Sunday, September 20, 2009

What Is The Best Stethoscope To Get For Medical School?

Continuing my beginner's guide to medical school for first year medical students and following up on my post on what books a first year medical student should buy, I address that timeless medical school question: what stethoscope should I get?

Many factors go into the purchasing decision. As a disclaimer, I should note that I have owned a Littmann Cardiology III stethoscope for the past few years and am quite happy with it. I have even recommended it as a gift for medical students (as that is how I received it), as well as a medical school essential. Thus, as a default option, I think you can't go wrong with Littmann Cardiology III.

That being said, there is a broad discussion online about what constitutes a good stethoscope. For example, Half MD argues against the Littmann Cardiology III in favor of the Welch Allyn Tycos stethoscope:
I don’t like it. I haven’t been able to hear as well with it as the marketing propaganda would claim. The fans will instantly cry out, “But it has a tunable diaphragm.” To which I would respond, “Do you even know what a tunable diaphragm is? And furthermore, if you pay any attention to the research that was conducted on stethoscopes beginning over 50 years ago, you’d realize that a tunable diaphragm is the exact feature that a stethoscope should not have.”

I prefer the Welch Allyn Tycos DLX. The sound quality is much, much better compared to the Littman. It has interchangeable ear pieces that come in various varieties of stiffness so that the user can choose based on comfort level. Finally, the diaphragm can be easily changed to a pediatric version. All I have to do is unscrew the adult version and then replace it with a pediatric one to convert my stethoscope into a listening device for the kids.

While I cannot argue against the Welch Allyn product, the Cardiology III has a pediatric diaphragm that easily attaches to the bell of the stethoscope. And I have had no trouble appreciating most clear murmurs. Another post from Practicality argues in favor of the Littmann Master Classic II stethoscope
Buying an expensive stethoscope because you don’t want to lose out is an absolutely ridiculous reason. Unless you’re buying a China-made $17 stethoscope, there’s almost no loss in skills of cardiovascular/respiratory/etc. examination with a $95 Littmann Classic II SE compared to the rest. Don’t let your friends pressure you into this.
That said, J. supports the 3M Littmann Classic SE, and not because it has tradition on its side. It is light, bendy (knots can be tied in it), of good quality, available in grey and most importantly, way cheaper than its more illustrious counterparts.
And of course, J. refuses to cave in to herd mentality: "everyone’s using at least a Cardiology III, mustn’t lose out!"

Ultimately, my view is that any of the Littmann or Welch-Allyn stethoscopes will provide decent enough sound quality and functionality to get through medical school. The two sets of students I would caution to think a little more deeply about their decision is anyone interested in cardiology or in pediatrics. For the cardiology people, investigate your decision a little more closely and try out several scopes to see which works best for you. Read reviews online and ask cardiology fellows and attendings for their advice. For the peds people, consider getting a pediatric sized stethoscope. I am not sure if it actually helps you hear heart sounds that much better than a regular adult stethoscope, but it makes sense given the patient population.

Confused yet? As I said before, the default gold standard seems to be the Littmann Cardiology III stethoscope so try that first. If you already have a stethoscope, what type do you have? Are you happy with how well it helps you during your cardiovascular and pulmonary exams?

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Updated 2015-12-18


  1. My littman classic 2 SE freebie was not able to pick up LDA sounds (I'm a vet student) that I could hear loud and clear with my friend's master cardiology. As nice as the master cardiology is, I wanted one with a paeds piece for small animals and heard bad reviews about the cardio 3 from other student. Went with the harvey elite instead as our cardiology prof recommended it and uses it. Like it so far. My brief experience has taught me that even as a student, not all stethoscopes are good enough and sometimes it's worth paying up for a better one (student discount helps though).

  2. I have the Classic II and it works fine for me. No issues so far.

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