You name it - the breadth of knowledge required for internists today is immense, and ever-growing. Internal medicine has experienced an explosion of its information base over the past four decades, and the predicted doubling of the National Institutes of Health budget between 1995 and 2005 is a sign that this trend will continue and accelerate. These advances are welcomed by all health care providers, even given the challenge of keeping up with this mountain of new data.

My recent "first-hand experience" only further convinced me of the need for an efficient way to keep abreast of the changes in medicine.

About three years ago I moved to the University of North Carolina as Chairman of the Department of Medicine. In academic medicine, departments of medicine consist of ten or more divisions that function quite autonomously. Cardiologists (I was previously Chief of the Division of Cardiology at the University of Texas Medical Branch in Galveston) primarily provide care for patients with heart disease, oncologists for patients with cancer, geriatricians for older patients - you get the picture.

After more than fifteen years of specializing in cardiology, albeit providing internal medicine care for my cardiovascular patients, I fully anticipated that I would be a bit rusty in some aspects of internal medicine. Suffice it to say that I was shocked at what I did not know. I wasn't a little rusty, I was completely out of date.

Given the demands of increasing patient volume and the attendant paperwork, I began to wonder how internists kept up. To be certain, there are excellent tools, for instance the >2500-page, detailed textbooks like Harrison's Principles of Internal Medicine (edited by Braunwald et al. and published by The McGraw-Hill Companies) or the easily accessible electronic databases like "Up-to-Date" (http://www.uptodate.com) and "Emedicine"(http://www.emedicine.com). These are terrific references, indeed I've come to rely on them, but none provided what I needed - a concise but complete guide to all of internal medicine.