A physician's group compared multiple scope models in multiple settings and were impressed with the Sprague. I purchased it as a secondary scope to stay in the vet truck and am beyond satisfied. Obviously there are some personal preferences, but I found the reviewer's comments of ""almost as good as the Littman Cardiology master"" and ""better than most, sound-wise"" to be spot on. You would not expect this from a $20 stethoscope, but it's true. Yes, the double tubing rubs a bit and there is nothing polished or otherwise classy about it, but the clarity is very good. Great for student budget, communal use, or when you want a second scope in case your prize one forgets to come on-call with you, walks off, or gets left behind somewhere. It beats the standard Littman hands down and costs far less.