Bickley. Bates' Guide to Physical Exam and History Taking

[Guest Ian Wong]

Bates' Guide to Physical Examination and History Taking, 7th Ed. Bickley, L. S. 1999. Lippincott Williams & Wilkins. USA.

 

ISBN: 0-7817-1655-1

Chapters/Indigo.ca price: $101.28

Pages: 789

 

I bought this textbook on the recommendation of my second year classmate immediately after our first year Orientations. At the time, in first year, I thought it was an extremely useful book, but I don't find myself using it a great deal now, and I'm not entirely sure why.

 

The Bates text itself is a common textbook used throughout many North American medical schools, and this is reflected in its long lineage, with the current edition being the seventh in 17 years.

 

This book is extremely readable, and has many colour diagrams and photographs to supplement its text. Clinical correlations relevant to each part of a physical exam maneuver appear along the margins of the page in red text, so that as you read about how to perform a certain examination, that you may read a little about some of the pathologic symptoms which may be present. Another useful quality to the book, particulary for the clinical skills neophyte, is that each chapter dealing with the examination of a specific organ system begins with a short introduction to clinically relevant anatomy and physiology for that section.

 

This is particularly useful if your medical school, like UBC, teaches the Clinical Skills sessions for each organ-system during the same time that you are covering that organ-system in PBL/lectures. Unfortunately, despite this synchronization, there will still be times during clinical skills when you will be expected to know details of each organ system before you have been taught them in PBL/lectures. For these times, having a quick review of the anatomy and physiology via the Bates textbook in the same chapter as the clinical skills material that you are expected to read and master can be extremely handy.

 

Finally, there is a large series of tables in Chapter 2 which cover many of the subtypes of various common disease processes. eg. discriminatory details such as location and quality of pain of different types of abdominal discomfort. There is also a fairly large amount of information on neonatal and pediatric examinations, much more so than the other clinical textbooks previously mentioned.

 

I suspect that the reason I don't use this book too often anymore isn't due to a lack of quality of the Bates textbook, but rather a reflection of my personal learning style, and the type of clinical skills instruction that we receive at UBC. I find that I prefer a textbook that is a little heavier on giving me some of the disease processes along with the clinical skills examinations (such as Talley and O'Connor). For me, this helps me remember the details more clearly. I've also discovered that I prefer reading a more compact book; unfortunately, each Bate's chapter lacks a quick summary of a clinical skills encounter with relevant history-taking questions. For example, in order to progress through a complete respiratory system examination, you will need to read through the entire chapter. This makes the Bate's book less useful when you are trying to reference a short part of the examination, or are using it as a last-minute refresher before a Clinical Skills session or test.

 

Overall, I think this is a good textbook, but it is one that I don't use very often. It was more useful in Med 1 than it was in Med 2, because by that time, I discovered Talley and O'Connor, which I prefer. However, between the two books, Bates is more user-friendly when it comes to photographs and diagrams, and for that reason, it's a book that you may want to consider purchasing. Although this book probably doesn't have quite the notoriety and popularity of the Netter Anatomy atlas, you won't have any trouble re-selling this book either, so it may be a worthwhile purchase for the early years of medical school.

[Guest monkey]

hey

 

would you guys recommend that students buy the new 8th editition of the bates book (coming out in august)? its a lot more expensive, but if you guys think there will be changes, let us know!

 

Thanks!

[Guest JSS02]

I e-mailed Dr. Sue-a-Quan (who's in charge of our Clinical Methods course), and he said you didn't need the 8th edition. However, I'm thinking of buying it instead of the 7th edition anyway, just because it will be easier to sell later on.

[Guest monkey]

hey JS02,

 

where on UWO website did you find the course coordinator contact name/email addy?

 

PS: do you know how much UWO is selling 8th ed for? and 7th?

 

thanks

[Guest JSS02]

You can now find it in the updated first year timetable on the website, at www.med.uwo.ca/UME/sched0...verall.htm . But I actually got Dr. Sue-a-Quan's name and contact info by e-mailing JJ (i.e. UWOMED2005).

 

The 8th edition is $109 according to the UWO bookstore website. But that's just their estimate - the price hasn't been finalized yet. The 7th edition is $75 if you order from Chapters Online, and around $100 if you get it from UWO or amazon.ca.

[Guest Ian Wong]

Get the cheap one. Either way, you'll outgrow it by third year and will want to get a better book! Bate's is a good introductory book, but on lots of your rotations, particularly Internal Medicine, you'll need to be a level about Bates.

 

Ian

UBC, Med 3

[Guest UWOMED2005]

Yeah, and I 'think' I have a 6th edition that I'm willing to sell for $10-$15 (it came as a package with a bunch of other books I bought off a graduating 4th year for cheap so I'm just looking to get rid of it). I looked through it and it's pretty much the same as the 7th edition, with a different colour cover. My clinical methods instructor was using the 5th edition. I had promised it to one of the other incoming 2006s. . . but there's a possibility they've decidided to go elsewhere. I'll check that out ASAP. So I think it's still up for grabs.

[Guest Akane200]

At U of T, we had to choose between bates and the swartz textbook for physical diagnosis. I bought both being very indecisive about my needs at the beginning of first year (being confused by the bates vs. swartz debate).

 

I never opened my Bates, and I've always been using swartz. Here's why:

-Bates is very wordy. Although it is step by step, I didn't have the time to read it (10-20pgs) before going in ASCM the next day on top of all the other things I do. Swartz is less of a read, but more content packed. It may not always have step by step instructions, but that's what clinical classes are for.

-Swartz is very clear and complete. There are manuevers in Swartz that we used and learned that are NOT mentioned at all in Bates.

-In terms of text and pathophysio correlations, Swartz has more in those aspects as well.

-Swartz even has a section at the beginning of each chapter going through relevant HPI symptoms and signs.

 

I think it depends on how you learn and what suits you best. But Bates is an introductory book that I found rather useless. I was always looking in Swartz for more, or I just used the Essentials of Clinical Diagnosis book.

 

I still have my Bates and it's as good as new. If anyone in U of T meds wants to buy it from me, just let me know.

[Guest UWOMED2005]

Yeah, unfortunately UWO practically teaches the Clinical Methods course out of Bates. But I agree that it's not very good.

 

And btw. . . that copy of Bates I was offering is taken.

[Guest phantom8]

Overall, I haven't found Bates all that useful for my Physical Examination class for two reasons: a) after reading the chapter out of Bates, I would go to Physical Exam class and STILL not know any of the answers and the Bates textbook really only explains 50-75% of the maneuvres that our class is expected to know. The book is rather inefficient as well; it discusses a lot of anatomy, etc. before finally getting to the techniques to do!

 

The one thing I did like about the textbook was the Heart Sounds CD that was included with it. It is a VERY basic CD, but good if you're just starting out with heart sounds. It's a more user-friendly CD than the one that comes with the Littman stethoscope.

 

One last thing: I don't know how many physicians I've mentioned this textbook to, and they always say, "That's the textbook they use for nursing students" (and they look at you like you're crazy to even mention the book). Kinda frustrating to hear when you've just been using the book to look stuff up in!

[Guest Ian Wong]

This is a bit off-topic, but if you are trying to learn auscultation skills, I think the internet is a great place to start. Here's some links to sound files on the internet:

 

pub125.ezboard.com/fpremed101frm24.showMessage?topicID=3.topic

 

Now, this sounds corny, but if you play a sound file, and just click your media player to loop the sound bit over and over, you can literally listen to the same murmur while you are on the internet looking up PBL issues, checking your email, whatever.

 

The point being, that just like hearing a song over and over ahead, playing a murmur over and over again will stick itself completely into your memory, so if you hear a different murmur, it will strike you as being different from the first one. Do this for just a few days/weeks, and you will see a huge increase in your ability to hear and distinguish between different murmurs. Best thing I ever did for learning to auscultate (other than listen obsessively to every new patient).

 

Ian

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