Dear TLS reader and fellow med student: Like I promised, I will now tell you about my experience as an intern in The Lancet.

The last two weeks I’ve spent at The Lancet offices in London, realizing how much I don’t know about evidence-based medicine. What is that, you ask? (I know you didn’t really ask, but bear with me). 

According to David Sackett in his famous editorial, evidence-based medicine (EBM) “is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research”.

Well, I knew nothing about it. EBM was mentioned a couple of times in one or two classes I had over the last few years, but I never had critical appraisal lessons or anything remotely like it. The lectures I attended to were given by doctors who based their knowledge on a combination of textbook and decades of clinical experience. So going from that to hearing everyday about RCTs, quality of evidence and external validity was like diving head first into EBM.

I must say that these days at The Lancet were a very eye-opening experience. I had the opportunity to be in the rooms where the big decisions are made, with the people who make them. It’s a thorough, complex process, always different and never dull. I was welcome to participate and I even got to write a comment about end of life decisions in Argentina.Although I am far from being a fanatic, I was blind and now I see: I do believe that unless we have some form of scientific support for the practices that we implement in our everyday life, we are far from providing the best possible care... and closer to shamans and witch doctors. But not everyone agrees with that, I’m afraid. Just for laughs, I recommend you give this a read: Seven alternatives to Evidence Based Medicine. Can you come up with any other alternatives? What is education like at your University?

I would like to thank everyone at The Lancet for their kindness and congratulate them on their professionalism. I am incredibly lucky to have met you and to have been a part of the team for a while. ¡Muchas gracias!