Very difficult to get on & off of a scope (Littmann Cardiology II & III). If it had a spring-clip for easier removal, I'd give it five stars. Working as RT in ER/ICU, I have to clean my scope numerous times per night; this just gets in the way and is too difficult to move. Also, with very high-end scopes, you can hear the clicking of the watch through the scope. Maybe some insulation of some sort to dampen the sound?