It’s probably not an exaggeration to predict medical students of the next decade will not lift a physical textbook. In fact, even ownership of a discrete entity, formerly referred to as a “textbook’, may be a historical footnote. Instead, students may simply rent the chapters they need for a particular course, paying a recurring subscription fee to the publisher for the period of usage. This system could foster innovation and allow for dynamic ebooks that change with standard of care, as I’ll discuss in this post.

For many medical students, who have grown numb after repeatedly paying $100 to $200 per book, this more financially sane model can’t come soon enough. In fact, college students buying multiple texts for a course lasting just two or three months are probably even more eager for such a system.

However, while renting textbooks may seem like a strange and wondrous departure for those of us who still pridefully maintain shelves of outdated medical textbooks, the more necessary revolution will actually be upending the illusion of completion when a textbook finally reaches the printing press.

By this, I am suggesting the barrier between finished textbooks and the rapidly evolving nature of medical knowledge most certainly needs to be more porous. Going even further, the interactive and non-linear nature of learning are at odds with the centuries-old format of a linear, immutable text.

This is not to say that textbooks are anachronisms. Something very valuable comes out of the care and scrutiny of an author polishing each paragraph and page with great care. But, why should the craftsmanship stop at the moment of publication?

This is where the iPad and its future kin come in. The proliferation of ebooks and, in particular, e-textbooks will be great for students and practitioners alike. At a minimum, ubiquitous availability and more reasonable pricing models will open the doors to more sales and more happy customers.

But, this will just be the beginning. The real golden opportunity will come from continuing the engagement of the authors with the readers and, even more importantly, the readers with each other.

What this would open is a world where learning occurs just as much in the “wild” as it does in the classroom and where the roles of students and teachers start to intertwine. In other words, something like the real world, rather than the sterile enclosure of the lecture hall.

I imagine the authors of a book continuing their engagement with their readers and even acting as occasional consultants, further enlarging and enriching their reputations. I imagine a “book” that changes over time and re-engages the readers when new information arrives or when they perform searches on their device.  We all know how change can happen instantaneously in the medical field – these changes or new evidence based care could be implemented immediately with ebooks on the iPad – much like updating an app.

In short, what I am looking forward to is an electronic book that soars beyond the simple conjugation of a screen and a book – and is significantly more dynamic than the tangible good.