Tuesday, February 3, 2015


I have finished the first 2 rotations of my clinical training programme for the past 12 days. They should consider renaming the course from CP3 to CPR as I am literally dying. I had a bad experience with this hospital about 5 years ago and I am glad that it was not repeated this time. In fact, I am so happy that I never bumped into my ex-preceptor haha..

I thought I would be able to enjoy the time away from work, from scolding people, and from getting scolded. Doing the same thing (clerking cases) everyday is also driving me mad. One bad thing about being a perfectionist is that I want to quickly get everything that needs to be done. The thing is, writing SOAP notes for hospital cases is very different from my past experience with SOAP notes. I am used to just pure chronic or pure acute cases. In pure chronic cases, I just need to assess current therapies, treatment goals, and find targets are not met and how to adjust the therapies to meet the goals. In pure acute cases, I just need to choose a therapy to recommend. In hospital, the cases are always mixed. Especially for those already discharged, am I suppose to discuss the acute problems which were already solved? Or am I suppose to discuss the chronic problems which may not even be related to the thing that caused them to be admitted in the first place.

I tried to clerk about 15 cases but only less than half turned out to be okay: some are too similar (UTI cases), 1 is incomplete because patient was discharged and the case notes were already archived, some are too complicated for me to join the things together. Finding interventions are also not easy as there are so many things that I don't know or I have already forgotten. To be honest, there are a lot of things that I memorised but forgotten after not using it for the past 2.5 years. Of those things that I use daily and remember, they are sort of outdated now as I don't follow the latest guidelines. Bleah...

I guess clinical thing is just not my thing. In the future, I will not consider anymore clinical stuff be it PharmD, Masters in clinical stuff, residency, or whatever. Clerking case etc is just not my way of learning. Ultimately, I don't think I really gain a lot of benefits from this. I don't expect anything extraordinary and I am hopeful that I can get at least something useful and applicable for my daily work. It does not seem the case. In hospital setting, treatment is done aggresively because the goal is to discharge patients as soon as possible and as healthy as possible. At times, I feel that they are just following guidelines to treat the disease but they do not consider things I normally consider at chronic setting: compliance, pill burden, cost, etc. Starting diabetes medications, including insulin, for 90+ or even 100+ year old? Keeping cholesterol medicines although the LDL is already 1.1x? Bleah.. I just cannot agree with these kind of things lo...

Tomorrow I am back to my normal work and I hope things will be good. Although I highly doubt it as there are a lot of work and emails pending for me to clear already T_T

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