We two authors used to attend medical conferences that felt more like pathetic gladiator battles. Weapons included poison-tipped USB sticks, monotone delivery, and a complete lack of eye-contact. The audience’s ritualized beating often also included an entirely pointless ten-minute speaker biography, followed by a bludgeoning from 120 slides. The cruellest speakers went further still: “there’s too much information on this slide but let me try anyway;” “I know my time is up but I’ll just go overtime.” In brief, we were tired of the “sage on the stage.”

We paid good money to live (and die) through blurry images and the entire front page of their manuscript stating the blindingly obvious. We endured the speaker delivering the same tedious joke as last year—and it wasn’t funny the first time. For reasons we could never deduce this death-via-powerpoint often included a picture of the presenter’s children. A big question mark on the final slide then indicated that it was time for the chairperson to contrive a gratuitous question. He or she had to, after all the audience was now comatose. Sometimes, we would leave with a morsel of medical insight. More often we would depart with a sore arse, indecipherable notes, and a useless rucksack. That, and during the break there was never enough tea and biscuits!

However, empires crumble and time marches on. In the educational ring, this has meant the explosion of what naysayers call “infotainment” and what we choose to call “about bloody time”. Thanks to the hard graft of @ffolliet, SMACC and the other people’s champions, we believe that the medical conference has changed and will never be the same again. Admittedly, some of these newer events feel like rock concerts, and have ticket prices to match. Faculty may still be a little too pleased with themselves, and likely still trade invites to the next conference. However, increasingly the presentation is geared to the audience’s needs and not the presenter’s ego.

The goal is to disrupt and to inspire via an engaging story that “sticks.” Multimedia is widely applied and no useful emotion is spared. Some presenters have been known to loosen their ties and some to shed a tear. Regardless, we are big fans and occasional contributors. These talks are both celebrated or derided by calling them “TED-style.” This is after the organization that launched conferences around Technology Entertainment and Design in 1984. At the time these talks really were revolutionary, and were eagerly shared via that other wonder of the modern world—the internet.

Importantly, TED has subsequently worked hard to stay current and user-friendly. They understand that a speaker riding a unicycle while performing beat-poetry (we made that up) might be oodles of fun, but not necessarily fit-for-task. Moreover, for everything gained, something may be lost. Bite-sized inspiration is easy to digest, but doesn’t always offer nutritional balance. Before we overdo this dietary analogy, the point is that we still need nuance, detail, thought, and debate. Above all, we need a conversation.

TED releases long form interview podcasts from speakers where the backstory can be further dissected. These complement rather than compete with the flash-bang of the big stage performance. Long-form conversational podcasts include three hour offerings from celebrity-atheist Sam Harris, the polymath Joe Rogan and Canada’s most unapologetic man, Jordan Petersen. Of note, these are hugely popular, and assuming that most-downloaded equals most-influential. Regardless, the popularity of long-form argues that learners do not have the attention span of a goldfish. Moving back to our more comfortable dietary analogy: we all enjoy tapas, but we will also order an entire meal: it just needs to be tasty.

The value of a medical conferences will always be in its unscripted conversations and the discussion afterwards that matters most. It’s that lightbulb moment when we realize we need international coordination and collaborative research. Importantly, these disruptive discussions often occur away from the stage’s twinkling lights. Accordingly, the best conference makes time for breaks, encourages the hoisting of pints, and emphasizes that debate long outlive the event. Notably, the disruptive and marvellous EMCrit Conference no longer promotes speakers, but rather people to speak with. The organisers provide a platform, a relaxing setting, along with time and space to simply talk. Like us they seem eager to celebrate the long-lost art of conversation. After all, some things should never get old.

Matt Morgan is Honorary Senior Research Fellow at Cardiff University, Consultant in Intensive Care Medicine, R&D lead for Critical Care at University Hospital of Wales, and an editor of BMJ OnExamination. He is on twitter @dr_mattmorgan

Peter Brindley, Professor of Critical Care Medicine, Medical Ethics, Anesthesiology at University of Alberta, Canada. He is on twitter @docpgb

Competing interests: None declared.