Book reviews • PROFESSIONAL PRACTICE
Book reviews
Clinical Cases for General
Practice Exams
Susan Wearne
McGraw-Hill Australia, 2005
$34.95, ISBN 0–74–71542–9
Coming To Life
David Mackenzie
Australia: Harper Collins, 2002
$30.00, ISBN 0–7322–750 0–8
As a general practice registrar, I jumped at
the opportunity to review a book that aims to
assist doctors in their preparation for the clinical
component of the RACGP Examination.
‘Clinical cases for general practice exams’
contains 50 cases based on common clinical
scenarios designed to be used as practice role plays
to help familiarise the reader with the exam format.
Each case starts with an information sheet
for the doctor, paired with information for the
role playing patient. A checklist for a suggested
approach that the ‘examiner’ can tick off during
the role play lists all points that should be covered.
Each case concludes with a summary of the key
issues and a list of references for further reading.
The author suggests that the intending
candidate approach each case fresh rather than
reading the book cover-to-cover. This aims to
develop the logical application of clinical skills
and knowledge, rather than just reading and
memorising.
This book is useful for general practice
registrars and other doctors preparing for clinical
gen er al p rac ti ce ex am s, a s wel l as med ic al
students. It would be best used in a study group
or with supervisors or colleagues. The author also
suggests an isolated doctor could use the cases
to practise with other doctors via telephone or
teleconferencing. I found it helpful participating
in the cases as the doctor, patient, facilitator and
observer. The cases are clear and easy to follow.
The cases are similar to those in the exam,
and the author’s status as an examiner for the
RACGP definitely instils confidence! I recommend
this book to anyone planning to sit the FRACGP
examination (or similar) to become familiar with the
style and set-up of the clinical examination, and to
improve their consulting skills for real life.
Lona Brown
Melbourne, Vic
Reading David Mackenzie’s compelling book,
subtitled: ‘A journey of emotional and spiritual
awakening through terminal illness’, gives grounds
for consideration of yet another medical discipline
– pre-palliative care.
Mackenzie takes us on his journey with motor
neurone disease (MND) from the day he was
diagnosed, even the months before when it was
mooted but still not proven – ‘Oh, you’ll have
to wait for the MRI and, as it is not urgent, with
the current waiting list that will be in 4–6 weeks’.
It took eight. He and his family felt there was
little positive support during these anxious weeks
of waiting, especially through the extra delay
period. Perhaps their doctor was just too bu sy
– aren’t we all, didn’t inquire what concerns they
might have, or had other things on his mind –
don’t we all?
‘Macca’ reminds us that we are all on
a terminal pathway but the needs of those for
whose predictable end is days or weeks away the
issues of need are different for those whose end is
months, years or even decades away. Mackenzie
pulls no punches concerning his relationships with
health staff, or in his walk with himself and his
family and friends. He tells it ‘warts and all’.
As doctors we need constant reminders that
it is not what we say to our patients and their
relatives, although it often is, but what was heard.
We need to make sure we find out what they
‘heard’. We need to remind ourselves that we have
a responsibility to ensure that they have access to
the information they want and recognise that this
may change with the course of their disease.
No doctor, indeed no health care worker,
who deals with patients or carers of those with
‘a terminal illness’ should read this book. Be
reminded, be humbled, be concerned, be directed,
but be changed to become more thoughtful,
choose words more carefully, explore where
patients and their carers are at, be honest. After all
we do call them ‘my’ patients.
Anthony J Radford
Adelaide, SA
Reprinted from Australian Family Physician Vol. 34, No. 11, November 2005 4 981
