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Jesse Myer, Sir Osler (1913)
LIFE AND LETTERS OF DR. WILLIAM BEAUMONTThe American Journal of the Medical Sciences, 146
Edited by Neville F. Hacker, Joseph C. Gambone, and Calvin J. Hobel 5th ed, 475 pp, $59.95 Philadelphia, PA, Saunders/Elsevier, 2010 ISBN-13: 978-1-4160-5940-0 Of the lessons which a young man entering upon the profession of medicine needs to learn, this is, perhaps, the first—that he should resist the fascination of doctrines and hypotheses till he have won the privilege of such studies by honest labor and a faithful pursuit of real and useful knowledge.—William Beaumont1 Since it was first published in 1986, Hacker and Moore's Essentials of Obstetrics and Gynecology has been a mainstream textbook for US medical students completing their clerkships in obstetrics and gynecology. Certainly the current fifth edition will be no exception to that legacy. It continues the tradition of being a text authored by physicians within the University of California, Los Angeles medical community. It is exceptionally well organized, with excellent graphics and the use of in-text bolding to indicate key points. Many tables and charts are included; some present basic material that will be useful to the medical student learning the specialty, while others are quite advanced and will only serve as material for future reference. Purchase of the text also gives the student online access to the entire text as well as to United States Medical Licensing Examination–style questions, additional illustrations, case studies, statistics, and animations demonstrating a variety of items such as vaginal delivery, ovulation, and a multitude of techniques used in the specialty. The textbook is divided into 5 parts. The introduction not only includes chapters on anatomy, physiology, and clinical approaches but also an excellent chapter briefly covering topics such as patient safety, ethics, and quality improvement. The section on obstetrics covers the major topics with which most medical students should be familiar. Useful charts describe topics such as drugs to avoid while breastfeeding, the risk of aneuploidy based on maternal age, clinical correlates of serum magnesium sulfate levels, and maternal and fetal complications of diabetes. However, some charts may be confusing or misleading without further clarification. For example, a chart listing the prerequisites for intrapartum management of multiple gestations fails to recognize that such standards may be impossible to meet in a rural environment. Also, the chapter discussing intrapartum monitoring of fetal heart rate does not include recent changes relative to nomenclature and classification. Because some of these changes have only been recently published, for future editions the editors might develop an approach to include such new material in an electronic version even before the next print edition is available. The section on gynecology focuses on the key topics covered in a general medical education. Most of the chapters provide the appropriate amount of detail for medical students, supplemented with some advanced tables or charts that can be used for future reference such as the Pelvic Organ Prolapse Staging System and the American Fertility Society classification of endometriosis. The chapter on pelvic pain is noteworthy in that it stresses careful history taking. The chapter on ectopic pregnancy provides a useful algorithm for diagnosis. The chapter on family planning broadly covers the key topics using the World Health Organization medical eligibility criteria as a guide. The section on reproductive endocrinology and infertility covers important topics such as puberty, menstrual disorders, infertility, abnormal bleeding, and menopause in reasonable depth. There is a reasonable balance between the basic fundamentals as well as information that is more clinical in focus. The final section deals with gynecologic oncology. The major gynecologic cancers are reviewed along with the principles of cancer therapy. A major shortcoming is the absence of the newest approaches to cervical cancer screening and the treatment of preinvasive disease based on age and human papillomavirus status. As noted above, the editors might consider using the electronic version to present revised material before the revised print edition is available. Despite a few shortcomings and the occasional unevenness typical of multiauthored texts, the current edition of Hacker and Moore's Essentials of Obstetrics and Gynecology for the most part achieves the right balance and is the standard against which most textbooks for medical students learning obstetrics and gynecology will be judged. With the increase in online sources, an obvious question is where print textbooks such as these will fit in the future. Certainly, there will need to be sources of important material, including time-tested facts within a specialty, which will allow students to ground themselves as new information becomes available. Thus, the approach to providing key knowledge through effective student textbooks will need to continue. What is unknown is whether students using only electronic versions will gain a reasonable degree of mastery of the broad range of a medical field or will revert to only looking up material as needed when on the wards or in the clinic. Back to top Article Information Financial Disclosures: None reported. References 1. Myers JS, ed. Life and Letters of Dr. William Beaumont. St Louis, MO: CV Mosby; 1912:21, 23
JAMA – American Medical Association
Published: Jan 20, 2010
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