It is now more than 25 years since we set out to write the first edition of Clinical examination in our spare time as registrars at the Royal North Shore Hospital, Sydney. Much has changed since then with regard to both the management of patients and medical education. At the time we began the first edition we were both strongly influenced by our recent experiences as basic physician trainees. The Royal Australasian College of Physicians training scheme had and still has a major emphasis on excellence in history taking and physical examination as the basis of management. We both feel strongly that a thorough grounding in these skills and arts is essential for everyone beginning a career in medicine. A diagnosis is the foundation of all medical practice, and history taking and physical examination are key in the diagnostic process despite the everincreasing sophistication of diagnostic testing. Tests ordered indiscriminately or inappropriately can seriously mislead and be dangerous: test ordering must be based on the findings of a proper clinical assessment of the patient. Making the wrong diagnosis can cause harm and distress that lasts a lifetime.
It is distressingly common for tests to be ordered and referrals made without an adequate history or even a cursory examination of the patient. In this new edition of Clinical examination we cover the core clinical skills from the basics to an advanced level. We have taken an approach that is patient-centric and evidence-based; the patient must always come first. This edition has been brought right up to date with the latest clinical data, including new research specially commissioned for this edition. Learning should also be fun and the book is deliberately laced with humour and historical anecdotes that generations of students have told us enhance the learning experience. Not only have there been changes to medical practice over the last 25 years but the format of teaching and use of books has changed irrevocably. The flexibility now offered by computer and tablet versions of books has altered the way students study and perhaps think. This edition offers the book in three formats: a paper book, an eBook and an enhanced eBook. Each version offers new features to help students to study. Again we are grateful to all those who have helped us with the increasingly complicated job of producing a book like this: our publishers, the colleagues who have contributed pictures and advice, and the many students who have written to us to correct errors (real or perceived).