Textbook Recommendations, Questions, and Discussion

[chinaski]

Only issue is that T'o'C is pretty much the standard in Australia...

YMMV but our clinical skills/osces take heavily from ToC, and further postgraduate things, such as training, do as well.

Agree ++. I would strongly recommend you get to like ToC, because it's pretty much cornered the market for clinical skills, all the way up to and including post graduate training. If you're going to go with another text, at the very least you should still refer back to ToC, as the latter is very much considered the canonical standard. Hospital staff - regardless of where they went to med school - will invariably return to this text, so it doesn't really matter what school you are at.

 

[Cathay]

Talley and O'Conner's clinical examination: For all the raving people do about this book, I haven't found it useful in the least/have barely opened it. I guess my clinical skills tutor gives me pretty comprehensive notes, which means I barely need it anyway, but overall I'm not even that much of a fan of the small amount I've read in this book.

While I don't disagree that T&O'C was of limited use in the Otago pre-clincal years (because the clinical skills module had their own comprehensive material written, based on T&O'C of course), I will mention that T&O'C becomes much more useful in the clinical years - every ALM* OSCE I've had so far examines us based on T&O'C techniques/routines, and one consultant said "everyone has slightly different preferences, but if you do what is written in Talley & O'Connor, if you get asked 'why did you do it that way' you can justify yourself". In fact, I even remember a consultant calling Prof Talley (who is currently the President of the RACP) "God's representative on Earth".

*ALM: Advanced Learning in Medicine, Otago's way of saying "clinical years".

I'd disagree with this actually. TO'C is by far the most widely used clinical examination text but as a book, it's just not user friendly. It's an ugly wall of text, tends to go into things which we can't really appreciate as med students anyway and is definitely lacking in pictures, diagrams etc. It's main redeeming quality is the one liners peppered throughout (which I'll admit are hilarious).

That was my main complaint with T&O'C too - thankfully in the 7th edition they've organised the book a bit better (sections for body systems and separate chapters for history, examination, and correlating signs, instead of the old "wall of text about body system" chapters). It could still do with some more pictures, but the 7th edition is much easier to use, which is great given how universally accepted T&O'C seems to be.

 

[geeoftee]

ToC is the single most useful text I have found as an Australian medical student. You will need to get a rudimentary understanding of its process for OSCEs during med school You will need to master it if you want to go down the physician route. As a doofus who got onto the ToC wagon late, get it in first year, learn it back to front and then blow away everyone with your systematic approach to patients during clin years. You wont need any other resources for mastering your physical exam.

 

[chinaski]

I wouldn't recommend route-learning Talley before you get to clinical contact. It's easier to learn once you've got some practical experience, plus you risk learning the wrong way without the context of practical instruction to back up the text.

 

[Havox]

Finishing the last day of my last clinical term today, I thought I would update this list:

Clinical Medicine:
Toronto Notes: Toronto Notes is a complete, yearly revised set of dot point summaries for nearly every medical subspeciality written in a level of detail that is perfect for medical students. This book is focused on clinical medicine only and devotes little time on physiology and anatomy but as a primary text, with lectures as a supplement, I cannot recommend any book higher and this was my most used textbook in all my clinical years. The paediatrics and psychiatry sections are completely adequate as a standalone. I recommend the 2013 edition if you need to read up on DSM IV TR and onwards for DSM V.
Common Clinical Cases - A Guide to Internship by Sanjaya Senanayake: A superb clinical case book written in an easy-to-read and often humourous manner dealing with situations commonly encountered by a JMO. This book walks you through a case, quizzes you on questions you should be asking and highlights the important things you need to consider in the encounter and what you should do. Highly recommended.

I wouldn't recommend route-learning Talley before you get to clinical contact. It's easier to learn once you've got some practical experience, plus you risk learning the wrong way without the context of practical instruction to back up the text.

Unless you're a UWS medical student with OSCEs in first year in which case I highly recommend ROTE learning the examinations if not the written content in Talley.

 

[chinaski]

UWS has OSCEs before students are exposed to clinical training...? Cart, horse, much?

 

[Havox]

UWS has OSCEs before students are exposed to clinical training...? Cart, horse, much?

Touche

 

[chinaski]

Just to clarify, OSCEs in first year aren't that uncommon - certainly not a UWS peculiarity. Before any clinical training or contact on the other hand....

 

[Havox]

Just to clarify, OSCEs in first year aren't that uncommon - certainly not a UWS peculiarity. Before any clinical training or contact on the other hand....

I think my point was that UWS students start their "Introduction to Clinical Medicine" component in week 2 so should be reading Talley from day 1.

 

[pi]

+1 to Toronto Notes, great summaries. I eTG all treatments though (if I can), they do it a bit differently up in Canada

On of my reg's recommended me "250 Cases in Clinical Medicine 4th by Baliga" which is quite interesting! And a consultant recommended me "Neurological Differential Diagnosis 2nd by Patten" which is quite interesting but a bit of a read and probably a bit above my current level haha, always nice to flick it open (library copy haha) to something though

Just to clarify, OSCEs in first year aren't that uncommon - certainly not a UWS peculiarity. Before any clinical training or contact on the other hand....

Monash also has pre-clin OSCEs in first and second year. We do get a couple of "site visits" to a GP an hospital per semester, along with our clin skills tutes with a doctor + our peers, not much exposure though. I guess the reasoning (or so they said) was so we could identify and get comfortable with what was "normal"?

 

[Cathay]

Otago-wise, we have OSCEs in second and third (i.e. preclinical) years, where our only "clinical" exposure is in clinical skills tutorials, practicing on each other and the one or two annual patient visits where a "friend of the medical school" (yes there's a programme for long-term patients of specialists to get involved in preclinical education) comes in to show us some abnormal findings. They do try to expose us to semi-clinical-like stuff, but it's nothing compared to clinical years.

For us, reading T&O'C is helpful in preclin, but not essential for doing well in the OSCEs, because we get given clinical skills handbooks with all the information we really need for those OSCEs. (Yes, those handbooks draw heavily on T&O'C, and many of the tutors have T&O'C along in case they needed to clarify something)

 

[chinaski]

I think my point was that UWS students start their "Introduction to Clinical Medicine" component in week 2 so should be reading Talley from day 1.

And my point was about discouraging learning it before clinical contact occurs. I don't know which med school geeoftee attends, but got the impression they were encouraging learning it in pre-clin phase.

 

[pizzagreen]

Just to clarify, OSCEs in first year aren't that uncommon - certainly not a UWS peculiarity. Before any clinical training or contact on the other hand....

Adelaide also has First Year OSCEs. But it along with 2nd year OSCEs are just on SPs who basically have nothing wrong with them, so it's all about (for physicals) your structure and technique. We have weekly clinical skills session practising with the SPs. So it is a bit odd, because yes we practice the exams and history taking, but the exams especially are fairly farcical because it's just going through saying 'there's no this, this or this, that was normal, etc.'
It's in year 3 once we've had some clinical exposure (1 day a week) where patients in OSCEs actually have something for us to note.

 

[chinaski]

Adelaide also has First Year OSCEs. But it along with 2nd year OSCEs are just on SPs who basically have nothing wrong with them, so it's all about (for physicals) your structure and technique. We have weekly clinical skills session practising with the SPs. So it is a bit odd, because yes we practice the exams and history taking, but the exams especially are fairly farcical because it's just going through saying 'there's no this, this or this, that was normal, etc.'
It's in year 3 once we've had some clinical exposure (1 day a week) where patients in OSCEs actually have something for us to note.

That, too, is not uncommon. You need to understand normal before you get to more complex things like accurately interpreting signs, so junior student clinical exams invariably involve surrogates - it's more about assessing your procedure than anything else. It's also quite difficult to round up enough patients with signs in order to examine students, so it's an investment that is reserved for the more senior of the bunch. Nevertheless, senior students regularly miss clinical signs in summative exams on real patients, and still pass (marking criteria are often not as stringent as you might think!).

 

[quail]

Regarding clinical medicine textbooks, I was just wondering about the usefulness of 'oxford handbook of clinical medicine' and 'get through medical school: 1100 SBAS/BOFS and EMQS'. Toronto notes and TOC seem to be quite good for the clinical aspect of things - but I was wondering if there was anything outside of this list that students might have found useful during their studies?

 

[Benjamin]

Regarding clinical medicine textbooks, I was just wondering about the usefulness of 'oxford handbook of clinical medicine' and 'get through medical school: 1100 SBAS/BOFS and EMQS'. Toronto notes and TOC seem to be quite good for the clinical aspect of things - but I was wondering if there was anything outside of this list that students might have found useful during their studies?

A lot of my colleagues absolutely love the Oxford Handbook of Clinical Medicine and carry it with them at all times on the wards. Many of them even use it as their primary revision text for our final year exams as it covers things in enough detail to remind you of what you need to know but not too much that you get bogged down.

I personally didn't use it at all, though I think that's 100% a result of my book having a few torn pages which bugged me when I first picked it up ... so I put it back down and never used it again.

In terms of other texts for clinical medicine, the Toronto notes seem to be a good basis for your study and give you a reasonable idea of the depth of learning you need for final year exams but their management and pharmacotherapy is often slightly different from the Australian guidelines. I coupled Toronto with the Australian Therapeutic Guidelines for medicine, for surgery I predominantly used Bailey & Love's Short Practice of Surgery as my main reference book with a somewhat difficult to obtain secondary book for study called "Examination: Surgery" which I found to be absolutely excellent. I also used the "Examination: Medicine" book for my medicine revision as it's written by Talley & Connor but covers things quite differently - I cannot recommend these two books highly enough for a very succint, clear and interesting read with regards to exam revision.

Outside of some select books for Renal/Neurology/Haematology I haven't consistently used any other clinical medicine textbooks. My suggestions for those topics are as follows: Renal is brilliantly covered by "The Renal System by Field & Pollock", the textbook "Clinical Neurology: A Primer" is one of the best textbooks I've ever read & the Hoffbrand Essential Haematology is pretty great too.

Paediatrics I had a hard time finding a good book that covered things in the appropriate depth and I instead used Toronto as a guideline of what I needed to study and coupled this with the Royal Childrens Hospital Guidelines (here: http://www.rch.org.au/clinicalguide/).

For Obstetrics and Gynae I used a textbook called "Obstetrics & Gynaecology: An Evidence Based Guide" as my base level of knowledge and then added in the RANCZCOG clinical guidelines for major conditions.

 

[Ilearner]

Hi @bennajmin
How useful would it be to have a text on Latin and Greek roots?
Alex

 

[rustyedges]

Hi @bennajmin
How useful would it be to have a text on Latin and Greek roots?
Alex

Probably not useful enough to warrant purchasing a textbook for it.

 

[Benjamin]

Hi @bennajmin
How useful would it be to have a text on Latin and Greek roots?
Alex

As Rustyedges said, it's not terribly useful. You find that you pick up a bit of prefix/suffix/general terms but these are just mixed in with all the other things you learn at the same time. I certainly didn't spend any time specifically studying it - it's useful for anatomy mostly.

 

[Ilearner]

@rustyedges, @bennjamin,
Thanks guys ....
now it's just a wait and see game, not there yet (still hopeful).