Approaching basic science can be daunting. Without clinical experience to offer perspective, the novice student must acquire, assimilate, and apply information within a near vacuum. And yet it must be done. As the word “basic” implies, this is a body of fundamental knowledge that must be mastered before you move on to advanced topics. So how can one effectively master basic science? The best first step is reading. Some educators recommend reading a little every day; others advocate reading in continuous thematic chunks. Whichever method you choose, the key is to make reading a constant part of your learning schedule,...
Approaching basic science can be daunting. Without clinical experience to offer perspective, the novice student must acquire, assimilate, and apply information within a near vacuum. And yet it must be done. As the word “basic” implies, this is a body of fundamental knowledge that must be mastered before you move on to advanced topics. So how can one effectively master basic science? The best first step is reading. Some educators recommend reading a little every day; others advocate reading in continuous thematic chunks. Whichever method you choose, the key is to make reading a constant part of your learning schedule,...
The physician’s job, said Voltaire, is to amuse the patient until nature heals the disease. Of course, Voltaire lived in the eighteenth century when patients would have been lucky if their physicians attempted no more than amusement. This was the age before antibiotics, anesthesia, and other innovations that define modern medicine. Today, the art of medicine is much more. Modern physicians have three responsibilities: to make a diagnosis, to offer a prognosis, and to create and implement a treatment plan. The last task, treatment, seems to be the essential one—the one that defines the physician’s therapeutic role. Nevertheless, this textbook...
Clinical Evaluation Medical History Much has been written about how to obtain the medical history, but there is a catch: these writings tend to make the most sense only to readers who are experienced enough to no longer need them. In light of this paradox, this book will not say much on the subject; there is no formal chapter on the medical history. Rather, what follows is only a simple list of guidelines. These instructions are an incomplete education, but they are a start. Introduce yourself. By introducing yourself when you enter the examination room, you bring a necessary human...
The study of disease is the study of patterns. Making a diagnosis is a process of matching a patient’s presentation to a set of signs, symptoms, and findings that represent a defined biologic process. This matching process allows you to offer interventions and make prognoses on the basis of your Observations. Students beginning their study of disease would do well to create a mental template—an outline—for each disease to make recognizing its pattern easier. You begin to understand a given disease once you are able to define it and describe its prevalence, pathology, presentation, differential diagnosis, and associated methods of...
The English word anatomy is derived from the Greek anatome, meaning dissection; and for many generations of students, the primary center of anatomy instruction was the dissection laboratory. Dissection will no doubt continue to be part of medical school training, if for no reason beyond tradition: the transformation from college senior to freshman medical student begins with the pickling of hands in cadaver preservative. Nevertheless, anatomy instruction must go beyond that because a semester or two of dissection usually provides too much distracting detail for those students not entering the field of surgery and too little necessary detail for those...
Approaching basic science can be daunting. Without clinical experience to offer perspective, the novice student must acquire, assimilate, and apply information within a near vacuum. And yet it must be done. As the word “basic” implies, this is a body of fundamental knowledge that must be mastered before you move on to advanced topics. So how can one effectively master basic science? The best first step is reading. Some educators recommend reading a little every day; others advocate reading in continuous thematic chunks. Whichever method you choose, the key is to make reading a constant part of your learning schedule,...
The idea for this book took root on a chilly Sunday in April 1990 as I was nearing the end of my internship. On this particular day, I got a call from a medical resident working in the emergency department asking me to see a patient with a “fibia” fracture. The patient, it turned out, had only an ankle sprain, a common and not particularly thought-provoking injury. What got me thinking, though, was that the doctor who called me—a sharp guy, who today is probably chief of cardiology somewhere—did not know the names of the long bones. Years later, Dr....
