Clinical Practice of Medicine

Andrew Symons MD, MS.

Andrew B. Symons, MD

Dear future doctors,

My name is Dr. Andrew Symons. I am a family physician and director of the Clinical Practice of Medicine (CPM) first-year course. This course introduces you to interviewing and examining patients. I am sure that you have heard that our medical school prides itself on the fact that we introduce our students to actual patient care right from the start. I think you will find this very exciting and gratifying.

Since you will be learning and practicing physical exam skills in the first semester, you will need some medical equipment right from the start. Below is a list of equipment. The only two pieces of equipment you will need in September are the stethoscope and blood pressure cuff (sphygmomanometer). You will need the otoscope in November and ophthalmoscope in the second semester.

Students often ask whether they need to purchase equipment or if equipment will be available at school or in clinical settings. Everyone certainly needs to own their own stethoscope. Although blood pressure cuffs are often available in clinical settings, there will be times when they will not be, and it will be helpful to have your own blood pressure cuff.  Also, we practice taking each other’s blood pressure during our seminars, so you will need to have access to a blood pressure cuff. You will be considered unprepared if you do not have one. I strongly recommend you purchase a BP cuff.

Although ophthalmoscopes and otoscopes are available on the wall console in many clinical settings, and in our clinical competency center, there are times when they are not. For instance, they are usually not present in hospital rooms.  In addition, owning your own equipment also affords you more opportunity to practice your skills at school and at home. There will be several times during the first year when we will ask you to bring in an ophthalmoscope and otoscope to practice those skills on each other. Owning your own complete set of diagnostic equipment will serve you well throughout your four years of medical school and into residency. I realize these are costly, but they are worth the investment. I feel it is sort of “rite of passage” of becoming a doctor.

So, in summary, you certainly need to own your own stethoscope. You will be expected to have access to the other diagnostic equipment during CPM and throughout your four years of medical school, and I highly recommend you purchase equipment.

Students often want some guidance as to how and where to obtain the equipment. I am sure that some of you may be receiving gifts of equipment from friends and family. Some of you may also decide to start shopping for your equipment before coming to school, either at stores or online. That is fine, as long as the equipment is of reasonable quality. For instance, you won’t go wrong if you choose name brands such Littman or Welch Allyn.  Please be sure to purchase equipment of “diagnostic” quality (as opposed to, for instance, a stethoscope intended just for obtaining vital signs). The list below has some examples of equipment.

In order to help you obtain equipment and receive some guidance in choosing the equipment, we have asked a local medical supply company to do a presentation on equipment choices early in the semester. You may also choose to purchase equipment through the University Medical Book Store or other local surgical supply stores. You will have several days after the equipment exhibit to make your decision as to where to purchase the equipment and still get your equipment in time.

Whichever way you decide to go about getting equipment, please make sure to have the stethoscope and blood pressure cuff with you in class mid-September (for the session where we start to teach you to obtain vitals).

The Clinical Practice of Medicine course relies on physicians in the community accepting students in their office for 4-5 afternoons in the fall and 4-5 afternoons in the spring.  Physicians usually really enjoy having first year students come to their office. If you have physician relatives or friends in the Buffalo area who would be interested and willing to help us with this, please have them e-mail me, as we are always looking to expand our ranks of volunteer faculty.

You are embarking on an exciting journey. I look forward to introducing you to the world of clinical medicine.


Andrew B. Symons, MD, MS
Professor and Vice Chair for Medical Student Education
Course Director, Clinical Practice of Medicine I (IDM 520/521)      
Department of Family Medicine

Required Clinical Instruments for the Clinical Practice of Medicine Year One Course

Sphygmomanometer (BP cuff) adult size required, pediatric optional

Consider the Welch Allyn DS66 Trigger Aneroid with cuff (I like the trigger deflation one-hand operation, but you can also get the standard screw-valve deflation: DuraShock)

They are often packaged in a set which includes pediatric, regular adult, and large adult cuff sizes (more money than buying just the normal-size adult cuff, but you might as well have all the cuff sizes)

Stethoscope of diagnostic quality

Consider 3M Litmann Cardiology IV or Welch Allyn Tycos Harvey Elite

Otoscope (with insufflator bulb)/Ophthalmoscope

These are usually purchased together as a “diagnostic kit” like the Welch Allyn 97200-MSL

Although the “pocket-sized” otoscopes (ears) are handy, my experience has been that the “pocket-sized” ophthalmoscopes (eyes) are very hard to use well. I would get the full-sized equipment, and consider a pocket-sized otoscope as an added purchase at some later date. Keep in mind that even the “full-sized” equipment fits in the pocket of a white coat.

Miscellaneous Equipment

  • Reflex hammer
  • Tuning fork, 128 Hertz
  • Measuring tape
  • Handheld eye charts