The Clinical Anaesthesia Viva Book, 2nd Edition.  By Julian M. Barker, Simon J. Mills, Simon L. Maguire, Abdul-Ghaaliq Lalkhen, Brendan McGrath, and Hamish Thomson. Cambridge, U.K., Cambridge University Press, 2009. Pages: 448.

Price: $66.00.

Preparing for the anesthesia oral board exam brings a shudder to anesthesiologists. In addition to the amount of information one must master, there is the added challenge of learning how to take the exam and understanding what will be expected of you. The Clinical Anaesthesia Viva Book  is an excellent tool for anyone preparing for the oral boards. The equivalent of the American oral board exam in the United Kingdom is the viva exam. Although the format is not exactly the same, it is very similar, with both exams consisting of short and long format questions. Thus, although this book is designed specifically for the British exam, it can easily be used to study for the American oral board exam.

This book is organized into three chapters. Chapter one is a basic summary of the British vivas and guide for preparation. This chapter contains very helpful advice on how to study solo and also in groups. There are also very helpful strategies for organizing one's thoughts and suggestions on how to deliver a well-phrased answer. The section on the opening sentence was especially helpful, as just beginning one's answer can be extremely anxiety-provoking.

Chapter two, “The short cases,” is a series of one- or two-sentence clinical scenarios, with or without some imaging, followed by a series of questions. The majority of the questions focus on preoperative, intraoperative, and postoperative management. However, there are plenty of questions that cover a wide range of topics, including basic science and physiology, pharmacology, disease process, surgical procedure, positioning, analgesia, regional anesthesia, pain syndromes, pediatrics, obstetrics, critical care, and even statistics.

In chapter three, “The long cases … the one about …,” a much more detailed description of a clinical scenario is given, including the past medical and surgical history as well as information such as laboratory values, electrocardiograms, and imaging studies. Each of these cases is followed by a question asking one to summarize the case or demonstrate an understanding of the major issues related to the management of the case. Finally, there is a series of questions that encompass the same broad range of topics as the second chapter.

The strength of this book lies in its helpfulness in categorizing information to aid in both memorization and thought processes used for the oral exam. There are many highlighted blocks throughout the book that summarize important clinical facts and present useful tables and charts. The reproduced chest x-ray films and electrocardiograms are good quality and cover the images most likely to be seen on the exam. The summary of the clinical evidence and references are organized and are very up to date.

The only potential problem with this book when using it to study for the American board exam is that it cites British Society Guidelines. Less of a problem is that some of the terminology and nomenclature are different than what is used in the United States. However, these differences can be easily overcome with a brief search, and I found the differences to be interesting, thought-provoking, and sometimes a bit humorous.

In summary, I believe this book is an excellent study guide, not only for the British viva exam but also for the American oral board exam. For practitioners already board-certified and working with residents, it provides useful clinical scenarios and teaching points to discuss. Because this book was easy to read and even provided some occasional humor, I will use it continually to brush up on my clinical knowledge.

West Virginia University, Morgantown, West Virginia. allenk@wvuh.com