I'm at Oxford currently preparing for finals in medicine and surgery. I recently bought this following a recommendation from a friend and I have found it very useful. I think the symptom-based approach, i.e. chapters based around a topic like 'shortness of breath', forces you to think diagnostically and so is especially useful for consolidating lots of disparate bits of knowledge. Having said this, it would also have been of great benefit at the start of clinical school when I was looking for a framework with which to approach the common problems. The chapters succeed in logically taking you through from history to examination to investigation interpretation and management options while forcing critical analysis of the case at each stage. The 'viva' pages really bring to the fore key points which you may otherwise have glossed over.
All in all, a valuable addition to any student's library, complementing the many established reference texts.