www.merckmedicus.com

In the first of a series of reviews of comprehensive medical resource sites, Auckland GP Jon Wilcox details the merits of the useful but less well know Merck Medicus.

The "medical internet" appears to have become some form of clinical necessity in recent times.

A bewildering number of sites such as Medscape (free), MDConsult (subscription only), DocGuide (free), CyberRounds (free) and other "all-purpose CME Centres" are frequently recognised by today's increasingly "global" clinician, both in the primary and secondary care areas.

But this "world famous in New York" Merck site, is probably less well known. The site is freely available, and has all but complete accessibility to international "subscribers" and is, in my view, quite possibly the best of the lot.

As with the uniquely popular and well-established Merck Manual, Merck Medicus is also sponsored by Merck and Company in the US. The advantage of having a "benevolent sponsor" is self-evident.The site is well designed, well maintained and is in my opinion, exceptionally good value to clinicians from poor "second world" nations, such as New Zealand. And, while this site is no cheap conduit to full text medical journals, it is nevertheless incredibly well endowed with a wide range of other not-for-profit services such as:

• Best Practice of Medicine (Evidence Based Medicine for a range of clinicians)
  CME Course credits (CME support courtesy of a sub-site CE Medicus)
  Drug References (detailed prescribing support information)
  Harrison's Online (unfettered access to this famous, and current 17th edition online)
  Journals - a range of up to date journal summaries and some full text access to the main primary care/general practice/family medicine journals.
  The Merck version of MDConsult from Elsevier Publishing, which includes a wide range of Elsevier-backed online texts and other clinical support services (currently this component is unavailable to clinicians outside of the US as a formal "medical education number" is required from the AMA)
• Mobile Merck Medicus - a fantastic mini resource for the PDA-enabled clinician. The family practice version includes preselected abstracts and titles of current journal articles, optional laboratory test handbook type information and the full text of the current Merck Manual.

While GPs do tend to do most of their clinical work from their office desktop it can still be certainly useful to have a full medical text buried and searchable within a small pocket-sized PDA.

Medical texts - the remainder of the free text range is substantial and includes:
-  Cecil's Textbook of Medicine (2500p)
-  Ferri's Clinical Advisor*
-  Hospital Medicine
-  Merck Manual of Geriatrics

Texts specialising in allergy, dermatology, ECG, cardiology, immunology, endocrinology, breast disease, internal medicine, gastroenterology, paediatrics, orthopaedics, respiratory medicine, rheumatology, infectious diseases, chronic pain etc.

- Danforth's Obstetrics and Gynaecology
- Manual of Family Practice
- The 17th Edition Merck Manual
- Patient support services, such as "health maps" and patient handouts.
- Clinical Tools (such as Therapeutic Guides for Pain and Antibiotic     Management)
- Medical news (including medical, specialty, consumer and MD alerts)

Merck Medicus does not offer a comprehensive journal abstracting, article catergorisng or summary service, such as provided by DocGuide, but does offer links to a wide range of specialty and primary care journals. There is also a separate group of full text journals listed.

The reason I have singled out this site is the excellent support for PDAs (personal digital assistants) and also the unbeatable and comprehensive range of up to date medical texts, obviously, including Harrison's.

So, while some components of Merck Medicus are limited to clinicians with a US practicing certificate, 95 per cent of the site is fully accessible to the global community.

Maybe Merck Medicus is a good reason to buy that PDA.

* Ferris Clinical Advisor is a remarkable annual hardback and electronic publication from WB Saunders, which provides succinct single page intensive disease summaries, together with sections on: symptom-related assessment; laboratory investigations: and a substantial section devoted to clinical algorithms.