The Unofficial Guides to Medicine

The Unofficial Guide to Medicine is an academic publishing group that has been publishing medical and scientific literature since 2012. It is based in London, UK, but has a worldwide distribution network. Titles include "The Unofficial Guide to Radiology", and "The Unofficial Guide to Passing OSCEs".
Unofficial Guide to Medicine

The Unofficial Guide to Medicine is a project that seeks to combine the philosophies of crowd sourcing and junior doctor/medical student (junior) led teaching to the field of medical textbooks. Four titles have come out of the project so far. , and have been distributed in 40 countries. Another ten are in development, and are set to be released in 2015-6. Currently (5/6/14), three of the books are in Amazon Europe's top ten best selling medical books list.. The medical education project, and the textbooks stemming from it have been covered in a wide range of literature, by medical student organisations, medical journals, and charities such as Heart Research UK who have been supported by money raised from the project. These sources highlight several key facts about the books, like for example the links to charities, and the popularity of the books. Recently, the project received national recognition when the Association for the Study of Medical Education (ASME) in the UK awarded the publishing group a prize for its achievements. The most recent book, "The Unofficial Guide to Radiology", has been added to the core undergraduate resource list of the Royal College of Radiologists in the UK . The International Journal of Clinical Skills has also published reviews of several of the "Unofficial Guide to Medicine" titles. The reviews identify many of the strengths of the project, such as the use of fresh graduates, and the depth of content in the tile, but also important limitations, such as not using online video technology, and certain titles like "The Unofficial Guide to Radiology" being heavy to carry around.
Few publishing groups directly recruit juniors to write textbooks, and none use them as their primary base of authors and editors, partly because historically teaching has been led by established experts. "The Unofficial Guide to Medicine" developed a new approach to developing and publishing medical textbooks which explicitly sought to lead with juniors. This approach has been successful in other forms of teaching . The first textbook in the series, ‘The Unofficial Guide to Passing OSCEs’, involved 37 juniors as authors and editors. To date, it has sold over 8000 copies worldwide, it has consistently been ranked as a top medical book seller in Europe, and it has been reviewed positively in medical student journals
The role of textbooks in medical education
For generations, textbooks have had a crucial role in the learning process at medical school. Teachers will often recommend specific textbooks in their lectures or course reading lists, expecting students to use such books to consolidate knowledge gained in class. The textbooks are generally considered as an accurate and comprehensive source of information that are essential to grasping both the depth and breadth of medicine. However, in recent times there has been a rapid rise in alternative learning media including e-learning resources such as online tutorials and smartphone applications. They have gained great traction with students due to their portability, accessibility and convenience. Additionally they have the benefit of being constantly updated, unlike textbooks, which due to production costs are generally only updated every five years. These novel approaches have been shown to play a key role in improving learning efficiency. However, although these new learning media are gaining popularity, students still consider traditional textbooks central to medical education.
The publication model
The first key point about this project is that it is potentially open to any juniors who want to participate. Any interested juniors can contact the publishing group. All interested juniors are then invited to offer feedback on current and possible future textbooks. This allows an initial measure of their level of commitment and ability to contribute. Many individuals do not respond to this invitation and have no further involvement in the project. However, those that do respond and show enthusiasm, organization, and hard work, progress to a junior reviewer level for material in a new textbook. This allows firstly for a formal role to be taken, but secondly, allows for an initial insight into the textbook production process, akin to an apprenticeship. Each junior works closely with the editor to ensure that material in the textbook is relevant to and expressed in a manner that is easily understandable by current juniors.
Subsequently, junior reviewers may progress to become authors and are provided with templates to facilitate drafting short sections of textbook chapters. Editors provide feedback on their performance, and authors who show promise are offered the opportunity to co-edit a subsequent textbook. This involves developing a textbook idea and structure, coordinating its development, and, unlike traditional publishing models, being involved in the graphic design, proof reading, and print review of the book. This process allows rapid progression of committed and competent juniors, even though they typically have no previous textbook writing experience. To date, 4 medical students have progressed from reviewers to editors in less than a year.
The potential benefits of juniors as teachers
Several theories have been put forward as to why less experienced doctors or students might be perceived as better teachers by medical students. One is that the
reduced psychological and developmental distance between teacher and learner may mean that they are better able to understand each other’s difficulties, explanations and language. Second, juniors could be perceived as 'advanced beginners' rather than experts, and as such might be better in teaching novices using a step-by-step approach, in contrast to experts, who generally apply a more holistic and integrated approach. This is reflected in the fact that several studies have reported students feeling that teaching from juniors is more relevant to them than that delivery my more experienced staff. Other potential advantages to juniors that have been reported are increased approachability and passion. Evidence for this has been suggested in bedside teaching, procedural skills, and resuscitation training .
There are also benefits incurred to the teachers themselves in terms of professional development, both in terms of teaching and clinical competence. One study, based in South East Scotland, suggested that juniors, after participation in teaching, felt more confident, enthusiastic, and more prepared to teach. Additionally, participation in tutorials was associated with a perceived improvement in both clinical skills and clinical knowledge of the tutor, not just the students
Criticisms to using juniors as teachers
Juniors do not have the same depth of knowledge and experience as senior clinicians. This may reduce the reliability of any output, for example explanations may be oversimplified or inaccurate. Therefore senior involvement is crucial to any junior-led publication. There is also a risk that juniors may fixate on material needed to passing exams and neglect some areas relevant to clinical practice that may be less frequently assessed or more difficult to assess. Juniors with little experience in medical education and less confidence in the material may have to do a larger amount of research than senior clinicians and may also require several more drafts of their work to be viewed.
There is a clear concern about loss of academic integrity when senior staff are not involved in any teaching, and therefore most junior-led doctor programmes have got some some senior input. The Unofficial Guide to Medicine Project relies heavily on intensive feedback for juniors from experts and experienced editors to try and overcome this limitation.

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