Medical Textbook

This latest edition (17th) of Harrison's Manual of Medicine is published by McGraw-Hill, and is based on software from Unbound Medicine (who also support high-end references like the BMJ and Ovid).

The Faculty of Medicine purchases licenses for all Dalhousie Undergraduate Medical Students, and detailed instructions for how to receive the software for free, are available on Dalmedix.

Referenced to the world's best-selling internal medicine textbook, it contains lots of explanatory physiology and diagnostic information, but also covers adult therapeutics. The PDA version reads like a textbook, so scrolling is required. It would find most use in a hospital environment or Internal Medicine service and is our recommendation for undergraduate medical students (Med1 and Med2).

Harrison's Manual of Medicine is available from harrisons.unboundmedicine.com.
It is compatible with the Palm, Windows, Blackberry and iphone devices.

Griffith's 5 Minute Clinical Consult, published by Lippincott Williams & Wilkins, is another popular reference work for students and practicing clinicians alike. It provides comprehensive yet concise information on over a thousand topics under the fields Basics, Diagnosis, Treatment, Medications and Follow up. It would be useful in an ambulatory clinic and contains some pediatrics. It is available online from several medical websites (Skyscape, HandHeldMed, Unbound Medicine, and even Lexi-Comp).
It is compatible with the Palm, Windows, Blackberry and iphone devices.

An excellent all-in-one title is named PEPID, which comes in various specific packages-including one for emergency physicians (ED), one for primary care physicians (Primary Care Plus), and one for medical students (Clinical Rotation Companion Suite). Compared to eMedicine (below) PEPID is point-form and less in depth, so it is easier to look up practical answers rapidly in PEPID. But eMedicine has more complete write-ups, so often the two are complementary. PEPID also has a linked drug database, conversion calculators, lab values reference, a database of medical equations, a table of Canadian trade names and other handy references. We have reviewed the ED and CRC versions in depth, and have found them to be excellent references--in fact, members of our committee are using them on a daily basis. We highly recommend the CRC version to clinical clerks (Med3 and Med4). It is compatible with the Palm, Windows, Blackberry and iphone devices.

The 30th edition of the Washington Manual of Medical Therapeutics, by Lippincott Williams & Wilkins, is also available in PDA format. It provides more information on inpatient therapeutics, and offers drug information and clinical practice guidelines (which are American based, however). It takes just 2.4MB of memory. It can be purchased at discount in bundles from several medical web sites.
It is compatible with the Palm, Windows, Blackberry and iphone devices.

Midnight Medicine (from Medical Wizards) is a quick-reference meant to assist Emergency, Primary Care Physicians, Mid Level Providers and House Staff in managing patients during the initial hours of common medical emergencies. It was written by members of the Department of Family Medicine at the Dalhousie University Faculty of Medicine.

Clinical Medicine Consult is a comprehensive electronic textbook written exclusively for handheld computers. The entire collection covers 2,500 topics in most specialties, including 135 step-by-step procedures. There are more than 230 useful line drawings that reproduce very nicely on handheld computers. The content is intended for generalist primary care physicians, including internists, family physicians, emergency physicians, residents, and students. Both learner and experienced physicians working in office and hospital practices find it useful. Authored by a single Board certfied internist (Carl G. Weber), other specialists have edited some sections, and the author invites comments and suggestions from anyone. The entire database requires 5.2 MB memory and the ISilo or MobiPocket reader, and can be stored on an expansion memory card. Individual topics can be purchased as well.
It is compatible with the Palm, Windows, Blackberry and iphone devices.

Publishers

A number of titles are offered in different versions by different publishers; below is a list of five of the most popular, who between them offer versions of all the titles mentioned above:

• www.skyscape.com would be a good place to start looking. This publisher offers many references that cross-index with each other. Their products are easy to use. Many of these titles can be downloaded for a trial period before purchase, so users can ensure the book meets their needs before committing to a purchase. Look for bundled discounts on multiple titles; a residency program discount is also sometimes available.
• www.handheldmed.com sells many medical titles (including the Red Book and Merck Manual) that use their free Reader software. This means individual titles require less memory space. They also have free trials and bundles. Their version of the Harrison's Companion Handbook was discontinued in late 2002 when McGraw Hill put out the 15th edition, but is still available in the software bundle from PCPC at an attractive price.
• www.unboundmedicine.com also sells many medical titles (including the Harrison's Manual of Medicine, 5MCC, and Taber's dictionary), all with built-in audo-update features.
• www.lexi.com, which is known for its LexiDrugs drug databases, but also carries a version of Griffith's 5 Minute Clinical Consult as well as Stedman's medical dictionary, which integrate well with LexiDrugs.
• www.medicalwizards.com, who publish Netter's Anatomy Flashcards, Midnight Medicine, and versions of Taber's medical dictionary and DrDrugs (for physicians and for nurses).

The Canadian Federation of Medical Students has negotiated a substantial discount for medical students with some publishers (go to www.cfms.org for more information). The Canadian Medical Association also provides discounts on both PDA hardware and software to members at their website, www.cma.ca (go to ePractice Tools and click on PDA Centre).

A decision on which medical text(s) to use will depend on several things. Requirements will be different for a clerk and an experienced staff physician. Some texts will do superior jobs in an ambulatory clinic, while an inpatient unit will require a different book. Some people's preferences may lean toward terse summaries and bullet lists, while others may want narrative text.

Secondary considerations are how much space you have in your budget. You will definitely want to consider whether you'd like a suite of products that work well together, or prefer a choice of stand-alone titles. Ensure that your choice is evidence-based and free of bias or influence.

Finally, you will want a reference that you find easy to navigate; the most authoritative information will be of little help if you find it too cumbersome to use. Almost all titles have 30-day demo versions; try before you buy.