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research centre élisabeth bruyère research institute and a practising family physician with the riverside campus family health team ottawa ontario find articles by claire kendall 1 james maskalyk james maskalyk 2 james maskalyk md is an associate editor at open medicine an emergency physician at st michael s hospital and an assistant professor in the department of medicine at the university of toronto toronto ontario find articles by james maskalyk 2 anita palepu anita palepu 3 anita palepu md is editor of open medicine and a professor of medicine in the department of medicine university of british columbia vancouver british columbia find articles by anita palepu 3 author information article notes copyright and license information 1 claire kendall md is deputy editor at open medicine an associate professor with the department of family medicine university of ottawa clinician investigator at the c t lamont primary health care research centre élisabeth bruyère research institute and a practising family physician with the riverside campus family health team ottawa ontario 2 james maskalyk md is an associate editor at open medicine an emergency physician at st michael s hospital and an assistant professor in the department of medicine at the university of toronto toronto ontario 3 anita palepu md is editor of open medicine and a professor of medicine in the department of medicine university of british columbia vancouver british columbia anita palepu department of medicine university of british columbia 588b 1081 burrard street vancouver bc v6z 1h6 apalepu hivnet ubc ca collection date 2014 copyright by società italiana di otorinolaringologia e chirurgia cervico facciale this is an open access article distributed under the terms of the creative commons attribution non commercial no derivatives license which permits for noncommercial use distribution and reproduction in any digital medium provided the original work is properly cited and is not altered in any way for details please refer to http creativecommons org licenses by nc nd 3 0 pmc copyright notice pmcid pmc4242792 pmid 25426183 despite our passion for making high quality medical information freely and widely accessible we always knew it would come down to sustainability this is our final editorial in open medicine it has been an inspiring journey for all who have been involved in the journal s inception launch and day to day operations around the idea that there is a need for unbiased publicly accessible platforms for the dissemination of medical research and discussion a lively community gathered there were great debates wonderful authors and articles excitement and enthusiasm for what was possible and freedom from the constraints of paper and for profit ownership we are closing open medicine knowing that we have made a meaningful contribution to something bigger than ourselves and that our efforts have helped to change the landscape of medical publishing open medicine was born from our refusal to stand behind blatant interference with editorial independence in biomedical publishing 1 2 such interference is a recurring theme in medical publishing a fact hinging on the vested interests of medical journal publishers typically medical associations and societies who sometimes find themselves at odds with outspoken editors and of their advertisers mainly pharmaceutical and medical device companies our desire to free ourselves from this model launched us quickly and passionately into the emerging and evolving world of open access 1 our presence caused other journals to change to become more open and to evolve with the times although there is some debate about whether these efforts are open enough open medicine is both open access and open source for instance they have helped to make information access more equitable while inspiring the process was also chronically frustrating despite everyone s best intentions it was challenging for a small team to keep stoking the interest and engagement of the general academic community and it was difficult to recruit members to our editorial board and board of directors who could provide the kind of hands on involvement that our small but ambitious operation required academic medicine has been slow to recognize the importance of stepping out of the comfort zone of traditional publishing unfortunately the benefits of disseminating information freely still takes second place to the allure of publishing in a prestigious forum however difficult that forum may be for readers to access by the end despite continual efforts to deepen our bench strength there were few stalwart supporters perhaps our mistake was to focus our recruitment efforts too much on those who were well established in their careers rather than on up and coming authors and editors who might have been more likely to embrace new possibilities the work was also exacting launching and running a medical journal is more work than it might seem 3 based on our previous experiences we thought we might need operational funding of about 3 million dollars per year ultimately by dint of optimism and volunteerism we were able to run the journal and publish articles for a tiny fraction of that we built upon the public knowledge project s open journal system the open source platform whose development was led by our friend and publisher john willinsky and which now hosts over 7000 open access journals in 105 countries 4 we were also accepted for indexing in pubmed after three short years this was no small achievement 5 we had immense support from canadian research libraries thanks to their own commitment to making knowledge freely available and their frustration with ever escalating fees for bundled journal subscriptions we also had contributions from our own colleagues and institutions to build on in our early years finally thousands of volunteer hours were generously given to journal logistics technical support and web design not to mention what accrued from the editorial and communications expertise of team members and the contributions of our valued bank of peer reviewers the publishing landscape we are leaving is very different from the one we entered seven years ago the canadian institutes of health research have adopted and now strengthened an open access policy for their publicly funded research and are collaborating with the social sciences and humanities research council of canada and the natural sciences and engineering research council of canada to develop a tri council policy that will broaden and further reinforce these requirements many canadian universities now have institutional repositories to help their faculty meet these open access requirements as well as author funds to help authors pay publication charges that allow their work to be freely if not openly available most researchers now recognize that high quality open access publications require the same level of peer review and editorial input as traditional journals despite these achievements by open medicine and progress in the landscape of scientific publishing more generally further change is needed first while there has been a substantial shift toward making articles freely available whether in scientific journals or in institutional repositories many of our colleagues still do not understand that in view of the restrictions imposed by traditional copyright licences free to read doesn t necessarily mean free to distribute or to create derivative works second budget lines for open access fees in grant funding are rarely adequate are often incorporated with skepticism and are generally used with reluctance third many traditional toll access publishers have capitalized on the open access movement by adopting the appearance but not the spirit of open access charging hefty subscription fees to individuals and libraries while offering free access after charging a substantial fee to their authors this double dipping leaves little incentive to adopt new models and further entrenches an unfavourable view of open access finally the onslaught of predatory journals has added confusion to the mix by causing authors to associate publication charges with unscrupulous behaviour 6 policies adopted to ensure access to research findings for those who are unable to pay have largely failed because of a lack of enthusiasm in the high income world the who administered health internetwork access to research initiative hinari is a collaboration between commercial publishers and the who that provides researchers at institutions in low income countries with free access to medical literature published by participating journals unfortunately in 2011 elsevier withdrew its journals with little warning in bangladesh kenya nigeria and tanzania as opportunities for commercial licensing developed in urban areas even though there are many places in those countries where the costs are prohibitive after a substantial outcry the access via hinari was reinstated and confirmed but only until 2015 donor solutions lack sustainability and are governed by market forces that restrict information as illustrated above 7 if more journals were open access there would be no need for hinari had we a crystal ball in 2006 what would we have done differently there is no question that financial sustainability has been foremost in our minds although we have attempted to pay modest stipends for journal operations neither our scientific editors nor our editorsin chief have been compensated and most of our administrative and production staff have volunteered much of their time for fear of turning away authors we delayed instituting publication charges until quite late in the game as researchers we struggled to be good fundraisers communication specialists information technology and web developers and public relations experts as busy doctors we struggled to create space in our lives to accommodate our enthusiasm for what was possible as scientists ourselves we would have liked to experiment more we published the first wiki based systematic review 8 formed student peer review groups 9 and last month published the first wikipedia based clinical article in a peer reviewed format 10 we would have loved to experiment with novel forms of peer review making them open for instance or recording our editorial discussions but getting and writing high quality peer reviews is hard work we would have liked to explore more options to use paid advertising that is not conflict ridden we would have especially liked to develop strategies for reader engagement by providing more opportunities for rating commenting and post publication dialogue we are grateful to our board of directors and editorial board for their support over these years we are especially thankful to the many authors who entrusted their work to us and we are proud to see their articles archived in pubmed central on medline and on the open medicine website they are the reason we embarked on this journey and we will continue to advocate for accessibility transparency and accountability in health care publishing in canada we hope open medicine s readers and authors will as well it is with sadness that we write these last sentences we survey the landscape of publishing in general and see questions and struggles everywhere if articles are made freely available how does one assign them value how can one capture the dozens of hours that went into reviewing editing and publishing an important article are there better ways to do biomedical research and report it thus enhancing its ability to improve health and health care we know there are although we are not accepting submissions for the foreseeable future our enthusiasm for what gathered us around open medicine remains and a few of us are exploring possibilities about how we might continue re visioned in that spirit we will keep our eyes intently focused on the horizon alert to new opportunities to make medicine as open as possible so that no one is excluded from the benefits of medical knowledge and research contributor information claire kendall claire kendall md is deputy editor at open medicine an associate professor with the department of family medicine university of ottawa clinician investigator at the c t lamont primary health care research centre élisabeth bruyère research institute and a practising family physician with the riverside campus family health team ottawa ontario james maskalyk james maskalyk md is an associate editor at open medicine an emergency physician at st michael s hospital and an assistant professor in the department of medicine at the university of toronto toronto ontario anita palepu anita palepu md is editor of open medicine and a professor of medicine in the department of medicine university of british columbia vancouver british columbia references 1 maskalyk j why open medicine open med 200 1 1 e1 e2 doi 10 2174 187410450701011054 doi pmc free article pubmed google scholar 2 kassirer jp davidoff f o hara k redelmeier da editorial autonomy of cmaj cmaj 2006 174 7 945 950 doi 10 1503 cmaj 060290 doi pmc free article pubmed google scholar 3 willinsky j murray s kendall c palepu a doing medical journals differently open medicine open access and academic freedom can j commun 2007 32 3 595 612 google scholar 4 2013 annual report burnaby bc simon fraser university 2013 public knowledge project google scholar 5 murray s brophy j hoey j choi s giustini d kendall c et al open medicine is indexed in pubmed open med 2010 4 1 e1 e2 doi 10 2174 1874104501004010001 doi pmc free article pubmed google scholar 6 beall j predatory publishers are corrupting open access nature 2012 489 7415 179 179 doi 10 1038 489179a doi pubmed google scholar 7 chan l kirsop b arunachalam s towards open and equitable access to research and knowledge for development plos med 2011 8 3 e1001016 e1001016 doi 10 1371 journal pmed 1001016 doi pmc free article pubmed google scholar 8 mcintosh b cameron c singh sr yu c ahuja t welton nj et al second line therapy in patients with type 2 diabetes inadequately controlled with metformin monotherapy a systematic review and mixed treatment comparison meta analysis open med 2011 5 1 e35 e48 pmc free article pubmed google scholar 9 lail p wilkinson k metcalfe a the open medicine student peer review program open med 2011 5 1 e55 e56 pmc free article pubmed google scholar 10 heilman jm wolff j beards gm basden bj dengue fever a wikipedia clinical review open med 2014 8 4 e105 e115 pmc free article pubmed google scholar articles from open medicine are provided here courtesy of open medicine actions pdf 128 3 kb cite collections permalink permalink copy resources similar articles cited by other articles links to ncbi databases cite copy download nbib nbib format ama apa mla nlm add to collections create a new collection add to an existing collection name your collection choose a collection unable to load your 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