This week has gotten surprisingly busy. I've been reading for tox, working on my research protocol (though not as much as I would have liked), and finishing my research fellowship application. I'm still really enjoying tox. Wednesday we had a big snowstorm, and the resident and the other med student couldn't get over to Case. So I was the only one who made it in, and the attending and I went over that day's cases. We had a bunch of adult patients who tried to overdose on anti-psychotic drugs. I've gotten to know the psych drugs pretty well on this rotation, because they seem to be one of the more popular classes of drugs that people take when they try to commit suicide.
On Thursday, there was a mock LCME re-accreditation visit for Case. LCME is the organization that accredits medical schools, and Case is due for its re-accreditation visit in March. Most of the meetings are with faculty and administration, and then there are two meetings with students. The first one is for M1s and M2s, and the second one is for M3s through M5s. There were four of us, one M3 and one M4 each from the UP and CCLCM. We got asked about things that students had complained about in the survey last spring, like the OB/gyn rotation and student health services. Other questions were things like what we would do if we got stuck with a needle (call the exposure hotline) and what goes into our dean's letter if we have to remediate a competency (beats me, and I plan to never have to worry about this). I think now I am going to be asked to go to the real meeting too.
This afternoon I had my Friday research seminar at CCF on medical decision making. The first half on prediction tools was really interesting, and the second half on cost-analysis gave me a nice hour to daydream. At least I didn't fall asleep, which is more than I can say for a few of my classmates. ;-)
Friday, January 30, 2009
Friday, January 23, 2009
The Best of Toxicology
I am now halfway through this toxicology rotation, and I really love it. It's mostly didactics and not very much clinical stuff, but the subject is really interesting, and the attending has all kinds of cool stories to tell. For example, he testified for a criminal trial where someone poisoned the defendant. That was definitely cool. He also gets to travel around a lot. Monday he'll be doing consults, so we're going to go with him. I'm looking forward to that. We're also each going to do a presentation at the end on some kind of tox topic. Mine will be on alcohol withdrawal.
We spent Monday morning in the attending's lead clinic. This is an outpatient clinic where he sees kids who have lead poisoning, usually due to ingesting or inhaling lead-based paints. If their lead levels are high enough, he chelates them. (Chelators are chemicals that bind to lead so that the body can excrete it.) Since a lot of the buildings in Cleveland are relatively old, especially in the poorer areas of town, there is still a lot of lead-based paint here. One family had three little girls, all with almost the same names. The nurse practitioner was having trouble remembering which one was which, but the funniest thing was that the girls' mother was having the same problem.
Today's afternoon seminar was on the art of physical diagnosis, or rather, how this art is being lost because of the dependence on technology. We didn't actually practice any physical diagnosis, mind you, just talked about how we don't really learn it. Again, it's an important topic to think about, but three hours of it is really not necessary.
We spent Monday morning in the attending's lead clinic. This is an outpatient clinic where he sees kids who have lead poisoning, usually due to ingesting or inhaling lead-based paints. If their lead levels are high enough, he chelates them. (Chelators are chemicals that bind to lead so that the body can excrete it.) Since a lot of the buildings in Cleveland are relatively old, especially in the poorer areas of town, there is still a lot of lead-based paint here. One family had three little girls, all with almost the same names. The nurse practitioner was having trouble remembering which one was which, but the funniest thing was that the girls' mother was having the same problem.
Today's afternoon seminar was on the art of physical diagnosis, or rather, how this art is being lost because of the dependence on technology. We didn't actually practice any physical diagnosis, mind you, just talked about how we don't really learn it. Again, it's an important topic to think about, but three hours of it is really not necessary.
Friday, January 16, 2009
Starting Clinical Pharmacology and Toxicology
This was the first week of my clinical pharmacology and toxicology rotation. There are three of us on the rotation: an emergency medicine resident from Metro, a fourth year from the UP, and me. It was kind of a funny week, because the attending was out of town. He had left us a packet of questions to do, and he also wanted us to spend some time listening to the poison control nurses field calls. Other than that, we were pretty much on our own. We also took pictures to get University Hospital badges, which we still haven't gotten. The stupid part is that the badge expires at the end of the month, and I'm coming back to UH in March for my radiology rotation. But they said I'd just have to get another one then.
These questions are pretty hard. The poison control nurse I worked with commented that they were similar to the questions she had on her certification exam. I listened to calls with her for two days. Most of them were for pill checks, where people magically find some unlabeled pill and call the poison control center to get it identified. First of all, it would never occur to me to call the poison control center if I found a weird pill. Second of all, who just takes pills that random people give them? Most of the legitimate calls were either for toddlers who got into medications and household products, or for adolescents and adults who were trying to commit suicide. Amazingly, a lot of people try to commit suicide by overdosing on acetaminophen (Tylenol). That's an incredibly bad way to kill yourself. It takes three or four days for you to die of liver failure, and you feel really, really bad the whole time: excruciating stomach pain, nausea, vomiting.
Today's seminar was on meta-analysis. This one might have been the very worst of all, not the least of which because it went over time due to yet another ridiculous and pointless group activity. I hate to be rude, because I know these people are giving us their time. But there has to be some less painful way for us to learn this material.
These questions are pretty hard. The poison control nurse I worked with commented that they were similar to the questions she had on her certification exam. I listened to calls with her for two days. Most of them were for pill checks, where people magically find some unlabeled pill and call the poison control center to get it identified. First of all, it would never occur to me to call the poison control center if I found a weird pill. Second of all, who just takes pills that random people give them? Most of the legitimate calls were either for toddlers who got into medications and household products, or for adolescents and adults who were trying to commit suicide. Amazingly, a lot of people try to commit suicide by overdosing on acetaminophen (Tylenol). That's an incredibly bad way to kill yourself. It takes three or four days for you to die of liver failure, and you feel really, really bad the whole time: excruciating stomach pain, nausea, vomiting.
Today's seminar was on meta-analysis. This one might have been the very worst of all, not the least of which because it went over time due to yet another ridiculous and pointless group activity. I hate to be rude, because I know these people are giving us their time. But there has to be some less painful way for us to learn this material.
Friday, January 09, 2009
Research Protocol and Funding
This was my last week on research. I'm still not done writing my protocol, but at least I have a project more or less planned out. It's definitely going to be on trying to predict delirium in geriatric patients. I'm also working on my application for the medical student geriatrics research fellowship.
Yesterday, I met with one of the fellows about writing a protocol for a second project that sounds pretty cool. That would be a retrospective project, meaning that we'd be looking at data that have already been collected. He would use the results to support his application for funding to do a prospective trial, where new data would be collected. So it looks like I'm probably going to have two projects for my research year, which could be a good thing if I get two publications out of it. I don't know when I'm going to get around to writing that proposal though, because now I'll have to start doing work for my next rotation.
Other than that, it hasn't been a terribly exciting week. We've been trying to figure out where people are smoking that makes the cigarette smell drift into the med student office, but we haven't been able to find them so far. The funny thing is that apparently the people on the floor above us can smell it too, because someone who works up there came down to our floor to find out if it was one of us! I think whoever it is must be smoking outside next to a vent. There's no way anyone could smoke inside any of the CCF buildings without setting off the fire alarm. Believe me, people have tried!
Yesterday, I met with one of the fellows about writing a protocol for a second project that sounds pretty cool. That would be a retrospective project, meaning that we'd be looking at data that have already been collected. He would use the results to support his application for funding to do a prospective trial, where new data would be collected. So it looks like I'm probably going to have two projects for my research year, which could be a good thing if I get two publications out of it. I don't know when I'm going to get around to writing that proposal though, because now I'll have to start doing work for my next rotation.
Other than that, it hasn't been a terribly exciting week. We've been trying to figure out where people are smoking that makes the cigarette smell drift into the med student office, but we haven't been able to find them so far. The funny thing is that apparently the people on the floor above us can smell it too, because someone who works up there came down to our floor to find out if it was one of us! I think whoever it is must be smoking outside next to a vent. There's no way anyone could smoke inside any of the CCF buildings without setting off the fire alarm. Believe me, people have tried!
Friday, January 02, 2009
Slow Week
This has been another slow week as far as research goes. (Are you seeing a trend here?) We did have one patient to assess for delirium on Wednesday, but she was still intubated and sedated in the ICU today, which means that we basically didn't do the assessment at all. Next week I will be having a meeting to discuss the specifics of my project and hopefully get ready to apply for funding. The geriatrics grant that I want to apply for has a deadline in a month, so I need to get cracking on that. Nothing else exciting is going on except that I ordered my books for the rest of my rotations. I'm really looking forward to starting pediatric toxicology the week after next.
Subscribe to:
Posts (Atom)
Posts
