Open minds, Open access: The importance of FOAM

Last updated: December 27, 2023

Medical education has a heafty price tag on it making it unattainable to passionate clinicians and students, especially in developing countries. Traditionally, the framework would be to read expensive books and cutting-edge journals, and attend conferences in order to stay abreast. This changed when people started sharing ideas online and therefore, FOAM was born. In 2012, Dr. Mike Cadogan, an emergency medicine physician and co-founder of litfl.com, coined the term FOAM – Free Open Access Medical Education. Its concept is to be able to share whatever you make to educate people about medicine by putting it online and making it accessible.

According to Salim Rezaie from REBEL EM:

FOAM IS NOT Social Media

FOAM IS NOT a Teaching philosophy

FOAM IS independent of platform or media

FOAM IS an interactive collaboration of like minded individuals, free of geographic hindrances and time zones, with one single goal…to make the world of medicine better

Quite simply, FOAM is the concept. FOAMed is the conversation.

Benefits of FOAM

FOAM can be tailored to individual needs. This flexibility is important for time-poor students and clinicians as they can study at their own pace and focus on areas that need improvement, hence enhancing the overall learning experience.

The student can choose:

1. What to study

2. When to study

3. Where to study from

Challenges facing FOAM

“FOAM is not medicine 101”

It is not a one-size-fits-all solution. Unlike standardized medical curricula, FOAM consists of diverse opinions and experiences of clinicians (most of whom I must add are smart, talented, and motivated). Learners must critically appraise the quality of the content by evaluating its relevance to their specific settings, situations, and patient populations. Discerning the applicability of information is an essential skill.

Navigating the FOAM Universe

Here’s how to get started

1. Blogs and websites

Begin by following bloggers, websites and journals using tools like Feedly (an RSS aggregator) or Instapaper. They consolidate articles into one easily manageable and readable form.

Here are a few websites worth checking out:

2. Twitter

Engage in live discussions and interaction on Twitter where relevant FOAM is highlighted. Hashtags can be used to group tweets into different headings. Utilize hashtags like #FOAMed and #medEd

Some accounts to follow:

3. Video platforms

YouTube is great for procedural videos and recorded lectures. Additionally, platforms like TikTok and Instagram reels offer innovative educational content.

Some accounts worth subscribing to:

4. Podcasts

Take advantage of free, downloadable podcasts that can be listened to on the go. Podcasts can be accessed using applications like Pocket Casts, Spotify, Apple Podcasts, and Google Podcasts.

Some podcasts to subscribe to:

5. Digital Flashcards and Interactive Resources.

Flashcards and interactive resources are highly effective for retaining information and understanding complex topics.

Here are a few you can try:

Paid Resources vs. FOAM

While FOAM offers a wealth of knowledge, it coexists with paid resources such as Amboss and UpToDate (which is painfully expensive). The content quality and price of these resources can vary. It is important to evaluate these factors before investing. Not all paid resources offer content that is better than FOAM.

Conclusion

In conclusion, FOAM is not a superior method of learning medicine. Nowadays there is information overload. The sheer volume of medical knowledge might feel overwhelming to learn. The Pareto Principle holds true. 80% of effects come from 20% of the causes. You do not get extra points for reading, watching, or listening to educational material for hours on end. A small amount of effort in the right direction can go a long way in improving your knowledge. It is crucial to strike a balance between life and medicine. Ask friends what they use to study. Experiment with various resources and methods. Stick to those that work for you, and abandon those that do not.

Feel free to share your study techniques and resources! 😊

Reference Intervals ›

Biochemistry

ACTH	P: <80 ng/L
ALT	P: 5–35 U/L
Albumin	P: 35–50 g/L
Aldosterone	P: 100–500 pmol/L
Alk. phosphatase	P: 30–130 U/L
α-Amylase	P: 0–180 IU/dL
α-Fetoprotein	S: <10 kU/L
Angiotensin II	P: 5–35 pmol/L
ADH	P: 0.9–4.6 pmol/L
AST	P: 5–35 U/L
Bicarbonate	P: 24–30 mmol/L
Bilirubin	P: 3–17 μmol/L
BNP	P: <50 ng/L
CRP	P: <10 mg/L
Calcitonin	P: <0.1 mcg/L
Calcium (ionized)	P: 1.0–1.25 mmol/L
Calcium (total)	P: 2.12–2.60 mmol/L
Chloride	P: 95–105 mmol/L
Cholesterol	P: <5.0 mmol/L
VLDL	P: 0.128–0.645 mmol/L
LDL	P: <2.0 mmol/L
HDL	P: 0.9–1.93 mmol/L
Cortisol AM	P: 450–700 nmol/L
Cortisol Midnight	P: 80–280 nmol/L
CK ♂	P: 25–195 U/L
CK ♀	P: 25–170 U/L
Creatinine	P: 70–100 μmol/L
Ferritin	P: 12–200 mcg/L
Folate	S: 2.1 mcg/L
FSH	P: 2–8 U/L ♂; >25 menopause
GGT ♂	P: 11–51 U/L
GGT ♀	P: 7–33 U/L
Glucose (fasting)	P: 3.5–5.5 mmol/L
Growth hormone	P: <20 mu/L
HbA1C (DCCT)	B: 4–6%
HbA1C (IFCC)	B: 20–42 mmol/mol
Iron ♂	S: 14–31 μmol/L
Iron ♀	S: 11–30 μmol/L
Lactate (venous)	P: 0.6–2.4 mmol/L
Lactate (arterial)	P: 0.6–1.8 mmol/L
LDH	P: 70–250 U/L
LH	P: 3–16 U/L
Magnesium	P: 0.75–1.05 mmol/L
Osmolality	P: 278–305 mosmol/kg
PTH	P: 0.8–8.5 pmol/L
Potassium	P: 3.5–5.3 mmol/L
Prolactin ♂	P: <450 U/L
Prolactin ♀	P: <600 U/L
PSA	P: 0–4 mcg/mL
Protein (total)	P: 60–80 g/L
Red cell folate	B: 0.36–1.44 μmol/L
Renin (erect)	P: 2.8–4.5 pmol/mL/h
Renin (recumbent)	P: 1.1–2.7 pmol/mL/h
Sodium	P: 135–145 mmol/L
TBG	P: 7–17 mg/L
TSH	P: 0.5–4.2 mU/L
T4	P: 70–140 nmol/L
Free T4	P: 9–22 pmol/L
TIBC	S: 54–75 μmol/L
Triglycerides	P: 0.50–2.3 mmol/L
T3	P: 1.2–3.0 nmol/L
Troponin T	P: <0.1 mcg/L
Urate ♂	P: 210–480 μmol/L
Urate ♀	P: 150–390 μmol/L
Urea	P: 2.5–6.7 mmol/L
Vitamin B12	S: 0.13–0.68 nmol/L
Vitamin D	S: 50 nmol/L

Arterial Blood Gases

pH	7.35–7.45
PaCO₂	4.7–6.0 kPa
PaO₂	>10.6 kPa
Base excess	±2 mmol/L

Urine

Cortisol (free)	<280 nmol/24h
Hydroxyindole acetic acid	16–73 μmol/24h
Hydroxymethylmandelic acid	16–48 μmol/24h
Metanephrines	0.03–0.69 μmol/mmol cr.
Osmolality	350–1000 mosmol/kg
17-Oxogenic steroids ♂	28–30 μmol/24h
17-Oxogenic steroids ♀	21–66 μmol/24h
17-Oxosteroids ♂	17–76 μmol/24h
17-Oxosteroids ♀	14–59 μmol/24h
Phosphate (inorganic)	15–50 mmol/24h
Potassium	14–120 mmol/24h
Protein	<150 mg/24h
Protein/creatinine ratio	<3 mg/mmol
Sodium	100–250 mmol/24h

Haematology

WCC	4.0–11.0 ×10⁹/L
RBC ♂	4.5–6.5 ×10¹²/L
RBC ♀	3.9–5.6 ×10¹²/L
Hb ♂	130–180 g/L
Hb ♀	115–160 g/L
PCV ♂	0.4–0.54 L/L
PCV ♀	0.37–0.47 L/L
MCV	76–96 fL
MCH	27–32 pg
MCHC	300–360 g/L
RDW	11.6–14.6%
Neutrophils	2.0–7.5 ×10⁹/L (40–75%)
Lymphocytes	1.0–4.5 ×10⁹/L (20–45%)
Eosinophils	0.04–0.44 ×10⁹/L (1–6%)
Basophils	0–0.10 ×10⁹/L (0–1%)
Monocytes	0.2–0.8 ×10⁹/L (2–10%)
Platelets	150–400 ×10⁹/L
Reticulocytes	0.8–2.0% / 25–100 ×10⁹/L
Prothrombin time	10–14 s
APTT	35–45 s

Paediatric

Pulse Rate (bpm)
Neonate	140–160
Infant <1yr	120–140
1–5 years	110–130
5–12 years	80–120
>12 years	70–100
Respiratory Rate (tachypnoea)
0–2 months	≥60/min
2–12 months	≥50/min
1–5 years	≥40/min
>5 years	≥30/min
Blood Pressure (mmHg)
Term	65/45
1 year	75/50
4 years	85/60
8 years	95/65
10 years	100/70
Weight Formulas
3–12 months	(a + 9)/2 kg
1–6 years	2a + 8 kg
>6 years	(7a − 5)/2 kg
Haemoglobin (g/dL)
Term newborn	13–20
1 month	11–18
2 months	10–15
1–2 years	10–13
>2 years	11–14
MUAC (6 months–5 years)
Obese	>17.5 cm
Normal	13.5–17.4 cm
At risk	12.5–13.4 cm
Moderate malnutrition	11.5–12.4 cm
Severe malnutrition	<11.5 cm
Developmental Milestones
Social smile	1.5 months
Head control	4 months
Sits unsupported	7 months
Crawls	10 months
Stands unsupported	10–12 months
Walks	12–13 months
Talks	18 months
CSF WBC (/mm³)
Term newborn	0–25
>2 weeks	0–5

Calculator ›

3 Comments

Post DiscussionCancel Reply

Leila Jelle

October 24, 2023 / 1:15 pm Reply

Such a concise and informative read! Wonderful writing too. Keep it up!
Patricia Wanjiru

October 25, 2023 / 12:51 pm Reply

Thank you for the wonderful resources listed😊
Wahu Mungai

October 25, 2023 / 9:51 pm Reply

Edx, have very great programmes as well where they partner with schools like John Hopkins school and Havard medical school have short medical courses which you can learn online and can apply for funding so that you can take exams. Great insights and resources from the article. Thanks:)