Tuesday, February 5, 2019

Rotation 4, 5, 6: Drug Information, Critical Care, General Medicine

Posted by Andrea at Tuesday, February 05, 2019

Rotation 4: Drug Information

This rotation was with a drug information company and I was able to work remotely, as my preceptor also works remotely. We met two to three times a week for about one hour and communicated often during the week via email. My responsibilities were to write monographs for drug-drug interactions and drug-gene interactions (e.g. CYP2D6, CYP4A4, etc.). This consisted of reading lots of articles, learning how to scour PubMed for literature, and writing concise summaries.

Time management was incredibly important in this rotation. I had the freedom to create my own schedule each day, but this also allows for time to slack off. I had to hold myself accountable and ensure I completed my work. I learned a lot about what goes into writing the monographs when we search our drug information resource for quick answers about drugs and interactions. I always thought I would enjoy working by myself, so I was surprised that I missed interacting with co-workers and patients daily. Looking forward, I hope to find a position that balances independent work with teamwork or direct patient care.

Rotation 5: Critical Care

This rotation was in the surgical intensive care unit (SICU) at a local community teaching hospital. Going into this, I was nervous and intimidated by the complexity of critical care patients. My typical day started with working up patients (6AM-9AM), round with the team (9AM-11AM), eat lunch and finish working up patients (11AM-12PM), then meet with my preceptor (12PM-1PM). After this, I would work on assigned drug information questions or projects for the rest of the day. Working up patients in the ICU is based on the head to toe systems approach, rather than problem based like how we learned in class. This means problems were categorized by systems, which could include neurological, pulmonary, cardiovascular, GI/FEN (fluids, electrolytes, nutrition), I/O (ins and outs), ID, and heme. Patients were very sick and often had multiple problems within each system listed above.

I am very grateful to have had this rotation. I have a much better understanding of anatomy and how surgical changes can affect drug action/metabolism in the body. I also learned about weaning patients off pressors, opioid conversions, and nutrition. I had the opportunity to work with a large team, which consisted of an attending, fellow, residents, medical students, and dietitian. I also enjoyed working with my preceptor who was a great teacher and with another pharmacy student from a nearby school! Overall, this was a great learning experience and I am glad I was able to try it out.

Rotation 6: General Medicine (Adult Internal Medicine)

All P4 students are required to take the Gen Med rotation and I was placed on the Adult Internal Medicine service. This was a busy rotation, due to the patient load and weekly projects. My service capped at 11 patients and by the end of the rotation, I was managing the entire service. Patients had a variety of disease states, including pneumonia, UTIs, atrial fibrillation, and diabetes. The typical day started with working up patients (5AM-7:30AM), pre-round with my preceptor where I would present patients and run my recommendations by him (7:30AM-8AM), round with the team (8AM-11AM), and post-rounds with my preceptor where I would update him with any changes (11AM-11:30AM). The rest of the day was spent educating patients discharged on anticoagulation, meeting with my preceptor to go over patients or topics, and meeting with the other students also on Gen Med to present our projects. Time management and efficiency are key to this rotation and each student will develop their own schedule or system that works for them.

Pharmacists play an important role in antimicrobial stewardship and anticoagulation management on this service. I enjoyed the variety of patients and activities in this rotation. I was constantly learning and it made the long days fly by. My advice to students is to embrace this rotation and challenge yourself to learn as much as you can!

This rotation ended just before the holidays and I am currently on my off block. After this, only 2 more rotations until graduation!

Gen Med Block 6 students wearing our ugly Christmas sweaters!

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