Avocado...who knew?

It seems I always learn something about food when shopping at my favourite grocery store mcewans.  Even though many of the products are beyond a student's budget, I am easily persuaded when it comes to quality foods.  We usually go on Saturdays when we are certain to find a few vendors educating the customers about their products and providing samples to excite our taste buds.

Since the store's opening near to our house, I have learned a great deal about olive oils, breads, specialty meats, fine dining food combinations and most recently, avocado oil.  When possible, I always pass along cooking information to my patients and have found out that most people realize now that cooking with Extra Virgin olive oil is very counterproductive.  Virgin olive oil has a slightly higher burning point than Extra Virgin (harvested at a different time of year and contains different acidity levels) but I hear most naturopathic doctors still recommend grape seed oil as the one of the best cooking oils; and it certainly is.  So this is where avocado comes in.

Avocado oil has a burning point of almost 500F (200F degrees higher than most olive oils), just below that of grape seed, and here is what surprised me: it tastes amazing!  Furthermore, avocado is among a list of plants that contain beta-sitosterol which naturally lowers cholesterol.  Check it out at a health food store near you and ask your naturopathic doctor about more important healthy cooking tips.

That's not a kids meal

After Christmas my wife and I had the rare opportunity to take our children out for supper with us.  On both occasions, at two different popular restaurants, it was quite disappointing at what constituted a, "kids meal."  It would seem that kids eating out only enjoy a choice of: mini pizza, breaded mini burger on white bread (no pickle, lettuce, tomato), French Fries with ketchup or a grilled cheese sandwich on white bread.  That is not a meal anyone should eat, especially not a child!

I am sure that these restaurants are meeting the demands of their customers which makes me realize the magnitude of this public health issue.  Until change happens on a broader scale, be proactive in asking for healthier choices.  Skipping the kids entree choices and combining two side dishes at one of the establishments allowed for vegetables and coleslaw which were actually quite tasty.  And, sharing a small plate with your child from what you are eating may be the best choice anyways provided your selection is a healthy meal.

Happy New Year!

I hope 2011 will be a prosperous and healthy year for you.

Thank-you to all of you who have faithfully read this blog over the last 3 years.  It is hard to believe that nearly nine years ago I began this educational journey and 3 and a half years ago I signed up to be among the CCNM graduating class of 2011.  It is an end and a beginning all at the same time!

Over this next year, I will be transitioning from student to practitioner.  Many of my goals for this blog were achieved including being an advocate for naturopathic medicine to the thousands of people who have stopped by for a read.  Ultimately though, the greatest reward was when I was told by colleagues that they were inspired to start their own blog after reading this one.

Happy New Year everyone! 

Christmas Break

Christmas is one of my favourite times of year.  Unfortunately, it is too often an exhausting, over-commercialized pressure to buy everyone that "perfect gift."  So, I try to ignore that extra stress!  For me, Christmas provides an opportunity to spend time with family and friends, time to relax and time to reflect on what is really important in life.  And, it cannot come soon enough!

I have to admit that I was naive about the energy required to consistently give my best to patients with chronic health care issues.  Burn-out can become a reality very quickly if not anticipated and prevented (The age old phrase, "Physician heal thyself" is so important).  I realize now that my expectations of being a naturopathic clinician were primarily based on my limited experiences as a patient.  As such, I projected much of how I thought being a clinician would be like by attempting to put myself in the health care professional's shoes so-to-speak.  But I am just one type of patient and I do not have any chronic debilitating conditions or diseases.  Needles to say, I have made some adjustments to the understanding of my job description.

For those of you interested in becoming a naturopathic doctor, as the style of practice varies substantially from one ND to another, do not base your expectations on one particular style of practice or patient group.  Although it is impossible to know exactly what to expect, and even what type of practice you want to have, getting as much experience with several different primary health care providers will also help you understand what it will be like to be an ND.

Have a refreshing holiday and Merry Christmas!

Continual Improvement

The format of the 4^th year internship at CCNM gives the interns more patient interaction compared to some of the other naturopathic medical schools (where the supervising ND does the initial patient intake and the interns only do follow-up visits or work in pairs instead of alone).  Although the supervisor does make an appearance during the visit at CCNM, is available for consultation and is ultimately responsible for the patient, there is still a lot of responsibility on the intern to gather the correct information to guide treatment.  As such, I remember the anxiety walking into that very first visit.  It actually took several months for that apprehension to turn into excitement to see a new patient.

New changes at CCNM are following the format other schools have done to progressively integrate students into clinical patient experience.  This experience will help the intern build the confidence required to be ready for that first and subsequent patients.  Already, the 1^st years have been doing an observation shift and the 2^nd years sit in on patient visits and have the opportunity take patient vitals.  Starting in January, the 3^rd years, under the direction of the 4^th year intern, will have the opportunity to perform physical exams, and help with diagnosis and treatment plans. Although the CCNM academic team met some resistance from the 4^th years in terms of our extra roles and extra responsibilities as mentors, I think the change will ultimately benefit CCNM graduates.  Additionally, the patient gets the benefit of a team approach to their health concerns. 

Peer mentorship, at the student level, is not well developed at any medical school yet but is an upcoming area of improvement in medical education.  Doctor as teacher is one of my favourite naturopathic principles and I believe is exemplified at CCNM in these new changes.

CCNM Christmas Play

Come out and support the graduating class of 2011 who brings you the original holiday play, Jingle Bell Rock - A CCNM Holiday Tale, on Thursday Dec. 2, 2010 and Friday December 3, 2010. Doors open at 7pm with the play starting promptly at 8:00pm (Location: Canadian College of Naturopathic Medicine). Tickets on sale at CCNM for $10 in advance and $15 at the door. VIP tickets are available for $25, which includes premium seating, wine and cheese during the performance. See you all there for an epic evening of Rock and Roll and Holiday Spirit!

Resisting Burn-Out

As my  posts have slowly dwindled to a monthly endeavor, I feel the need to come clean about the toll this program has taken on my enthusiasm for extracurricular - even naturopathic related - activities.  Nearly every day for the last month or so seems to be a struggle to resist burn-out.  Unfortunately, it appears as if this is a common theme with this years' graduating class possibly due to several new program requirements.  Even within the last week, one of my colleagues started a new club where we have the opportunity to support each other and discuss ways to make positive changes.

I met a transfer student the other day who did one year of naturopathic medicine at Bastyr University and I was surprised to hear that the students there are possibly more stressed-out than at CCNM.  I didn't think that was possible!  How does the school maintain enrollment?  I am sure that Bastyr's campus located within a state park is helpful.  The thought of a state park...as great as the Paracelsus Herb garden is, and the Don Valley located across the street from CCNM, they are not a substitute for a state park.

I think Christmas will be my solace and I am certainly looking forward to a couple of weeks of bliss away from the busyness of Toronto. 

Here to Stay

Today I took my family to the Royal Agricultural Winter Fair in Toronto.  It was at least 15 years since I was there last, at that time with my siblings and parents.  The fair is a celebration of agriculture in Ontario where awards are presented to the finest specimens of farm produce and animals and includes a number of fantastic animal shows.  Complementing the food and agricultural theme this year was the “Journey to Your Good Health” educational presentations. Although much of the fair was the same as I remembered it from years ago, I was also aware of increased visibility of natural health products slowly permeating the conventional world and was happy to see a naturopathic doctor answering questions as part of a forum of health professionals.

Remember, we vote with our dollar.  So, support those small, local, environmentally conscious agricultural companies when you can - ensure they are here to stay.

Maintaining Mentorship

Most highly skilled professions have some framework of mentorship set in place to ensure that things which are not easily picked up in the classroom, or from reading a book, are taught in a practical setting. Naturopathic Medicine is no different. Mentorship maintained naturopathic medicine in the United States in the years following the 1910 Flexner Report when naturopathic schools could not afford to operate (the Flexner Report also shut down many "diploma mills" and substandard medical schools which was a positive outcome. Unfortunately though, the recommendations were to only fund schools with a pharmacological and technological focus).

Mentorship at CCNM begins in 1st year as new students are introduced to the teaching clinic with days spent shadowing their supervisor. Second and third year students get more involved with patients each year as clinical supervisors and 4th year interns take mentoring roles. There are certainly times where patients are surprised at the additional students that come into the treatment room and occasionally, the 4th year intern is inadvertently put in the hot-seat with all eyes on her or him. At these times, there is the potential for everyone involved to share an awkward moment.

My love for teaching and background in instructing usually dissolves my concerns about others watching me in clinic. Additionally, I recognize that I am not perfect at this yet and I may say the wrong thing or make a small mistake with someone else watching. However, as the mentor, it can still be an additional source of stress.

I wonder if this change in dynamic is currently making it very difficult for some students to fulfill another type of required mentorship called preceptorship. This is where students spend time with a ND, DC, MD or physiotherapist in their private practice (or hospital). If you are currently a student in naturopathic medicine, here are a few points to consider when being mentored:

1. Firstly, if at all possible, pick a mentor who's style of practice you like. This is very important for preceptoring and will eliminate many unforeseen disharmonies and make for a much more enjoyable day.
2. Recognize your mentor's strengths. Certainly there are times when you may learn how NOT to practice but try to glean the best of what the mentor is offering.
3. Show appreciation. This is so important in order to successfully continue a constructive and receptive attitude towards mentorship and maintain the philosophy of passing down knowledge to the betterment of the profession.

Residency is another type of mentorship offered to naturopathic graduates and I hope to write about this at a later date.

Slow Down!

Three years ago my wife flew into Toronto from Calgary (while I was finishing my undergraduate degree) and she picked the apartment we would be living at during the next 4 years of school at CCNM. On arriving a month later, I was so impressed with her choice as she selected a location with the beautiful Don Valley literally off our balcony. The Don Valley has hiking trails, mature maple forests and the Don rivers. It could be the most beautiful place except the high traffic brings in unappreciative guests. My wife and I spent many of our first hikes with a garbage bag in hand just attempting to clean up our little area. However, the Don Valley was still my temporary substitute for the wilderness I enjoy.
Recently though, my wilderness substitute seems to be mirroring my cumulative impressions of the largest city in Canada. Even nature seems to be telling me it is time to move on as the Black Swallow Wort (a predator invasive species) has multiplied beyond control choking out the indigenous plant species and my enjoyment of the valley at the same time. Also, the poison ivy proliferated exceptionally well this year and seems to be telling me that my time in the Don Valley is over.

The city of Toronto has many forms of exceptional entertainment including cultural & educational experiences. While living here, I have tried to take in as many of these things as possible. Too often though, I find people are in a rush. What's worse is it is often an angry rush! This was highlighted in recent research that demonstrated the traffic conditions in Toronto are negatively contributing to people's health.

If you are beginning to notice the rush, I want to tell you about the Evergreen Brickworks Slow Food Picnic. This event pairs local producers with Toronto's healthy minded food retailers & restaurants. Chefs cook gourmet food right in front of you to sample in a savory environment of appreciation for good food (Watch for this event next year and be sure to get a ticket). Below is a picture of me representing Mountain Lake Bison Range with Chef Maxine and Dave & Mario of the Healthy Butcher. This event reminded me that it doesn't matter where you are, where there are good people and a good cause, there can be moments of solace even in the largest city in Canada.