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Toxicology Rounds

Toxicology Rounds: The Best Medical Education App Ever

Gussow, Leon MD

doi: 10.1097/01.EEM.0000413157.77807.a8

    I love the iTunes Store. I hate the iTunes Store.

    The iTunes store is great if you're awake at 3 a.m. and simply must listen to, say, the stunning Gillian Welch/David Rawlings cover of Jefferson Airplane's “White Rabbit,” or the Sonics' classic “Strychnine,” or Hermione Gingold's wonderfully macabre and poison-ridden ditty “The Borgias Are Having an Orgy.” A click, a very short wait, and the songs are yours forever. As a distribution engine for music popular and obscure, the iTunes store is amazing.

    But iTunes can do much more than simply deliver music. Over the past three or four years, a large number of high quality educational medical podcasts has become available online, and more are popping up every day. Most of these podcasts are available for free by subscription through the iTunes store.

    This creates a problem. So much great material is constantly becoming available, and I find it is essential to be able to organize the podcasts I subscribe to and know when new episodes are posted. In this, the iTunes store is a pain — cumbersome, cluttered, and not user-friendly. It keeps dropping my subscriptions, does not give adequate notice of new posts, and is generally frustrating to manage. There must, I have long felt, be a better way.

    There is a better way. Recently, I discovered Instacast, an app that makes it blissfully easy to subscribe to and follow podcasts on an iPhone or iPad. Subscriptions are entered by touching one button, podcasts can be streamed or downloaded for offline listening or viewing, and show notes can be browsed while the podcast is playing — all without going through the iTunes store. Notifications of new posts are pushed automatically. In addition, to save time the material can be played at twice standard speed, if you like your podcasters sounding highly caffeinated. (You can also play at half standard speed so that the lecturer sounds like she's just taken a Quaalude.)

    Instacast makes the iPhone — and especially the iPad — an amazingly versatile medical education tool. It is now my favorite app of all time. It is available from the iTunes app store for $1.99. Instacast HD for the iPad with added functions is $4.99. (I have no association, financial or otherwise, with Instacast or its publisher Vemedio. I just love the app.)

    There is another app called Downcast that is similar to Instacast; it organizes and downloads podcast subscriptions. It also has a handy feature; when a podcast is playing, you can go back or skip ahead 30 seconds by simply swiping one finger across the screen. The Instacast HD interface is gorgeous on the iPad, though, and I prefer it hands down.

    To get started investigating the educational potential of Instacast, I'd recommend checking out some of the toxicology and emergency medicine podcasts.

    ToxTalk: This excellent podcast produced by the toxicology service at the University of Massachusetts in Worcester discusses a wide range of topics related to medical toxicology, and gives case presentations and pearls. A recent episode included an interview with Robert Hoffman, MD, on medical marijuana, and an instructive case about the folly of administering naloxone to an intubated patient.

    The Journal of Medical Toxicology Podcast: Howard Greller, MD, and Daniel Rusyniak, MD, review the latest issue of the Journal of Medical Toxicology, giving brief synopses of each article. Both are on the publication's editorial board, so the discussion isn't really critical, but it provides a good way to keep up with what's going on in my favorite toxicology journal.

    EMCrit: The brilliant and entertaining podcast by Scott Weingart, MD, is dedicated to “bringing upstairs care downstairs,” that is, providing ICU-level care in the emergency department. This site won the coveted “Best Medical Weblog of 2010” by readers of

    Emergency Ultrasound Podcast: Mike Mallin, MD, and Matt Dawson, MD, make even complex sonography topics such as diastolic dysfunction comprehensible. Their videocasts have great illustrations and cases. I can't imagine anyone interested in emergency ultrasound who would not want to download each episode as soon as it is posted. Check out their recent discussion of cardiac wall motion abnormalities. This podcast looks great on the iPad.

    ERCast: Rob Orman, MD, and guests discuss clinical areas of emergency medicine. Recent episodes have covered shoulder reduction, pediatric fever, and RLQ pain in pregnancy.

    Free Emergency Medicine Talks: This site has posted an incredible number of lectures selected by Joe Lex, MD. Enough said.

    Smart EM: David Newman, MD, and Ashley Shreves, MD, provide in-depth discussions of focused emergency medicine topics. Their episode covering a recent New England Journal of Medicine article on acute otitis media in children is one of the most spectacular dissections of a medical paper I've ever heard.

    EMRAP: Educators' Edition: Rob Rogers, MD, Amal Mattu, MD, Mel Herbert, MD, and guests discuss all things related to medical education and academics.

    All these podcasts are free, and Instacast itself costs a pittance. These are truly game changers. Keeping up with a good selection of medical podcasts is at least as important as following most medical journals.

    Comments about this article? Write to EMN at [email protected]

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    Dr. Gussowis a voluntary attending physician at the John H. Stroger Hospital of Cook County in Chicago (formerly Cook County Hospital), an assistant professor of emergency medicine at Rush Medical College, and a consultant to the Illinois Poison Center. He is also the editor of his own blog, The Poison Review (


    ▪ Download these apps and podcasts at:




    Journal of Medical Toxicology Podcast:



    Emergency Ultrasound Podcast:


    Free Emergency Medicine


    Smart EM:

    EMRAP: Educators' Edition:

    ▪ Visit Dr. Gussow's blog at

    ▪ Read all of Dr. Gussow's past columns in the archive.

    ▪ Comments about this article? Write to EMN at [email protected]

    © 2012 Lippincott Williams & Wilkins, Inc.