One way to get access to UpToDate when you are on an off campus network is to be on Columbia VPN. You can find more information about setting up and using a VPN at https://secure.cumc.columbia.edu/cumcit/secure/howto/vpn/index.html
Create an UpToDate Account
Another way to get access to UpToDate is to create an account. You can create an account by clicking on LogIn/Register link on the far right side of the top horizontal navigation bar in UpToDate.
Please note that you have to be on a campus network in order to register for an account. You will also need to be on a campus network when you renew your account credentials.
An added benefit of having your own account is that you can download and use UpToDate app on your mobile device.