The highlights for me were the excellent sections on the Nervous System and Reproduction, with coverage of the physiology of the mother, foetus and neonate. Cardiovascular and respiratory systems have thorough coverage. There is little material particularly relevant to students of Dentistry, but this could be easily remedied. Use of the Index is essential to obtain the full story on a particular topic. The references given at the end of sections and for each diagram should be an advantage when students focus on a particular topic in a ‘student-selected component’, now some 25% of the curriculum.
There have been dramatic changes in the undergraduate curriculum in the last 10 years. Now every Medical school has the freedom to achieve a different balance of knowledge between normality and disease within their course. Basic concepts of organ dysfunction are introduced from the start of many ‘integrated’ professional courses, creating problems for authors. Clinical Physiology is largely a separate section at the end of this text, but detailed content is lacking. This is a professional decision of the authors. Physiology and physiologists are concerned with normal organ function and system interaction. Their logical approach gives a background rationale that aids the transition from school biology to the multi-facetted, instant challenges of clinical life. Clinicians have experience and up-to-date knowledge in recognising and assessing organ dysfunction in the complex environment of the acutely-ill patient, where biological variation and multi-system failure are common-place. Using this text for a term in the Queen’s medical course I found a relative lack of material on topics such as electrolyte disorders and renal failure, the causes of autonomic failure and the long-term consequences of diabetes mellitus. Management of Type 2 diabetes frequently requires more than diet. Specific text-boxes could summarise the risks of hypernatraemia, hypokalaemia and hyperkalaemia (ventricular fibrillation is not mentioned). This book would be unsuitable as a preparation for post-graduate specialty examinations.
The attractive, discursive style of this text is particularly designed for a traditional preclinical course, as specified in the Preface. It would be a useful resource for ‘lost’ students, particularly those with a weak background in school Biology. However students of an ‘integrated’ curriculum would be at a loss when preparing for ‘case-based’ tutorials and examinations in years 1 and 2.