Future evolution of traditional journals and social media medical education.

Over the past two decades, the Internet has emerged as a powerful tool for the dissemination of medical knowledge. The routine online publication of peer-reviewed journals and the standardisation of the portable document format (.pdf) marked a coming of age for Internet technology allowing readers, authors and editors to quickly access articles old and new and share them efficiently. Although the most prestigious medical journals still view the paper versions of their journals to be the pinnacle product, it is now standard for articles to be e-published online ‘ahead of print’, weeks to months before the paper passes through the press, and arrives on the doorstep. Thus, for most web-savvy and voracious readers, by the time physical journals appear in mailboxes, important or controversial new research has often already been read, discussed and debated at length in online and ‘real life’ forums. Emails have been written and responses have been sent to the editors. Opinions have been formed. However, because of print delays, some of the most thought-out and qualified opinions (i.e. experts’ Letters to the Editor) have been embargoed from general consumption, waiting instead until future issues can be published. Meanwhile, print errors remain uncorrected. As the goals of peer-reviewed medical journals are to foster medical progress and improve research as a whole, this obsolete model must be phased out. The window between the acquisition of research knowledge and clinical translation can often gape longer than a decade. This was perhaps an acceptable although suboptimal reality before the advent of Internet-based technologies, but the recent social media revolution has made this untenable. If peer-reviewed journals adapt to a new reality, not only will such delays be shortened, but also the journals will find themselves to be more relevant than ever. On the other hand, those publications that fail to adapt will cease to be potent in the most meaningful ways. In this editorial, we suggest three key ways that peer-reviewed journals can maintain and increase their relevance in today’s milieu: first, by embracing real-time interactivity; second, by embracing new tools to measure clinical impact; and third, by finally eliminating print publication. Social media medical education might be the inspiration for many of these changes. However, medical social media is still in its nascent stages; it must evolve as well. It requires adoption and adaptation of systems for peer review and information verification to allow trust by clinicians. Furthermore, the time demands of product creation will not be sustainable unless there is a path for academic advancement to support these activities.