250 cases in clinical medicine – fourth edition

The current edition of the book 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.

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