# palmEM AI vs gistalt

The clearest difference is rating: gistalt at 4.9 against palmEM AI's 4.2. gistalt also leads on in-app purchases (none vs 6) and review sentiment (100% vs 82%). palmEM AI's advantage is update cadence (every 3 weeks vs every 22 months) and chart position (#114 vs unranked). On price, ads, device support and iOS requirement there is nothing between them.

Both are free to download. palmEM AI sells 5 in-app purchases, starting at $9.99 per month. gistalt asks for nothing beyond the download.

gistalt holds the better App Store score, 4.9 against 4.2. Both are backed by a comparable volume of ratings — 72 and 16 respectively. Written reviews point the same way: 82% of palmEM AI's written reviews are positive against 100% of gistalt's.

palmEM AI ships an update every 3 weeks, gistalt every 22 months. The most recent releases landed on September 26, 2026 and September 15, 2026 respectively.

## The numbers

| Metric | palmEM AI | gistalt |
| --- | --- | --- |
| Price | Free | Free |
| Rating | [4.2 (72 ratings)](https://appshunter.io/ios/app/palmem-ai-em-quick-reference/id481034047/reviews) | **[4.9 (16 ratings)](https://appshunter.io/ios/app/gistalt/id1520121253/reviews)** |
| Number of ratings | **72** | 16 |
| Positive reviews | 82.5% of reviews | **100.0% of reviews** |
| In-app purchases | Yes | **No** |
| Ads | No | No |
| Update frequency | **Every 3 weeks** | Every 22 months |
| Monetization | Free with in-app purchases | **Free** |
| Best chart rank | **#114** | — |
| Size | 139 MB | 35 MB |
| Requires iOS | 14.0.0 | **13.4** |
| Devices | **iPhone, iPad, iPod** | iPhone, iPod |
| Age rating | 17+ | 17+ |
| Developer | [palmER Worldwide LLC](https://appshunter.io/developer/481034130) | [Tom Fadial](https://appshunter.io/developer/1316852248) |

## What reviewers say

### palmEM AI

[App page](https://appshunter.io/ios/app/palmem-ai-em-quick-reference/id481034047)

**Currently charting:** #114 Top Grossing · Medical (US App Store)

This AI-powered emergency medicine guide provides rapid, evidence-based clinical decision support for medical professionals. It offers tailored guidance for specific patient scenarios and a comprehensive knowledge base, accessible offline.

**Highlights:** AI clinical decision support, Plain language medical queries, Evidence-based workups and management, Offline core content access, Medication quick reference, Procedure step-by-step guidance, Clinical decision rules

**Features:** macOS Compatibility, Family Sharing, Vision Pro support

**In-app purchases (5)**

| Purchase | Price | Billing |
| --- | --- | --- |
| Monthly Subscription | $9.99 | per month |
| Monthly Subscription \| Unlimited AI | $9.99 | per month |
| Monthly Subscription | $19.99 | per month |
| Monthly Subscription | $29.99 | per month |
| Annual Subscription \| Unlimited AI | $99.99 | per year |

**What reviewers like**

- 🚀 Quick and efficient reference tool for ED scenarios
- 👍 Easy-to-navigate interface with logical organization
- 📚 Comprehensive content covering emergency medicine topics
- 🎯 Concise, clinically-relevant information without unnecessary fluff
- 💊 Useful features like Broselow tape and drug dosages

**What reviewers complain about**

- ⚠️ Outdated protocols (ACLS, PALS)
- 🐛 Subscription model confusion and access issues
- 📱 Compatibility problems with newer iOS versions
- 🔄 Lack of regular updates over extended periods
- ❌ Note-taking feature removed or non-functional

**Reported bugs**

- App crashes on latest iOS updates
- Subscription verification fails for previous owners
- Access denied despite full subscription status
- App does not load on iPad
- Note section disappeared after update

**Requested features**

- Add toxidromes section
- Photo support in note-taking function
- Swipe-back gesture for faster navigation
- Procedure images or video links
- Dark mode option


### gistalt

[App page](https://appshunter.io/ios/app/gistalt/id1520121253)

This medical game challenges players to quickly assess patient acuity by swiping left for stable patients and right for those needing immediate intervention. It's designed to make training clinical impression skills engaging and fun.

**Highlights:** Patient acuity assessment, Swipe-based gameplay, Vital signs and lab results, Imaging interpretation, Performance scoring, Regular content updates

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases:** none


## Frequently asked questions

### Is palmEM AI free?

palmEM AI is free to download, with in-app purchases available.

### Is gistalt free?

gistalt is free to download, with no in-app purchases.

### Which has better reviews, palmEM AI or gistalt?

gistalt is rated higher. palmEM AI averages 4.2 out of 5 from 72 ratings, while gistalt averages 4.9 from 16 ratings.

### Do palmEM AI or gistalt have ads?

Neither palmEM AI nor gistalt shows ads.

### Which is updated more often, palmEM AI or gistalt?

palmEM AI ships an update every 3 weeks, and gistalt every 22 months. Most recently, palmEM AI was updated on September 26, 2026 and gistalt on September 15, 2026.

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*Compared by [AppsHunter](https://appshunter.io/) from daily US App Store data. Review summaries are generated from verbatim App Store reviews.*