Medicine is a huge undertaking, both to study as an undergraduate and subsequently to practise as a doctor. During your preclinical studies, you are expected to learn anatomy, physiology, and biochemistry but also genetics, pharmacology, pathology, microbiology, the history of medicine, psychology, sociology, law, ethics, epidemiology, and statistics. The list is never-ending! These are vast disciplines in their own right and medical students often struggle to understand what exactly they are expected to learn. The course objectives are frequently vague: ‘students should be able to identify the important anatomical structures of the pelvis and lower limbs’. You are also bound to see a course handbook state: ‘students may be assessed on any material from the lectures, group work, recommended reading, and anything else that the examiners feel students should know at this stage’. A common complaint of all medical students is that the material tested in exams feels disconnected from the topics taught. This is very different from the situation at secondary school in which core knowledge is tightly defined by a course syllabus. You would not be alone in becoming frustrated by the seemingly unpredictable, if not unlimited bounds of knowledge that appear to be expected by examiners.
Furthermore, the clinical years bring their own particular challenges. You are thrust into unfamiliar environments in which busy and overworked staff are trying to manage complex tasks with little time set aside to teach students, due to constant understaffing and lack of resources. The material that you painstakingly learned during the preclinical years somehow seems irrelevant to—or at least wholly insufficient to understand—what is going on in a practical and clinical setting. There are hierarchies, conflicts, and unwritten rules that you will navigate with varying degrees of success. You will never quite overcome the feeling of always being ‘in the way’. The overwhelming burden of boundless learning returns as you wrangle with over 60 different branches of medicine and surgery, from anaesthetics to urology. The knowledge expected of you by a cardiologist in a heart failure clinic will differ wildly to that expected by a skull base neurosurgeon in the operating theatre.
Hence, this handbook was conceived as a partial solution to the complexities of learning medicine in the twenty-first century. Sir William Osler famously wrote, ‘he who studies medicine without books sails an uncharted sea’. This handbook should serve as your map through the countless obstacles that you must overcome on your journey to qualifying as a doctor. First, it will help define the core knowledge that is expected of all medical students, which is often distinct from the niche interests of individual teachers. Second, it will identify ‘high-yield’ information and suggest what you should know (and so are likely to be asked) in any given clinical setting. Besides serving as a quick reference guide, this handbook introduces core topics to help guide you with further reading in your own time. It will also help you to prepare for some of the unfamiliar settings (such as etiquette and conduct in the operating theatre, on wards, and in the emergency department) where you are likely to find yourself over the next few years until retirement.
The Oxford Handbook for Medical School will provide you with succinct, precise, and accurate facts about medicine and surgery that are bound to come up on a daily basis whether in or out of your time in hospital. The core motivation was to bequeath all the important lessons about the medical course and subject matter to the next generation of NHS leaders, pioneers, and consultants as well as to reflect on what we would like to have known back when we were medical students. Whether you are in the cardiology clinic, on the surgical wards, in theatre, or witnessing emergency care, this handbook includes carefully selected clinical scenarios that will explain the logic behind the management plans as well as improve your confidence in explaining it to your examiners. With aide-memoires, mnemonics, pictures, and seminal research accompanied by concise text you will be able to easily deconstruct abstract principles into digestible and memorable information. Since medical school is not only about clinical attachment as it encroaches into your personal life too, there is plenty of useful information on managing finances, health issues, planning electives, and career guidance to improve your chances of professional success from an early stage. Not many other books, at least known to us, can say the same. We have also ensured that the handbook does not preach or lecture but communicates with its audience on an informal and conversational level.
Needless to say, writing this compendium has been one of the biggest professional challenges to the editorial team but if it means that we manage to improve the quality of medical education globally, uplift the competence of medical students in all corners of the world, and give you another reason to fall in love with this vocation, then all the personal sacrifices, compromises, and struggles will have been all the more worthwhile. Medicine is obviously voluminous and it is sometimes discouraging when the sudden realization dawns on you that there is much work to be done in order to carry out the responsibilities for your vulnerable patients. Hopefully the Oxford Handbook for Medical School will serve as a friendly companion to ease your stress throughout your studies as well as introduce you to other speciality-specific Oxford Handbooks for further information with our cross-referencing style.
The Oxford Handbook for Medical School is the result of efforts from eight doctors from a range of specialities to offer a one-stop survival guide for every medical student to make the most of their course from the very first day to the very last. There was a vision and intention to pose the commonest clinical scenarios, how to excel at medical school, and improve career potential early on. There are clearly many textbooks available on the market with too little or too much information, written formally as if you were being lectured, and with dense data that risk losing your attention. This survival guide synthesizes advice from over 100 doctors. It has been said that ‘you should learn from the mistakes of others as you do not have time to make them all yourself’. The time you spend reading this handbook could well be one of the best investments you make at medical school.
Finally, on behalf of the editorial team, we would like to take this opportunity to wholeheartedly thank everyone involved in the success of this handbook. We welcome your feedback to constantly improve the content of this handbook in subsequent editions and we hope that the Oxford Handbook for Medical School will serve you well.
David Metcalfe and Kapil Sugand
Members of the Editorial Team
Oxford Handbook for Medical School
May 2018