Journal Clubs: 1. Origins.

A journal club is a group of individuals who meet regularly to discuss publications that are relevant to their professional interests; the term is also used to describe such a meeting. The earliest mention of a journal club that I have found is in an 1854 paper by Sir John Forbes in The Association Medical Journal, which was published between 1853 and 1856, and was a forerunner of the BMJ. The Association was in financial straits, as Forbes discussed: ‘Our dear old ASSOCIATION is in rather a bad plight; but I hope and trust she is not in any risk of death or decay, but is merely passing through a dangerous crisis, to come out of it more vivacious and more vigorous than ever.’ He was mainly concerned about the future of the journal: ‘The Association, if it exists at all, must retain as part of its future constitution a weekly medical journal of the ordinary size, and conducted on the ordinary plan of periodical publications.’ However, he also made it clear that the Association had other things to do and that it should not be totally subservient to the plan of producing a journal: ‘I can never believe that anyone could bring his mind to contemplate the degradation of our noble Association into a mere journal-club, or to see the best energies of its members confined within the narrow limits of a commercial firm.’ He urged an increase in the annual subscription, in order to support the production of the journal, and enclosed a cheque for five guineas (about £600, €700, US$800 in today’s money). When Forbes pejoratively referred to ‘a mere journal-club’, he was clearly thinking of a club that published a journal, such as the Scottish Mountaineering Club Journal, the New York Athletic Club Journal, the Electric Club Journal, and the Journal of the Quekett Microscopical Club. Many of these continue today. The journal club proper, in a form that we would recognise today, may have been invented by William Osler, when he was at McGill University. In Harvey Cushing’s monumental biography of Osler, we read that Osler, keen to keep up with progress reported abroad, persuaded his colleagues to join him in subscribing to French and German journals. They ordered the first copies on 13 April 1875. Cushing referred to this as ‘a foreign-periodical club’. Osler repeated this strategy of obtaining journals that he could not himself afford when he went to the University of Pennsylvania in Philadelphia in 1884. He continued the habit when he arrived in Johns Hopkins Hospital in Baltimore in 1889, and the first meeting of what was called ‘The Journal Club’ was held in the library on 29 October 1889, when the current literature was reviewed. It is not clear whether those whom Osler persuaded to subscribe to the journals in Montreal and Philadelphia actually sat down together to discuss them. However, the term ‘journal club’ was already in use before 1889, at Johns Hopkins University and elsewhere. In a letter to Francis Galton in 1887, Joseph Jastrow described a course in psychology that was being run at Johns Hopkins. ‘There is,’ he wrote, ‘a seminary, journal club, and a strong interest in psychological subjects generally.’ A more detailed description appeared in an 1897 account of the botanical laboratory at the University of Michigan: ‘A journal club of a dozen or fifteen instructors, investigators, and advanced students meets weekly for reports on current literature.’ Linzer has given an account of the subsequent history of the journal club, also reporting that during the period 1835–1854, since the library at St Bartholomew’s Hospital in London was small, as Sir James Paget later recounted in his Memoirs, ‘some of the selfelect of the pupils, making themselves into a kind of club, had a small room over a baker’s shop near the Hospital-gate where we could sit and read the journals.’ It is not recorded whether they used the term ‘journal club’ to describe their activities; Paget did not. Today, journal clubs are run by healthcare professionals, both doctors and nurses, in many disciplines. In the next part of this article, I shall discuss why and how to run journal clubs and how to publish them in Evidence-Based Medicine.