Today and yesterday weren't nearly as exciting as Tuesday was, but I still got a lot accomplished. Yesterday I was still so exhausted from the day before that it was difficult to drag myself out of bed in time to get here by 9 AM. Actually I was kind of dragging all day. But luckily I didn't have to do anything more active than read more of the clinical research training manual, pick up my scrubs from the uniform room, and go through an orientation about submitting institutional review board (IRB) forms. All of the IRB submissions occur completely electronically here at CCF, which is very cool. When you answer the initial questions the site asks you, it automatically generates forms for you and tells you what documents you need to upload for the IRB to review your research. (The IRB is a committee that is responsible for protecting the rights of human research subjects.)
One of the residents was making fun of me yesterday for actually reading through the research manual, because it's like 250 pages and kind of dry. But I was glad that I had read some of it, because otherwise I would have had no clue when the person giving me IRB training was talking about. She was asking me questions about things like investigator brochures that I hadn't even heard of before I started reading the manual. (Investigator brochures are for clinical trial drugs that haven't been approved by the FDA yet. They basically function like the little warning sheets that come inside the packaging of all marketed drugs and tell you what all the known side effects might be.)
Today I've continued reading the manual, and I'm finally done. I was determined to finish the whole thing by the end of today so that I can do something else from now on. I also had a second orientation about case report forms, which are the forms where the official data from the clinical trial are recorded. Again, I only knew anything about what the guy was talking about from reading the manual, because I didn't know about case report forms before I got here either.
I also went to two Grand Rounds today, one for internal medicine this morning and another one for wellness at lunchtime. The internal medicine one was about drug eluting stents. Stents are little metal mesh tubes that are used to hold the heart's arteries open in people whose arteries are clogged. Well, the drug eluting kinds prevent the arteries from re-clogging better than bare metal stents do, but they apparently increase the risk of getting a blood clot. The good news is that co-administering certain drugs seems to decrease the risk of getting blood clots in people who have drug eluting stents.
The wellness talk was about obesity in children and teens. Probably the most interesting thing that I learned is that Cleveland is the 12th fattest city in the country, with 30% of children under age 18 overweight. She also mentioned that about 80% of obesity is attributed to genetic causes, and her group is trying to work with the remaining 20% that can be affected by behavior and environmental modifications. The worst news is that in order to gain ten pounds in one year, you only need to consume an extra 100 calories per day. I have to say that I've become a lot more aware of my own lifestyle habits since starting medical school. Seeing pictures of atherosclerotic arteries from obese middle school-aged children will do that to you....