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Long time contributors and fans of the “Clinician’s Pocket Reference” will note the cover no longer identifies this as the “Famous Scut Monkey Book.” In 40 years of publication of this manual no one has ever expressed concern or have been offended by the “Scut Monkey” character portrayal. In our new world of heightened sensitivities, the term “Scut Monkey Book” is not a prominent feature in this edition. However, the historical references to the “Scut Monkey,” which has always been considered an energetic, fun, and positive symbol of medical training, have been maintained in the introductory portions of the book as well as in the back-cover image. The editors and publisher appreciate everyone’s understanding and hope we have made it clear the “Scut Monkey” is only portrayed in a very positive light.

Since 1979, students, residents, practicing physicians, nurses, nurse practitioners, PA’s and other allied health professionals have turned to the “Scut Monkey Book” for learning the essential information on basic patient care. The Clinician’s Pocket Reference is based on the University of Kentucky manual entitled So You Want to Be a Scut Monkey: Medical Student’s and House Officer’s Clinical Handbook. The “Scut Monkey” program at the University of Kentucky College of Medicine was first held in the summer of 1979 and was developed by the Class of 1980 to help ease the sometimes frustrating transition from the preclinical to the clinical years of medical school. Based on detailed surveys from the University of Kentucky and 44 other medical schools, the essential information and skills that students should be familiar with at the start of their clinical years was developed.

The “Scut Monkey” program was developed around this core and consisted of a simple reference manual and a series of workshops conducted at the start of the third year. Held originally as a pilot program for the University of Kentucky College of Medicine Class of 1981, the program has become an annual event. Each new fourth-year class traditionally takes the responsibility of orienting the new third-year students in basic skills. The program is successful because it was developed and taught by students for other students. The 40th “Scut Monkey Day” was held on June 21, 2019 in Lexington. Students have been the main source of feedback for the book, critical to its longevity. Information on the rising third-year “Scut Monkey” orientation program is available from Charles H. "Chipper" Griffith, III, MD, MSPH, Vice Dean for Education at the University of Kentucky College of Medicine in Lexington (cgrif00@uky.edu). Over the years, similar programs, sometime referred to as “boot camps,” for new students and interns have appeared.

Over the last 11 editions, the book has been continually updated to reflect the dynamic changes in medical education and patient care. An attempt is made to cover the most frequently asked basic management questions that are normally found in many different sources such as procedure and lab manuals, and the extensive resources on the internet. This book is not meant as a substitute for specialty-specific reference manuals; the core information presented is the essential foundation for the new medical student or healthcare provider beginning to learn hands-on patient care. While some key pediatric content is presented, the focus of the book is on general concepts in adult medicine.

Our goal is to represent common medical practices around the country and internationally. Over the years, contributors from many different medical centers have enhanced the content of the book. The Clinician’s Pocket Reference has been translated into foreign languages, including Japanese, Chinese, Korean, Indonesian, Portuguese, and Spanish. The “Scut Monkey Book” was honored to have been asked by Warner Brothers, the producers of the TV show “ER,” to be one of the prop books used on their series. The book has also been a topic of conversation concerning medical education on National Public Radio (NPR). Medical students on the TV show “Scrubs” were lovingly referred to as “scut monkeys” by Dr. Cox in the “My Bed Banter and Beyond” episode.

With the explosion in online resources, downloadable apps, and many new pocket manuals, we thought the Scut Monkey would be laid to rest after the 11th edition was published in 2007. Over the years, feedback to the publisher and the desire for the book to be updated for a new generation of students has increased. The core content of the book is so enduring that the sales of the book continued to be strong even with a 2007 publication date. It was our pleasure to not only update the manual but also add new content to reflect the changes in contemporary healthcare education. Sections on multidisciplinary healthcare teams, palliative care, and outpatient medical management are just a few of the new chapters. Due to the rapid FDA drug approval process and the extensive resources available for online drug updates, we removed the general drug prescribing section of the book to allow for expansion of core clinical elements.

The 12th edition was updated during the 2020–2021 Covid-19 corona virus pandemic. Sections on lab testing, personal protection equipment (PPE), and cardiopulmonary resuscitation were updated to the latest information available at that time of publication. The 12th edition also received a major upgrade in terms of illustrations. The tremendous McGraw Hill Medical “AccessMedicine” online reference was a most valuable resource and we are appreciative of the opportunity to use many fine images from that resource.*

A word of eternal gratitude to the past Deans and administration of the University of Kentucky College of Medicine: Drs. Kay Clawson, Terry Leigh, and Roy Jarecky, and the then very young faculty member Dr. Richard Braen, who took a chance and supported a group of thirdyear medical students who wanted to try to do something a little bit different way back in 1978. Thanks also to the hundreds of past contributors, early edition co-editor Dr. Michael Olding, and readers who have helped to establish the “Scut Monkey Book” as one of the enduring references for students and residents. Every medical student at the University of Kentucky College of Medicine since 1979 has received a courtesy copy of this book as a small token of Drs. Gomella and Haist’s appreciation for UK’s dedication to producing outstanding and caring physicians who serve patients in the Commonwealth and beyond.

We would like to express special thanks to our respective wives Tricia and Meg and our children for their patience and long-term support of the “Scut Monkey” project. Our appreciation to McGraw-Hill, for keeping this book as one of their high priority publications. Many faculty, house staff and students from the University of Kentucky College of Medicine and the Sidney Kimmel Medical College of Thomas Jefferson University contributed critical 12th edition updates. Other faculty, residents, and students from a dozen other medical centers were valued contributors to this edition. Many of these colleagues have been involved with the “Scut Monkey” for many years over many editions.

As always, we look forward to your comments and suggestions as the creation of the essential content of the book would be impossible if we did not receive feedback from our readers. We hope this book will not only help you learn some of the basics of the art and science of medicine but also allow you to care for your patients in the best way possible.

Leonard G. Gomella, MD, FACS

Philadelphia, Pennsylvania

Steven A. Haist, MD, MS, FACP, FCPP

Highland Heights, Kentucky

Visit our website www.thescutmonkey.com for additional Clinician’s Pocket Reference content.

Drs. Steve Haist and Leonard Gomella at the University of Kentucky College of Medicine 50th anniversary celebration in 2010 at a display in honor of the “Clinicians Pocket Reference,” part of history at UKMC.

*https://accessmedicine.mhmedical.com/

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