Editor: John A. Goodfellow
Publisher: John Wiley & Sons
Medical knowledge is advancing unbelievably quickly, and medical practice has been revolutionised by scientific research that is not only groundbreaking, but well considered and based on sound scientific principles. Not surprisingly, many medical schools now expect students to participate in research projects, and evidence of such work is de rigueur for job applications post-qualification. By examining key developments in medicine we can see the complexities of the theoretical approaches and methodologies used. I find it essential to cultivate this understanding in the medical students I supervise; moreover, it allows them to experience the sheer excitement of medical research.
Understanding Medical Research, aimed at the young medical researcher of the future, should therefore be timely, especially given the focus made explicit in its subtitle, The Studies that Shaped Medicine. It is ambitious and covers a wide range of clinical disorders, and the authors of each chapter have chosen publications that contribute most to progress in their medical specialty. Each chapter ends with key questions, which are useful in pointing to further exploration, perhaps through involvement in research projects. This text avoids being a classic review of the literature, but seeks instead to provide a glimpse into the “unique blend of science and pragmatism”, to quote the chief medical officer Sir Liam Donaldson’s admirable foreword, which can have a profound impact on medical practice.
I found the opening chapter on the epidemiological aspect of medicine particularly effective in accomplishing that aim, with its historical context and deft glimpses of the complex interactions between medicine, sociology and political change, and broad-brushstroke sketches of those involved. Likewise, “Patient safety” begins with Florence Nightingale, who was not renowned for “medical research” but who is shown here to have used a meticulous, evidence-based approach in collecting and analysing data; a fine example for anyone starting out in population-based research. I appreciated the inclusion of James Reason’s work on accident causation, originally conceived for non-medical problems but which is now an approach that profoundly influences modern medical practice.
Other chapters juxtapose different research methods, for example computer modelling and in vivo studies, or describe the revolutionising impact of modern genetics. Research papers often tell a good story, and I was particularly engaged by the chapter “Helicobacter pylori, peptic ulcers and gastric cancer”. Understanding normal biology is essential in comprehending disease pathology, as is clearly shown in the chapter “Inherited diseases of haemoglobin”, and also in “Transplantation”, which focuses on monoclonal antibodies, now routinely used in basic research and chemical pathology.
Although there are many other equally fine examples, not all the chapters reach this high level. Overall, I am unsure whether this volume completely addresses the challenge of understandingmedical research, which requires appreciation of the researcher’s thought process, hypotheses and methodologies employed. Certainly I had a glimpse of the studies that shaped modern medicine. Perhaps it would have been more appropriate if the subtitle were the main title.
Who is it for? Medical students and doctors in their foundation year.
Presentation: Quite clear.
Would you recommend it? Yes.