It is astonishing with how little reading a doctor can practice medicine, but is not astonishing how badly he may do it

William Osler, Canadian Physician, ‘The Father of Modern Medicine’ (1849–1919)

1 What Is the Importance of Having Journal Clubs?

Reading journals usually starts when you are a postgraduate and a journal club forms an important part of your curriculum. A journal club is a meeting that should be attended by all faculty and trainees. Your mentor will decide which journal articles you should get ready to present and discuss.

There is an interesting story of the origin of the words ‘journal club’. Sir James Paget, a surgeon in St. Bartholomew’s Hospital in London, was the first person who started reading journals regularly with his students in a baker’s shop near the hospital gate. Since then there is usually a snack available at all journal club meetings (this also increases the attendance).

After postgraduation, your interest in reading journals usually diminishes unless you are in an academic institution or preparing a talk for some conference. For a busy practitioner, the reprints from journals handed over as a promotional activity by pharmaceutical representatives may often be the only source of enhancing his/her knowledge. This is a highly biased method with a blatantly commercial intent.

The reasons why you should read journals regularly are: [1, 2].

  • It is a form of Continuing Medical Education even for experienced staff who may not be active academically.

  • To gain knowledge about recent advances in a particular area of medicine and link this evidence to practice.

  • When you are in difficulties about what to do in a particular clinical situation.

  • To learn about the application of a new test which has been recently introduced.

  • To guide your research.

  • To help towards an oral presentation in a conference or a workshop.

  • To learn about a new treatment when a patient gets sick.

  • To boast of your recently acquired knowledge in the doctors’ mess.

  • To generate a publication in the form of a letter to the editor when an original article is discussed.

2 Which Kind of Articles Should Be Discussed in a Journal Club?

John Naisbit said that ‘we are drowning in information but starved for knowledge’. There has been a proliferation of scientific knowledge and the number of medical journals is constantly increasing. Although the exact number of medical journals and articles published each month is not known and maybe 35,000 it is estimated that every 20 minutes one article is being included in some indexing system.

You should choose an article to discuss which describes a new technique, test, treatment option, or suggests a change in guidelines for your practice. After reading the article quickly you should ask yourself whether what is published is:

New—Is it original?

True—Are the conclusions justified based on the basis of the information provided?

Is it important—Will it influence medical practice in your hospital, your country, or the rest so the world?

Should you change—The way you are currently practicing.

Some journals also carry a box that asks—What is already known about this subject and what does this paper add?

The types of articles published in a journal can be divided into primary literature which consists of original research papers, epidemiological data, case series, keynote addresses from conference proceedings, editorials, and letters to the editors. Secondary literature includes review articles, metanalyses, guidelines, book reviews, systematic reviews, and commentaries. Both are important for journal clubs. Whereas the former provides new information the latter summarises it concisely and in a way that is easy to assimilate.

Currently, there are more than 200 Indian medical journals that should also be discussed in journal clubs as they provide a perspective on health care in our country. All ‘landmark’ papers whether national or global should be discussed in a journal club.

3 What Is the Order for a Journal Club Discussion? [3]

  • The authors’ names and affiliations.

  • What is the impact factor of the journal?

  • Read the research question and how it has been addressed in the article. Dissect it in the PICOT style. Discuss the study design and how randomization was done.

  • Discuss the study population and the inclusion and exclusion criteria.

  • Discuss the results and examine whether statistics have been used correctly and effectively.

  • The Discussion section should be clear on the authors’ supportive statements about their research.

  • What future directions are suggested by the article’s findings?

  • Can the research be replicated in our country?

  • What is the take-home message from the paper?

  • And again, what was known about this subject previously and what the study adds.

figure a

4 How Do You Choose an Article for a Journal Club?

Fig. 44.1 gives a suggestion of how to look for an article.

Fig. 44.1
figure 1

How to look for an article?

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5 What Are the Future Prospects of Journal Clubs?

Electronic or e-journal clubs have been suggested to be a way forward both in the developed and in the developing world. Their many advantages include reaching out to a larger audience who are in many different institutions, better interaction, more scientific discussion, and more critical evaluation of an article. Twitter-based journal clubs have also been started. The first e-journal club has been started in the field of mental health in India. All aspects of the journal including the methodology, the strength, weaknesses, and how to critically discuss the journal are discussed [4, 5].

This we feel is the way forward.