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Medical genetics
  1. W Reardon

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    Oxford Core Texts, (Pp 315; £22:) Ian D Young, 2005, ISBN 0-19-856494-5.

    The average medical student now receives something like 15 hours formal tuition in our specialty. Practices appear to vary widely from medical school to medical school as to what format that teaching takes, as to the nature and background of personnel offering teaching in medical genetics, not to mention the means by which students are examined. In parallel with this fairly haphazard approach to teaching what is clearly considered to be a very minor subject of the medical school curriculum, the textbooks targeted at medical students have mushroomed. Not only has there been a proliferation of new authors entering this field but, as established observers will be aware, the size of the volumes offered expands with each passing edition. There is a theory in medical education that each lecturer thinks that students need to know about 80% of the knowledge the lecturer has themselves mastered. A passing glance at the ever increasing size of the textbooks in medical genetics aimed at the medical student market shows that geneticist authors are among the worst offenders in this particular category of sin.

    Ian Young is a long established author and teacher of medical genetics in several medical schools worldwide. Few people are as conversant with the aims of medical genetics teaching as laid out by the ASHG and by the BSHG. The thoughtful foreword to this new book establishes clearly his view that the teaching of medical genetics should be founded firmly on basic principles and the demonstration of their clinical relevance. Such views are in stark contrast with the “bigger is better” approach so beloved of most geneticist authors. As a medical student, I clung firmly to the view that no book was the best option, but if one was necessary, let it be as small and cheap as possible. Perhaps student natures have changed – maybe medical students nowadays want to own tomes that are all a minimum of 400–500 pages? If my recent experiences in this narrow jurisdiction are representative of global trends, students remain interested in smaller but clearly written textbooks.

    This is a new book from an established and respected author. It comprises 14 chapters, each designed to be subject of a single lecture. Accordingly, the chapter titles and content are carefully chosen. The breadth of material covered is wide – impressively so – and without omission of the essential principles. The style of writing is relaxed, as might be expected from a man who has given so much thought to these complex ideas that he knows how best to make them accessible to others. The pitfall of overfamiliarity with the material, which bedevils many experienced authors, is never a factor. There is no tiredness in the writing. The ideas naturally follow one another, their presentation fresh, accessible, and thoughtful. Appropriate figures, generally of a high quality, illuminate specific points. The diagrams, of which there are many, are clear, carefully chosen, high quality, and well presented. An interesting idea is to punctuate the text with specific case histories of celebrated examples of some point relevant to that chapter as well as to highlight and discuss a landmark original publication that has informed and moulded practice in relation to the issues under consideration. This is a very effective way of consolidating the principles in the text, practically showing the relevance, and reaffirming those principles again through the historic approach. Although placing a remarkable degree of burden upon the author, it is a highly successful approach to teaching. Who among us would have known of the contribution of “T-Boz Watkins”, an apparently well known rap “artist” (my apostrophes) in the area of sickle cell disease? The author likes to surprise us but the breadth of reading and knowledge required to inform this style of writing is formidable.

    This is a most impressive book, which achieves the clear sighted goals of its author and offers medical students enjoyable and interesting access to the core medical genetics curriculum without expecting them to practice as molecular biologists, cytogeneticists, or consultant clinical geneticists at the end of the exposure. At just under 300 pages, it offers achievable learning to students in a subject that, although minor to most medical schools, will probably be crucially important to most of tomorrow’s doctors. Our specialty owes Ian Young a great debt for taking responsibility for making our subject accessible and enjoyable in this concise textbook. A remarkable achievement and one that should be warmly commended to all medical students and others seeking a basic understanding of the principles of genetics as applied to medicine.