Epstein. Pocket Guide to Clinical Examination

[Guest Ian Wong]

Pocket Guide to Clinical Examination, 2nd Ed. Epstein, O., Perkin, G. D., de Bono, D. P., Cookson, J. 1997. Times Mirror International Publishers Ltd. Trento, Italy.

 

ISBN: 0-7234-2577-9

Chapters/Indigo.ca price: $28.95

Pages: 268

 

I actually picked this book up only a few months ago when the outgoing Med 4 class was having its moving sale for textbooks. I received the Epstein book as a throw-in for buying another textbook, and decided to bring it with me to my rural elective. I've been using it intermittently in that time to help refresh parts of my memory after patient examinations.

 

Much like the U of Toronto book, this is a small reference book designed to be carried with you while you are on the wards. It is also slightly smaller than the U of Toronto book, with the following dimensions: 11.5 cm x 19 cm x 1.3 cm. However, this book is significantly different than the U of Toronto book, in that it doesn't try to cram each nit-picky clinical examination detail in between its covers. Instead, it seems to cover each organ system, and concentrates on knowing the major parts of each examination, and then reinforcing those major details with plenty of photographs, diagrams, and tables. The U of Toronto book is extremely thorough with regards to how far to take each organ-system investigation. By contrast, I think the Epstein book tries to emphasize a few major points for each organ system; in other words, the ones that you should always remember first, because they are more likely to be clinically useful.

 

In many ways, I think this book is like a mini-Talley and O'Connor textbook. When you open it, the book is separated into chapters for each organ-system, and throughout that chapter (eg. Abdominal exam), where relevant you will find tables of questions to ask depending on which disease process is suspected. Therefore, if your patient presents with diarrhea, you can quickly find out which questions should be asked. A patient with jaundice will receive other questions from a different table. I really like this format, as a quick check through the tables will quickly help you to decide if you've missed a possible reason for the jaundice (what colour are the stools and urine, have you travelled recently, any previous blood transfusions, etc).

 

Line diagrams are plentiful, and are well-labelled and straightforward to understand. There are a number of photographs, all of which are black and white, but for the conditions that the photographs illustrate, colour isn't really necessary (eg. third cranial nerve paresis, pectus excavatum and kyphosis, etc).

 

I like this book quite a bit, although in my personal situation, I now have two pocket clinical skills books, and I'm unsure of which one I'll be bringing with me to the wards. One really good part about this book, especially for the new medical student who hasn't quite picked up all the medical lingo, is that the book will explain the physical sign/symptom that you are looking for, and then in brackets, give you the associated medical term. This will help your recall, and minimize the frustration that most of us feel when encountering new medical terms, or hearing your instructor use them, without any idea of what those words mean. Learning medicine really is learning a new language, and this book tries to ease that transition. For example, Chadwick's sign is first described as a bluish colour of the cervix due to increased vascularity in the beginning stages of pregnancy.

 

My suggestion for Clinical Skills is to pick up a larger Clinical Skills textbook, and then supplement it with a pocket textbook that you can bring with you to your teaching sessions and doctor's offices/hospitals. Unfortunately, I don't think there's a clear winner between the Epstein book, and that produced by the U of Toronto. The two books are quite different in their approach, although I do believe that the Epstein book is significantly friendlier for the neophyte medical student because it uses more diagrams, and has a wealth of practical tables. However, the U of Toronto book strikes me as being significantly more detailed, and this may prove to be an advantage in the long run. Of course, you could buy the Epstein book first, and then upgrade to the U of Toronto book afterwards, and sell your Epstein back to an incoming medical student below you.

 

In my opinion, this book is a pretty good value. If I had owned it earlier in medical school, I'm certain that I would have put it to a lot of use.