Over the past 2 decades, both medical training and clinical practice have benefited from the advantages and resources offered by the internet. Following the recent repeal of net neutrality regulations by the Federal Communications Commission, public focus has been on the future of consumer use of the internet. However, some worry that medical training and patient care could also be affected adversely.

A viewpoint article published in JAMA addresses these concerns about the future of medicine and the internet. According to the authors, “Awareness of the potentially harmful effects of changes to net neutrality policy is imperative to inform a coordinated effort on behalf of the medical community to ensure a free and open internet.”

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One major concern is that of possible prioritization of content, in which internet service providers could choose which sites are fastest and most easily accessible. The study authors point out that accessibility and speed are 2 main criteria for which resources are used in medical settings. There is also a worry that small budget, open access, or nonprofit resources could be placed in a lower bracket of priority. These resources are often invaluable to the medical community. Another problem with prioritization is the possibility for a “training gap,” a scenario in which resources would become subscription or fee based, affecting physicians based on institution or geographic region.

The researchers argue that because the internet has largely replaced medical libraries as the top resource for physicians who are practicing or training, having those internet resources become limited or inaccessible would have an impact on the training of future clinicians as well as on the research of seasoned physicians.


Cuk N, Robinson CL. Net neutrality repeal and the potential harm to medical education. JAMA. 2018;319:1655-1656.