Book and Multimedia Reviews: Media Review
Qbase Anaesthesia, Vol. 5: MCQ’s for the Final FRCA Hammond E, McIndoe AK, eds. New York: Cambridge University Press, 2006. ISBN 0-521-67705-X. 211 pages + CD-ROM, $50.00.
The Royal College of Anaesthetists, the professional body responsible for the specialty of anesthesia throughout the United Kingdom, includes a 90-question multiple choice test as part of its final fellowship examination. This book, intended as a study guide in preparation for the FRCA (Fellowship of the Royal College of Anaesthetists), is designed for the physician preparing for this test. The book includes well-written questions with explanations on a broad range of topics in anesthesia.
The book includes five tests, each with 60 questions. Each question is structured as a five-part true-and-false, with penalties for answering questions incorrectly. An answer key (with explanations) then follows at the end of each test. Additionally, a CD-ROM is provided to facilitate self-testing and evaluation. The CD-ROM includes the same questions as the book, with an additional option to help a test taker determine an optimal selection strategy.
Most other board review books (like those by Hall and Chu) have been designed with the frequently recurring topics on the American boards in mind, making them high-yield reviews for American students of anesthesia. This book has been designed with a similar purpose, but for the British board exams. The topics do generally mirror those of the American test, with normal physiology, pathophysiology, machines, cardiology, obstetrics, pain, regional, physics, and pharmacology all well represented. Pediatrics is somewhat underemphasized on these tests compared with the American test. Generally, the book’s questions focus more on minutiae than the American test, with detailed questions about topics such as E.coli and xenon.
The structure is entirely different from that of the American written board exam, which is composed entirely of multiple-choice and “K-type” questions. In addition, many of the questions in “Qbase” use terms, spellings, and names unfamiliar to American test takers. This tends to make the questions difficult to follow at best, and at worst virtually useless for preparation for American boards. For example, the book commonly refers to named devices and techniques that are seldom mentioned in literature familiar to American residents (such as the Benedict Roth spirometer or the Bryce-Smith tube). It features questions on drugs that have fallen out of favor in the United States, such as enflurane, and on tests and algorithms that are rarely used in the Unite States, such as the Goldman cardiac risk index, even though the index was developed in America.
This is not to say the book is badly written; on the contrary, it does have value as a clinical review for an anesthesia practitioner. The reader would need to briefly evaluate each question to determine whether it is relevant to practice in the United States (about 15%–20% of the questions are probably too based in U.K. terminology to be useful). The questions cover a broad variety of topics and each question comes with a thorough explanation of the reasoning behind the answers. However, this reviewer cannot recommend this book for written board preparation for a student taking the American anesthesia boards.
Jason Fehr, MD
Department of Anesthesiology and Critical Care
University of Pennsylvania