research Society