Wednesday, March 31, 2010

TCM and Acupuncture Progress

As would be expected before entry into clinic, completing 3rd year means completing quite a few practical exams. Still remaining is our emergency medicine practical, in-office procedures practical, manipulation (chiropractic) practical, and the one that I am studying daily for, the Asian medicine acupuncture practical.

I did not know until recently that not all the accredited Naturopathy schools offer Traditional Chinese Medicine (TCM) and Acupuncture as part of the curriculum. Well, CCNM has a very intensive TCM and acupuncture program. Just to give you an indication, here is how the final exam will happen. First, we are presented with a case and need to determine a correct TCM diagnosis based on symptoms as well as pulse and tongue diagnosis. Then, we are required to select points that correspond appropriately to the case. We are required to know the actions and indications for about 225 of the approximately 400 total acupuncture points we have learned. Finally, we are required to locate and correctly needle 5 indicated points (within half a fingernail width of their specific location on the body) all within a 15 minute time frame. I would have never thought this was possible when I started in first year!

Wednesday, March 24, 2010

OSCE Follow-up

What an experience! If it wasn't for the nearly crippling anticipatory anxiety, I could almost say it was fun - the kind of exhilaration that happens during an important performance. Being sequestered in a meeting room for an hour, in a group of nine, prior to the official start of the exams did not help. However, I heard many other groups used much better coping tactics than mine did and they were able to laugh off some of the tension. I will never forget the walk down the stairs to the clinic. Our group walked in silence and I felt like I was in the movie Gladiator right at the scene where they were waiting to get rushed out into the Colosseum.

However, once I entered the first room and began talking to the patient, things began to flow more naturally. All the hours of preparation and studying pathologies, redflags for life threatening conditions and physical exams was integrated into somewhat of a smooth patient experience.

The OSCE's at CCNM consist of 3 patient visits that are each 18 minutes long. Then following each case we have 5 minutes to write up how the case would be appropriately managed and answer questions on our understanding of the patient's condition. Although 18 minutes is certainly not enough time to investigate the root cause of many diseases, it is sufficient time to rule out whether the patient has an emergency situation. As the first principle in our oath is, "First do no harm," having the ability to quickly evaluate the severity of a patient's symptoms and provide a medical diagnosis (Primary Care responsibility) and management plan is essential to every ND's training.

Tuesday, March 16, 2010


Next week, the third year class will undergo the Objective Structured Clinical Examinations (OSCE). Passing the OSCE's are another one of those checks we require before entering into clinic in May...a really, really big check!

These exams were implemented 3 years ago as part of the continued progress towards ensuring ND's are ready for the field of being a Primary Care Doctor. The exams are the summation of all of our Primary Care knowledge up to this point and also tests our ability to clearly and effectively interact with patients. Although I am certainly under a lot of pressure right now, I can say that I'm proud that Primary Care is taken so seriously.

More on this topic after I pass!

Sunday, March 7, 2010

The Learning Curve

As most of my colleagues in 3rd year at CCNM will be simultaneously pounding out the last details of their Relevant Clinical Inquiry Assignment (RCIA) due tomorrow morning, I have paused for a moment to reflect on the journey. Maybe I'm pacing myself, or still recovering from burn-out, but I just needed to take a moment and see the forest through the trees.

At this point in 3rd year, the focus is about checking off mandatory requirements before clinic in May. Number of clinic observation hours complete- check; number of patients - check; case management file - check; preceptorship hours - check; Gynecological practical exam - check; Male Genitourinary and DRE exams - check; RCIA - check. Check, check, check...It took a lot of planning ahead and coordination to get those checks while still managing to study and go to classes and I have certainly gained a tremendous amount of experience in the process.

Looking back, last year I needed to believe that 3rd year would be easier. Now it wasn't really easier, especially this final semester, but the learning curve was different. When I talk to my second year colleagues, I realize that the learning curve in second year is the steepest and sets a high standard of work ethic that just makes third year more manageable. Third year fills in the details and is the clinically relevant stepping stone that is required before we begin our internship in May. It is more practical and if I can relax enough to admit it, it is more fun! And, on that note, I have school work to get back to.

Monday, March 1, 2010

Quote of the Month

“Practice does not make perfect, or necessarily improvement, but rather practice makes permanent. Only perfect practice results in perfection."
~A Wise Coach