Friday, February 22, 2008

I Heart the Heart

I turned in my portfolio yesterday. This is the last formative portfolio that we have to do this year. We have the same nine competencies that we had last year, but there are new standards for each competency that are specific to second year. For example, in research one of the standards is "Applies principles and skills in medical biostatistics and clinical epidemiology to analysis of data." We weren't required to address the specific standards for each competency, but I did it anyway so that all I have to do in April is just update my evidence. If any of you first years are reading this blog entry, you should do the same thing for your last formative too. Trust me on this.

We're back to doing cardio this week, and the seminars have been much better than last week. On Tuesday, we went to the Vascular Lab, where there were four different stations. Two were demos of ultrasounds and the pulse volume recording of a patient whose leg vessels were mostly blocked. Those stations were ok. We also had a nutrition station that was just ridiculous. First we waited around for the doctor for that station to show up. Once he got there, he gave an introduction and then invited the nutritionist to speak, but she didn't get to say more than one or two sentences before we were told to rotate on to the next station. I was kind of annoyed, because nutrition is an important topic, and we got no coverage of it whatsoever. The last station was the best. There was a patient who had familial hypercholesterolemia, which is a disease where the person is missing the receptors for LDL (the bad cholesterol). She had xanthomas in her Achilles tendons due to cholesterol depositing there, so the tendons were incredibly thick. Even I could tell that those tendons weren't normal! I had clinic in the afternoon, and everyone was in a bad mood, including me. Fortunately, my preceptor and I got out early because the 4:00 patient no-showed.

On Wednesday, we went to the Cardiology Exercise Stress Lab, where we saw a patient undergoing a stress test. I took one of these stress tests last year, and it's really hard even when you're young and relatively healthy. This patient was neither of the above, and the test had to be stopped early because the patient started getting some angina (chest pain). We also went over echocardiography and angiograms. It was a pretty good seminar. In the afternoon, we had a really awesome Clinical Correlation, one of the best that we've had all year. First, the cardiology pharmacist came and gave us an hour-long talk about the cardio drugs that he wasn't going to have time to cover on Friday. He is one of the best pharm seminar leaders if not the best, and his talk was really good. Then we had a second talk about coronary catheters and invasive cardiac monitoring, which was also excellent. After that we went and saw a few patients in the coronary intensive care unit (CICU). Overall it was a really long day, and I was tired at the end, but it was a good day.

Today we had the rest of the cardio pharm and then another one of those pointless POD small group discussions. Last week's POD small group discussion was surprisingly pretty good. Only three of the eight of us showed up, and we worked on the project like we were supposed to and even came up with some good ideas. It was almost actually fun. In comparison, this week's session was pure torture. That's about all I can say about it.

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