Overview

Reasoning Without Resources is a two-volume case-based learning text written to teach both clinical global health and clinical reasoning. The cases are actual admissions and clinical histories from a rural Ugandan hospital. The questions and answers are rooted in the fundamentals of bedside clinical medicine: the value and method of obtaining a meaningful history, key physical exam findings and their place in diagnosis, and clinical reasoning itself - how impressions are formed and diagnoses made - for better or for worse. Volume 1 presents all 129 cases with their related questions. The first presentation of the 129 case-question pairs does not include answers; the cases with answers, which necessarily fill many more pages, are presented starting at the end of Volume I (where cases 1-47 are presented with answers) and continue in Volume 2 (where cases 48-129 are presented with answers).

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Dr. Jerry Paccione's first experience in global health was between his 3rd and 4th years in medical school when, for a year, he was a medical practitioner for 3 remote villages in Guatemala. Since then he has integrated global health practice and training into his education career at Montefiore Hospital and Albert Einstein College of Medicine in the Bronx. As Director of the Primary Care/Social Medicine Program at Montefiore between 1985-2007, he initiated special clinics for immigrants in the South Bronx and victims of international human rights abuses, and created experiences for residents and students in Latin America, the Navajo reservation in Arizona, and Africa - all experiences linking medical education with meaningful clinical service. Since 2006, as Director of Global Health in Montefiore's Department of Medicine, Dr. Paccione has coordinated a collaboration between Kisoro District Hospital, medical schools from the United States, and the non-governmental organization Doctors for Global Health. This collaboration has treated tens of thousands of patients- the inspiration for this book - in an underserved rural area of Uganda while providing real-world training for more than 350 medical students and residents. With a strong community foundation, the program has also trained and actively maintains Village Health Workers in 52 Kisoro villages, and with them sponsors novel projects in a wide range of community-based services including chronic disease diagnosis/management and geriatrics. Dr. Sam Musominali is the head of the Kisoro VHW program.

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