FOAM, altruism and medicine

YOU might be familiar with foam. It’s an aerated liquid, bubbly. You might not be so familiar with FOAM, or Free Open Access Meducation.

It’s an online movement that has gone global ever since the name was coined by Dr Mike Cadogan, an emergency physician promoting online medical education via social media networks.

He was meeting resistance to this concept and while at a medical conference in Dublin, staring into a tall glass of frothy Guinness, he had an Archimedes moment and so FOAM was born.

Free open access education is nothing new. In fact, it is enshrined in the traditional Hippocratic oath taken by all physicians: “I will teach them my art without reward or agreement”.

What is new and novel with 21st century FOAM is a dual techno-social phenomenon.

Technically, an individual now has the ability, even with modest income or budget, to establish their own personal media outlet, combining online website, podcasting and social media identities.

It’s even easier now with internet-based free resources to learn and copy how to become your own home publisher.

Socially, altruism is making a comeback among medical professionals. Medical educators, paid or voluntary, are creating content and making it freely available online and promoting it globally via social media platforms like Twitter, Facebook and Google.

In their own time, often using personal finances, the community of online FOAM producers and authors extols the virtues of altruism in the sense that everyone who can access online material has the opportunity to benefit, without barriers of journal paywalls or a need to attend expensive commercial courses and conferences.

Why produce content for free, then make it available for free online, when this costs money to perform? Altruism! The desire to do good for the sake of making a better world.

Romantic, naive nonsense? Perhaps, but we are not alone. Wikipedia, Linux, Apache OpenOffice, Gmail, GoogleDocs – are all open access, free resources with no charge to the consumer/end user.

Recently, when the Ebola virus epidemic was sweeping through parts of Africa, many traditional commercial scientific journals waived paywalls and expensive pay-per-article costs to allow scientists to collaborate and share research to defeat an emerging serious threat to global health.

Why should life-saving medical knowledge and research be bought at a dollar cost? Should research and knowledge that save lives be hidden behind a paywall?

The FOAM ethos is that it should not. Ethical education requires we share our knowledge and learning with all, without fee or reward.

You may question quality and standards if things are produced for free, when it’s an open market to publish.

That’s a fair question and yet the answer is in the consumption. If you use Gmail, you don’t question its quality or standard. It works, it’s free, it’s that simple.

Similarly, with FOAM, you can see and follow what the majority are doing and consuming, and judge for yourself.

Also, just because you use Gmail doesn’t mean you stop paying to enjoy other things. So it is with FOAM. It’s not all or nothing and as in life in general, a middle ground is often the best balance.

Finally, the democratisation of medical education via FOAM allows greater participation by all, rather than elite professional educators.

It crosses professional disciplinary boundaries in a way that fosters creativity and sharing. It brings colleagues together globally and negates the isolation of rural and remote health care.

While working in the outback, I remain engaged, connected, and learning and teaching with colleagues in New York City, London, Norway and Fiji. In real time!

Vive la FOAM!

Dr Minh Le Cong is a rural trained general practitioner who currently works for the Royal Flying Doctor Service, based in Mount Isa, in northwest Queensland. His clinical and research interests are in emergency airway management, retrieval medicine and prehospital care.