Baliga 250 Cases in Medicine 4th Edition has been updated to reflect the new expectations of the Royal College of Physicians and its examiners. The practice of clinical medicine requires ‘connecting-the-dots’ across pieces of information; that is, it requires utilization of both verbatim memory and gist memory (JAMA, 2009;302:1332–1333). Verbatim memory involves mere recollection of facts (e.g. causes of pleural fluid) whereas gist memory involves interpretation (e.g. that a very low pleural fluid glucose in a patient with inflamed joints indicates that rheumatoid arthritis may be the cause of pleural effusion). Clinical examinations have been redesigned to reflect the day-to-day practice of clinical medicine. Therefore, success in clinical examinations requires development of both forms of memory. Astute clinicians utilize such gist-based reasoning to arrive at the right diagnosis, and their clinical reasoning is superior because they are able to recognize the gist of clinical symptoms: clinical examinations are designed to identify this competency. This edition has been updated keeping in mind these new expectations. More cases now have representative pictures to enhance gist memory to help a prospective candidate to ‘connect-thedots’ in the examination situation in a timely fashion; the text provides material to improve verbatim memory.
HOW TO USE Baliga 250 Cases in Medicine 4th Edition
Although Baliga 250 Cases in Medicine is designed for the clinical examination it is best utilized at least 6 months before the Part 1 MRCP written examination and at least a year before the PACES clinical examination. Simultaneous development of both gist and verbatim memory requires a lot of practice and, therefore, this book is best utilized at the bedside after seeing an index case. To improve gist memory by only seeing patients (without using this book) is like embarking on a trans-Atlantic flight without a flight plan, but merely to read books without seeing adequate numbers of patients is like a plane not taking off at all. Each candidate is encouraged not only to see at least three to four representative patients of each case but also to present each patient to a colleague who has passed the examination or a consultant physician (i.e. each case should have been presented by the candidate at least three to four times before the examination); style matters as much as substance and this requires practise, practise and more practise.
Baliga 250 Cases in Medicine 4th Edition should continue to be useful for MBBS, PLAB, LRCP, MRCP (UK), MRCPI, postgraduate clinical examinations in the US, Australia (FRACP) and Canada (FCCP), and MD (New Zealand, Malaysia, Singapore, India, Pakistan, Sri Lanka and Bangladesh). The current organization of this book should also be appropriate for medical students in the US taking the USMLE and for the American Board of Internal Medicine Examination (ABIM). Cases for examinations are drawn from the same pool for both undergraduate and postgraduate examinations, although in the latter the candidate’s performance has to be faultless and he or she will be expected to know certain aspects in greater detail.