It really is hard to find a good internal medicine resource that you can get through and understand all the details. This book is the best I have found for a reasonable read that actually explains the mechanisms behind the disease and treatment. It folds a case into each topic and then has a decent sized discussion about aspects such as differential diagnosis, why it is this and why it is not this, treatment, and then finishes with comprehension questions. While the questions are a bit too brief and not that difficult, they are helpful for remembering the important bits. Also, it includes a little box at the end of each section that highlights the key points. I would not replace MKSAP with this, rather I would use it with MKSAP. Then read this again for step 2, as you'll swear after reading this, you see some of it almost verbatim on step 2.Highly recommended.