UCSD’s Practical Guide to Clinical Medicine
A comprehensive physical examination and clinical education site for medical students
Web Site Design by Jan Thompson, Program Representative, UCSD School of Medicine.
Content and Photographs by Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, California 92093-0611.
Send Comments to: Charlie Goldberg, M.D.
This guide has been assembled with an eye towards clinical relevance. It represents a departure from the usual physical exam teaching tools which, in their attempts to be all inclusive, tend to de-emphasize the practical nature of patient care. As a result, students frequently have difficulty identifying what information is truly relevant, why it’s important and how it applies to the actual patient. By approaching clinical medicine in a pragmatic and demystified fashion, the significance of the material should be readily apparent and the underlying principles more clearly understood. In particular:
- Each section is constructed to answer the question: “What do I really need to know about this area of medical care?” The material covered is presented in a concise, ordered fashion that should be readily applicable to the common clinical scenarios that you will actually see in day to day practice. Esoterica has been purposely excluded.
- The Web-Based format allows for easy access to information and provides integration of text, pictures, and sound.
- Exam techniques are described in step-by-step detail. Special maneuvers that are frequently utilized are also described.
- The rationale for each aspect of the examination is addressed and, where appropriate, relevant pathophysiology discussed.
- Detailed descriptions of how to function in clinical settings are included. In general, students identify their role in patient care either by trial and error or through the beneficence of more advanced students, residents or staff. This is not particularly efficient and diminishes the potential for learning and fun. The following sections are included to specifically address this issue:
- Oral presentations
- Patient write-ups
- Working in outpatient clinics
- Functioning on an inpatient service
- Clinical decision making
- Pictures clearly identifying appropriate techniques accompany each section. Examples of common pathologic findings are included as well.
- Images of gross anatomic correlates (denoted by the “daVinci Icon” shown above) are incorporated within a number of the segments.
- Video clips of selected examination maneuvers and findings.
- Carefully selected links to other useful websites are available.
I hope that this site helps to make the educational process both fun and rewarding.
As the skills required of a physician cannot be learned from any single source,
I encourage you to make use of as many other references as possible. This should
reinforce basic principles and alert you to the fact that there are often many
ways of achieving the same end (i.e. there is frequently no single right way
of doing something). What follows, then, serves merely as