‘There must be a good reason to write a new textbook of medicine when there is already a good number on the market.’ So began the preface to the First Edition of Clinical Medicine, published 33 years ago this year. Edited by Professor Dame Parveen Kumar and Dr Michael Clark, ‘Kumar and Clark’ has become synonymous not just with a medical textbook, but with the combination of excellence and accessibility they sought to provide. Their desire to empower clinical students and doctors has been the driving ambition behind the book ever since – ‘to strike a balance between exciting new developments in medical research and the vast quantity of established fact that needs to be absorbed… so that the management of the disease can be based on sound physiological concepts’.
The book they produced has become an international medical best-seller and has played a crucial part in the education of a generation of doctors – among them a new team of editors, humbled to be standing on the shoulders of these medical giants. Taking over is an honor and a great responsibility, and we are grateful for the legacy they have left, as well as for their continued support and input as we have brought this current edition to production.
Clinical Medicine has always attempted to bridge the gap between basic introductory texts and larger reference works: to be as comprehensible as it is comprehensive. The pace at which medical science continues to develop is astounding. The present generation of junior doctors and undergraduates must provide high-quality, patient-centered care in the context of a burgeoning body of medical research, patients presenting with multimorbidity and resulting polypharmacy, continuing inequalities in society and across the world, and a medical culture that expects doctors to work within teams, bridging traditional specialty and professional divides.
For this reason, we have introduced into this edition a number of new chapters to equip readers to address these new challenges: Evidence-based practice (Ch. 4), Surgery (Ch. 11), Public health (Ch. 14), Geriatric medicine, frailty and multimorbidity (Ch. 15), Haematological oncology (Ch. 17) and Men’s health (Ch. 40). In some cases, we have divided up larger chapters to highlight conditions that straddle traditional subspecialty boundaries but require a joined-up approach: Sepsis and the treatment of bacterial infection, (Ch. 8), Venous thromboembolic disease (Ch. 29), Hypertension (Ch. 31) and Obstetric medicine (Ch. 38).
We have included new clinical skills content at the beginning of most of the chapters to try to fulfill the historic aims of this book: bringing the clinical sciences to bear on the problems experienced by patients in day-to-day medical practice. We hope readers will learn not just to take generic histories and perform routine physical examinations, but to tailor their approach according to the presentation of the individual patient in front of them. We offer our own take on the clinical method and the importance of building a therapeutic relationship with patients in a new first chapter, describing what we believe remains key to the art of medicine: diagnosis (Ch. 1).
Online, readers will find a range of additional resources, including self-assessment questions, bite-sized overview topic pages covering major conditions, clinical skills videos, and expanded coverage of subjects with particular international or regional relevance. We hope you will find this edition helpful in your efforts to learn and practice medicine. Any suggestions you may wish to make are warmly welcomed and will help us to ensure that this book continues to meet the needs of its readers.
Adam Feather, David Randall and Mona Waterhouse
2020