Sunday, February 8, 2009

Weekly run-down and some thoughts

I had another good week in my Psychiatry rotation. I really enjoy taking a full Psychiatric history, and evaluating the patient as a whole person. Without sounding twee, it feels like a privilege to hear the details of their lives that they may not have told anybody else before.
I always find it interesting to compare the level of detail that I am told in my friends' and family members' lives to that of the lives of the patients who I interview. I know that there are things that I would tell a therapist that I would not tell my family members, too, so it doesn't strike me as strange. 
It is just easier to tell somebody things if they are there as a professional and you don't really care what they think of you and you won't have to see them at parties and family celebrations. This is another reason that it is important for us to maintain professional distance - the therapeutic relationship is more workable if the patient can focus totally on themselves and not worry that they are upsetting the doctor.
Anyway, I have been interested in psych for a long time (as my brother told me this weekend, I have been contemplating it for "years") so it is a big relief to find that I am enjoying the rotation and have a good beginning level of skill at interviewing and talking to patients. 
I'm also enjoying learning about the drugs and seeing the effect changing the dose or introducing new ones can have on people in a matter of days. Reading about them in action on a daily basis always makes them easier to remember, too. 
I am finding fun ways to remember the drug names, before they get stuck into my memory properly. Clozapine, for instance, should be kept in the "closet" because it can induce agranulocytosis and requires regular blood testing. Quetiapine  (Seroquel) can help people who are experiencing psychosis find some "quiet" from their mind and "serenity." 
I would like to learn more drug names via cool drug pens, but I haven't had enough access to the pharmaceutical reps just yet. (Yes, I am aware of the ethical issues surrounding this, and the evidence that it can affect drug choice. However, I am just a student, and the use of pens as learning aids can only be a good thing, right? ;) )
For those of you who aren't familiar with the Australian training system for doctors, we all do a general year or two of resident training before starting to specialise, so even if I am set about what I want by the time I come to apply for a graduate job, there will be at least a year before I can start to train properly. Thus, there is no rush in making a decision, which is kind of nice, even though I am getting more certain as I progress further through the gamut of study and training that is medicine. :)

No comments: