Spotlight on UpToDate

What is UpToDate?
UpToDate is an excellent background resource for medical students and residents interested in efficiently filling holes in their knowledge base. UpToDate is a large on-line medical textbook that contains short, well-written discussions of medical topics in internal medicine, pediatrics, ob/gyn and family medicine. Each review article is written by an expert in the field being discussed, and is designed to provide a quick way to get up to speed. The database is updated periodically.

Who is the intended audience for UpToDate?
UpToDate is useful for any medical professional or student who is trying to learn about or review a topic.  Most entries assume a basic level of knowledge consistent with a medical resident or medical student in their clinical years, but it is also very useful for practicing physicians.  In general, the articles are too technical for lay audiences.  At UW, the license for UpToDate is restricted to certain locations (see access webpage).

When should I use UpToDate?
If you are trying to learn about a medical topic as quickly and efficiently as possible, there is probably no better resource available.  UpToDate is written to provide the most important information on a topic in a high quality, streamlined fashion which is extremely useful on the wards or in the clinic.

What are the limitations to UpToDate?
UpToDate is used very widely by medical students and residents, and for good reason. However, it is important to understand when that use is appropriate and when other resources would be better choices. For use in evidence based medicine, UpToDate is a mixed bag. UpToDate can be used cautiously to answer clinical questions (i.e. PICO questions), with the understanding that it is not a pure evidence-based medicine resource. Articles are a mixture of medical conclusions based on data from well designed studies and the expert opinions of the individual authors, and it is not always clear which statements are evidence-based and which are not. In general, when answering a clinical question, a resource such as the Cochrane Database would be a better choice, since their topic reviews are more rigorous and systematized.

Additionally, while most of the entries are of high quality, not all are quite as good, and some of the articles are not as up to date as one might hope. In general, UpToDate is particularly strong in internal medicine, and weaker in Pediatrics, although that is improving.

What other resources are similar to UpToDate?
The commercial site Emedicine (www.emedicine.com) is a similar database to UpToDate, and is largely available for free on the web, with the exception of some of the pictures, which are available only to subscribers.  Many of the medical textbooks available online through the Ebling Library, such as Harrison’s Principles of Internal Medicine or the Merck Manual also perform a similar function