The novice trainee can be thrown into situations wherein immediate recommendations are expected, often over the telephone. This is particularly true for subspecialties where junior-most fellows cover considerable responsibility for providing first-line consultation in emergent settings. This can be nerve racking in the initial months of fellowship, and handy resources in the form of a “survival guide” can ease transition into subspecialty training. Despite easy access to web-based resources in the present day, a practical pocket-sized handbook can sometimes fill this void quite efficiently. This softcover, 273-page handbook has a unique, conversational style that takes the reader from the first telephone consultation through patient evaluation, differential diagnosis, laboratory testing, and management of common gastrointestinal emergencies. Conceived and edited by 2 accomplished clinician-educators at Boston University School of Medicine, each chapter is written by gastroenterology trainees and internal medicine residents with a faculty collaborator, with the intent of providing practical and evidence-based direction to the novice gastroenterology subspecialty trainee. The book does achieve the intended objectives for the first several months of subspecialty training, within the limits of the actual patient vignettes discussed. Recommendations are made with bulleted text, supplemented with a “key points” box within each chapter. Flow diagrams, algorithms, and tables complement written text, although font size in some of the figures makes reading on the go a challenge. Content is generally consistent with current guidelines and practice of gastroenterology, although newer medications are not uniformly included. The best chapter in the handbook is that on fulminant colitis, where many possible scenarios related to this emergency are covered with continuation of the case vignette, and contingencies beyond the presented case are used to describe alternate management direction and complications. The chapters on complications of endoscopy, and caustic ingestions, foreign body, and food impactions add further value to the intent of the handbook. However, the handbook is hampered in content by the fact that each chapter is case based; therefore, mostly material relevant to the case are discussed. This is despite the fact that certain chapters digress to detailed pathophysiology and clinical descriptions rather than focusing on managing the vignette. Consequently, certain gastrointestinal problems frequently encountered in emergent settings (such as nausea and vomiting, dysphagia, fecal impaction, or even Crohn’s disease–related emergencies) are only mentioned in passing and do not make it in as vignettes in the handbook. One fifth of the book is devoted to gastrointestinal bleeding, focusing on variceal and nonvariceal upper gastrointestinal bleeding, and lower gastrointestinal bleeding, but approaches to obscure bleeding, from the small bowel for instance, are conspicuously missing. Further, the case vignettes are not consistent in content and length; some vignettes have more details than the others. Some chapters provide an initial segment under the heading “Initial Response to the Call,” whereas others delve directly into pathophysiology and etiology before direction on how to proceed is presented. The chapter on ischemic disorders does not quite describe the approach to the vignette, with a detailed treatise on conditions that fall into the broad category of ischemic disorders of the gut. The handbook would benefit from uniformity in chapter organization, with consistent headings and subheadings throughout. The chapters that start with the flow of patient evaluation (eg, the chapters on gastrointestinal bleeding) seem to fulfill the handbook’s objectives well, whereas the chapters reverting to didactics over patient approach require extensive reading to determine what the next step should be. Nevertheless, the major gastrointestinal emergencies are covered, and the novice trainee can potentially flip open the book to the appropriate chapter to figure out what the next step should be when called with an emergency. For the gastroenterology fellow, the value of the handbook will be highest in the early part of gastroenterology training, when the trainee transitions from residency to fellowship—beyond this initial period, the gastroenterology fellow is expected to acquire in-depth knowledge of gastrointestinal diseases, and will be moving on to other resources to complement clinical experience in the learning process. Consequently, the handbook could turn out to be most valuable for residents and junior trainees in core specialties (medicine, surgery, emergency room) or subspecialties (critical care) who are actually evaluating the emergencies discussed, in the emergency room or in the intensive care unit, so that evaluation and management can be initiated appropriately while a gastroenterology consult is being sought. Bottom Line: This book is useful for entry level gastroenterology fellows during the initial portion of their fellowship; it may be more useful for emergency room and intensive care unit trainees of all levels.