Wednesday, November 29, 2006

Lipoprotein Seminar, PBL, and Clinical Skills

I was really dragging today, and I have to confess that I was basically counting down the time until I'd be able to go home. I'm just happier than I can say that I have tomorrow off and I can finally get some sleep. This morning, we had a lipoprotein seminar. It was pretty research-intensive and covered some material that the seminar leader thought was important but that was not really covered in the textbook yet. I thought it was a pretty good seminar, although a lot of people felt like maybe it was too specific. I don't know. It's hard to know when you're a first year what is going to be important to know about later on.

In PBL, we continued on with our case. I think that today's session went pretty well. Everyone did a good job with their presentations and we finished on time. Our patient is improving but is still not where he ideally should be. We got into a really interesting debate about whether we should treat him more aggressively with drugs or focus more on his lifestyle factors. The group was pretty much split half and half on that, with some people wanting to be conservative and give the medications more time to work, and others wanting to be more aggressive because they thought the patient's life would be in danger. I was on the side of wanting to wait until we were sure that he wasn't improving any more on his current dosage. It turns out that the doctor in the case did decide to up the patient's dose, and luckily the patient has not been experiencing any side effects. Anyway, it was really a good discussion, because sometimes there is not one easy answer to these kinds of questions. For Friday, I am going to be presenting about the drug regimen that the patient was put on, and what was the logic behind it.

After class, I went to a Pharm Free talk. This talk was given by the same pharmacist who is in charge of our pharmacology thread. Basically, it was about the dangers of physicians accepting free items and drug samples from pharmaceutical reps. CCF has a pretty strict policy about what drug reps are allowed and not allowed to do. They have to register, they can't see doctors unless they have appointments, and they are not allowed to provide food on campus. Personally, I do not view pharmaceutical companies as being all that evil. Yes, they do spend too much money trying to influence doctors and patients to buy their products. But a lot of good can also come out of their actions, especially when doctors give the free samples from drug companies to their low income patients or help such patients apply to the drug companies to get drugs for free or at reduced price. Anyway, the general point that you have to be careful when dealing with drug companies is a good one and well taken.

In the afternoon, we had our clinical skills class. Today was very enjoyable. We have a few different preceptors who have been teaching clinical skills to us, and the one we had today is my favorite. The other three students in my group and I have also figured out the best method for learning the skills. First we have the preceptor demonstrate one skill, and then all four of us try it. Then we go on to the next skill, and repeat all the way through the list. Our standardized patient today was a girl and she was really nice. We were doing the ears, nose, and throat exam, so I got to see her tonsils and her eardrums. Eardrums are very pretty, kind of pearly looking. For the communications portion of the class, we watched the videos we made four weeks ago with one of the communications preceptors. Watching my video, I thought I had done a good job with being empathetic, but I definitely need to work on the medical portion of the exam. Well, a big part of my problem there is the fact that I don't know very much medicine yet! But I'm getting better.

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