FOAM — This is not the future of medicine, it is medical education NOW!

Originally Published: Common Sense, Jul/Aug 2013

Original Author: Meaghan Mercer, DO AAEM/RSA President

Like many great ideas in medicine, the concept of FOAM (Free Open Access Meducation) project was born in a pub over a pint of Guinness. Doctors Mike Cadogan and Chris Nickson, from (LITFL), recognized that social media has changed how we communicate and educate. Ideas now traverse the globe in hours, allowing an open and interactive approach to how we learn and practice medicine. As one of the fathers of AAEM and greatest teachers of our specialty, Dr. Joe Lex, stated,

“If you want to know how we practiced medicine five years ago, read a textbook. If you want to know how we practiced medicine two years ago, read a journal. If you want to know how we practice medicine now, go to a (good) conference. If you want to know how we will practice medicine in the future, listen in the hallways and use FOAM.”

FOAM is the concept, enacted via the Internet. #FOAMed is the conversation, enacted via Twitter. Twitter, blogs, podcasts, and online videos are all part of the FOAM medium that is comprised of free, high quality medical education that all of us can use — or should be using. This is not just for medical students and residents. As Chris Nickson put it, “This is a movement where the hierarchy is flat. There are no leaders; everyone is a leader. A nurse can teach a doctor, a medical student can teach an attending. When it comes to FOAM, quality cannot be stopped from bubbling to the top.” FOAM is a true convergence of ideas and reflects that we are in this together.

With any new idea comes criticism and concern, the biggest being the “lack of peer review.” As all FOAM supporters will attest, this is not necessarily a weakness, but could be one of the greatest strengths of this movement. Peer review happens in real time. Medical knowledge can advance at an accelerated pace and even those not inclined to traditional research can share their experience or expertise. Also, many of the tweets contain links to journal articles and other formally peer reviewed evidence.

Another concern is that FOAM leads to information overload or “trying to drink from a fire hose.” But isn’t that how medical education has always felt? Per the LITFL website, one of the biggest ways to prevent that is through good filters. Start by following the innovators in the FOAM community and high quality information will be passed to you effortlessly. Other concepts that are embraced by FOAM are the flipped classroom and asynchronous learning. The flipped classroom is an idea that education should evolve into an open discussion, and that unidirectional teaching is, in some ways, outdated. As adult learners we can target our weaknesses and can digest the videos, podcasts, or even tweets at a self directed pace using learning styles that are suited to our strengths. This is asynchronous learning. Formal classroom time can then be spent discussing, clarifying, and brainstorming with the teacher. #FOAMed provides a platform where we can learn and ask questions in real time — even without a classroom.

FOAM is contagious, it is a revolution, it is a community of educators who want to collaborate and freely share ideas for the betterment of all. Joining in is easy; one great resource is, which directs you to other great resources and can become your filter as you dip your feet into the ocean of FOAM. A big thank you to my attending, Dr. Cleveland, @NathanCleveland, who introduced me to #FOAMed, the crew, Dr. Lex, @JoeLex5, Michelle Lin @M_Lin, Cliff Reid @cliffreid,,, and all the FOAM and #FOAMed participants whose open access information provided the content for this article.