One of the best and most up to date free CME tools for a wide range of clinicians is the enduring website at DocGuide.

It is administered by a slightly enigmatic organisation called PSL which appears to be somewhere out in cyberspace - roughly, it seems equidistant from Montreal, London and New York!

On further investigation, it appears PSL is a market research organisation targeting the medical marketplace for the pharmaceutical and allied industries. This is achieved through a claimed global clinician database population of over 400,000 subscribers. PSL claims to work with 80 per cent of the top 20 pharmaceutical companies and says it provides "real-time clinical information within the reach and interest of physicians, employing multiple modalities and the latest technology to ensure that even the busiest, 'on-the-go' specialist can be kept up to date".

Having said that, DocGuide is no "new kid on the block" and has been around for over 10 years - which is saying something in these days of never-ending cyberspacial transience. Furthermore - and despite being updated every day or two - the simple format for the website appears remarkably unchanged over that same seven to eight years.

DocGuide is comprehensive, objective, relevant and certainly appears to be very well resourced. And, after all, providing clinical summaries from 2000 journals on a regular basis is hardly a non-labour intensive activity. DocGuide appears to have the majority of its staff spread around the northern hemisphere - most seemingly based in Montreal.
Similarly the site is multilingual in its display options with a choice of seven (albeit non Asiatic) languages.

My interest was originally aroused when I registered some seven to eight years ago with DocGuide, but could not always find time to access its real benefits especially in more recent, more hectic, "post-capitation" years. Despite that, I have happily and faithfully remained on their regular email list and I really do feel it is a good time to acknowledge the reliable and valuable service provided by this organisation.

One of the reasons, perhaps, that I did not review DocGuide earlier was its nebulous pedigree. Compared to those such as Medscape with their globally respected and highly reputable editorial boards, DocGuide does not seem to have an editorial board at all, and, if it did, I am sure it would be bragging about it as do its competitors.

But, as one might expect, the service provided by DocGuide is different from others such as Medscape. Despite being covertly industry oriented there does not appear to be an inappropriate emphasis on pharmaceutical publishing content, although that is clearly a difficult parameter to easily or accurately measure.
The DocGuide base matrix - also called DGNN (or the DG News Network) - describes itself as an "independent news network that has been keeping physicians up to date with specialised clinical information for over a decade".

The site provides personalised hardware-specific access based on an IP address (rather than on a password) - which is probably a little old-fashioned and can at times be clumsy in these days of laptops and readily portable off-site web availability.

The three major areas of content provided at DocGuide are news, webcasts/CME and case studies - all related items conveniently colour coded for simplicity.

The news section is the most comprehensive, the most current and probably the most used section and within this section are four separate subsections: DG News, DG Reviews, DG Dispatches and Top Abstracts.

DG News content is based on news released from various organisations academic and otherwise, but is said to be "selected based on relevance with regard to patient treatment and clinical advances. News that does not focus on new medical research or that is promotional or marketing related is not approved for publication".
The backbone of DocGuide - the DG Reviews - are more clinically oriented; concise news reports from selected research papers and abstracts published in the peer review literature resourced from a claimed 2000 peer-reviewed journals. There are also online links to the relevant articles. Reviews are chosen based on relevance and focus on clinically significant therapeutic research.

The third section in the news section is DG Dispatches. This is a conference proceedings section and aims to "provide conference reports in a clear and concise format with research methods and results clearly highlighted".

The final section in the news section is "Top Abstracts" which provides the most read abstracts from DocGuide's DG Reviews in the last week and the last three months.
Perhaps the greatest feature of the DocGuide website, however, is the ability to personalise the service and to subscribe to multiple "channels" of journal abstracts within the DG Reviews component. These are preselected interest areas which are made readily available and accessible with each weekly mailing. If one has an interest in cardiology or neurology or infectious diseases, for example, then these subtitles can be nominated and will appear as the leading items with each weekly update.

Access to alternative subject areas is also quick and simple when needed. The special interest areas are not too broad-based and can include such intricate topics as addictions, Alzheimer's, ADHD, back pain, cancer pain, cirrhosis, dialysis, erectile dysfunction etc. The appeal of this section is the broad journal base from which the abstracts are taken and this can give a very detailed and comprehensive state of the art review - useful especially for the poor GP who is expected to know something (if not everything) about everything.

The user can also create a list of "favourite journals" with their own selection from a wide range of medical (non-surgical) journals among DocGuide's 2000 journal base. Full text articles are generally not available apart from known free text journals.

The CME content is also very good and makes interactive review-type webcasts available to hook up to while the opportunity to look at more "static" case studies is also provided. The webcasts start off live (with the dates and times advertised) and the proceedings are then archived for future accessibility.
A sample webcast showing currently is "Parkinson's Disease: Quality Assessment and Improvement of Care". While a sample case study shown recently was "Goodpasture's Syndrome with Positive C-ANCA and Normal Renal Function: A Case Report".

All in all, I would certainly recommend signing up with DocGuide and getting onto their email list. Their weekly updates will provide a much wider range of clinical content than some of the more fragmented services from various organisations. As always, the challenge is finding that hour or two each week or fortnight to get the most out of all these wonderful clinical tools we now have at our disposal.

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