The New England Journal of Medicine, founded in 1811, is the world's longest-continuously published medical journal and is published by the Massachusetts Medical Association. The journal provides important, original research findings, clinical findings, and perspectives in biomedical and clinical practice, with an emphasis on practicality. More than half of the articles were written by people outside the United States. The journal is the most widely read and cited medical journal in the world, with a readership of more than 600,000 physicians, students, researchers, and other medical experts from approximately 177 countries and has a circulation of 200,000 in the United States. The magazine website has been upgraded to provide online access to all articles from its publications, as well as more powerful search and support services.