Well the sports medicine conference season is approaching. Already the Americans have kicked off with AMSSM in Austin, Texas and ACSM in Nashville; soon the Scandinavians will herald the summer solstice with the international injury prevention meeting in Oslo and the season will wend its way south to the Australian, New Zealand, and South African meetings before returning north for the BASEM meeting in sunny Scotland.

For the well heeled traveller, attending as many meetings as possible certainly gives the opportunity to see much of the world. Throw in a few pharmaceutical company junkets and you can fill in the gaps. After all who needs to work?

It seems to me that the days of the mega-conference are waning. Conferences like the ACSM meetings are simply too big to survive. Having 10 000 delegates with 20 concurrent sessions at any given point in time coupled with an abstract book that requires a forklift to move and you start to get the picture. The first few times that you attend these meetings the typical conference novice really only can see 10% of what is on offer and the conference passes in a frenzy of hyperactivity. The next stage is of frantic attendance for the first couple of days with excessive guilt for what you have missed in the programme rapidly followed by burnout and inactivity. After becoming an experienced ACSM old hand, one starts to whittle the programme down to topics of immediate professional interest. Then as the years pass, a meeting of that size simply becomes a social event and one usually never leaves the coffee shop unless forced to (or thrown out when it closes). In some venues (Orlando springs to mind here) this caffeine enhanced restful contemplation is essential as the conference centre is so vast that the mere thought of several kilometers of walking between sessions is simply overwhelming. The final stage is that you no longer bother to attend more than once every decade and only then as a tax write off when the meeting is in a location that is on the way to a planned holiday.

Shakespeare described this process best in the romantic comedy As you like it, when he illustrated the seven ages of man finishing with the “…lean and slippered pantaloon…” of the conference veteran.

The other problems of a huge US meeting is that there are relatively few cities with venues large enough to host such a meeting. Strangely enough, these cities are not usually the ones high on the wish list of great places to visit.

So what is happening? Increasingly we are seeing smaller single topic meetings that appeal to a smaller market. The upside is that everyone who attends actually wants to be there and as a result the sessions are well attended and the social programme is vigorous. It also means that smaller conferences can go to nicer places to visit, which adds to the fun.

Conferences also have another Shakespearean facet about them. In the same speech from As you like it, the protagonist Jacques opens with the immortal lines, “All the world’s a stage…” Some conference presenters clearly take this to heart. Ever since Bill Gates gave us PowerPoint, god bless his cotton socks, the sky’s the limit in terms of utilising each and every feature of the programme. I have been to lectures where lines of text floated, whizzed, spiralled, popped, appeared, crept, rose, descended, typed, dissolved, and chequerboarded onto the slide. Often at the same time! All this with the US flag waving in an imaginary breeze in the background.

I have also sat through talks where I have been so dazzled by the gimmicks that whatever might have been said never even reached my cortex. I sometimes wonder whether this was a deliberate ploy to hide the lack of data.

Mind you, computer presentations also give us the new phenomenon of peer assistance. In the era of slide projectors and jammed slides usually one or two members of the audience could be relied upon to offer assistance but now with the familiarity of computers in our lives, everyone is an expert.

I conservatively estimate that 10% of conference presentations usually have a computer glitch and in the absence of professional audio-visual technicians, my current observed record (which I fully intend to submit to the Guinness Book of Records in due course) is 11 audience member gathered round the lectern actively involved in the diagnostic process. Some of course may have been counselling the presenter in the desperate hope that a reboot would solve the problem. Such PowerPoint slide trauma syndrome (PSTS) is often prolonged but rarely fatal and creates significant autonomic dysfunction in the presenter.

Of course, if you are a Macintosh user, then bring your own personal professional AV technician because the Macintosh variant of PSTS is definitely fatal.

My ultimate conference presentation experience was remarkable for both the technological wizardry and the absence of computer problems in spite of the complexity of the performance. Imagine, if you will, three simultaneous PowerPoint screens running side by side, with a coordinated presentation running across all three screens simultaneously. As the talk was on the US space programme, the slides included movies and music from the relevant period of the 1960s and 1970s. It was tour de force and only took 6 months of work to put it together. It lives in my memory as the ultimate aspiration of any presenter and I think remains the most single talked about ACSM lecture of all time.

I started this piece with a quote from that 60s group, The Byrds (or from Ecclesiastes in The Bible if you are a stickler for accuracy) and will finish with another line from the same song that could have easily been written about medical conferences. “…There is time for every purpose under heaven”.

Occasionally conferences can teach us facts but mostly we should just stay in the coffee shop and enjoy the process.