Well it is finally here: the final mental marathon required to become a licensed ND. My head already feels like I'm in need of a break after a 6 day NPLEX (Naturopathic Physicians Licensing Examinations) review course. And I haven't even officially started studying yet!
Like any large and difficult task, I think half the battle is overcoming the intimidation and making a plan to break it down into smaller "digestible" components. NPLEX II tests a naturopathic doctor's correct and safe utilization of the following components to prevent and treat disease in every organ system in the body: clinical nutrition, botanical medicine, physical medicine, physical and clinical diagnosis, lab diagnosis and imaging, pharmacology, psychology, emergency medicine, homeopathy, traditional Chinese medicine and acupuncture. It is a tremendous scope of information! So, for the next 10 weeks, new naturopathic graduates in Canada and the US will be reviewing and studying full time in order to be successful on NPLEX II this August. Starting May 30th, I will be following a weekly objective schedule that breaks topics up by organ system and modality. Of course, 8 hours of sleep, daily exercise, phosphatidylcholine and fish oil are just a few extra requirements necessary to survive the NPLEX II saga!
Well, with yet another blog post about survival, I realize that sometimes I take the risk over-informing prospective students. Accordingly, I have periodically considered not disclosing information because some degree of naivety can be beneficial in undertaking a difficult task. As such, in being candid with the extensive, somewhat unrelenting effort it takes to become a naturopathic doctor, my hope is not to discourage anyone from being an ND but to provide an opportunity for proactive students to become informed. However, if for example only one or two of the naturopathic modalities are of interest to you, then maybe making all the extra effort to become a naturopathic doctor is not for you. Keep in mind that there are practitioners who specialize in each of of the modalities that ND's are licensed to practice and maybe you would be better suited as an herbalist or registered dietitian or chiropractor or homeopath or psychologist or an acupuncturist. At least now you can make a better informed choice.
Friday, May 20, 2011
Monday, May 9, 2011
Naturopathic Medicine Week 2011
May 9th - 15th is Naturopathic Medicine week in Canada. If you are interested in learning the benefits of naturopathic medicine, take a look at these locations across Canada where Naturopathic Doctors will be giving free information seminars.
This is a great opportunity for both prospective students and people who are suffering with health problems to go and get some questions answered. Have a great week!
This is a great opportunity for both prospective students and people who are suffering with health problems to go and get some questions answered. Have a great week!
Saturday, April 30, 2011
It's Graduation Time!
The graduating class of 2011 is done!! It seems absolutely unbelievable...I'm sure the reality of being finished internship will quickly set in as I begin to prepare for NPLEX and board exams, but right now I'm basking in the accomplishment. And what a journey this has been...filled with a lot of ups and downs, the appearance of gray hairs and the skills to help improve health care in Canada.
One thing I was not prepared for this last month was saying goodbye and transferring the care of many patients I have got to know very well over the past year. Although I'm sure their new intern will work as hard as I did, there was a sadness in not continuing along their health journey with them. Well, I do not want to end on a note of sadness as this is a time for celebration. So, congratulations to all the naturopathic medical students in North America who will be graduating this spring. I wish everyone the greatest success.
One thing I was not prepared for this last month was saying goodbye and transferring the care of many patients I have got to know very well over the past year. Although I'm sure their new intern will work as hard as I did, there was a sadness in not continuing along their health journey with them. Well, I do not want to end on a note of sadness as this is a time for celebration. So, congratulations to all the naturopathic medical students in North America who will be graduating this spring. I wish everyone the greatest success.
Sunday, April 17, 2011
Real Health Care in Canada
With only 2 weeks remaining in my clinical internship, and the timing of this federal election, I was paying greater attention to the politics of the profession and the vital role naturopathic doctors have in changing the course of "health care" in Canada. I put, "health care" in quotations because what our politicians have not yet been made aware of is that healthy people are not the ones being taken care of in Canada. Rather, our conventional medical system is in fact a disease care system of medicine.
I realize this is my bias, but I would like to see naturopathic doctors (ND's) be the primary care gate-keepers of the health care system since we have the widest scope of practice of any health care provider (and subsequently the greatest number of therapeutic tools). When necessary, ND's would also know when and which specialist would be best for the patient to be referred to within the conventional and complementary health care systems. I believe this would revolutionize Canada's health care system which is in a state of patient care deterioration and financial crisis.
Most people feel like they are too busy to write or ask their local member of parliament about what health care truly means to them or to let them know about the benefits of naturopathic medicine. But, we can all quite easily talk to our friends, mention our vision for a true health care system on Facebook or Twitter. Many small actions will build into a large movement!
I realize this is my bias, but I would like to see naturopathic doctors (ND's) be the primary care gate-keepers of the health care system since we have the widest scope of practice of any health care provider (and subsequently the greatest number of therapeutic tools). When necessary, ND's would also know when and which specialist would be best for the patient to be referred to within the conventional and complementary health care systems. I believe this would revolutionize Canada's health care system which is in a state of patient care deterioration and financial crisis.
Most people feel like they are too busy to write or ask their local member of parliament about what health care truly means to them or to let them know about the benefits of naturopathic medicine. But, we can all quite easily talk to our friends, mention our vision for a true health care system on Facebook or Twitter. Many small actions will build into a large movement!
Saturday, March 26, 2011
Individual Medicine
One of the challenges in naturopathic medicine is treating every person individually. This entails pulling together treatment ideas and prescribed changes from a host of resources and, in some respects, I often feel like I am reinventing the wheel with each patient. For the clinician, this is a recipe for a lot of work and at the end of the day, it can be difficult to separate the "office" from home life as the realization of this responsibility sets in.
This is a sharp contrast to conventional medicine which has an established algorithm or standard of care for most medical diagnoses. I can't say for sure, but, when an MD leaves the office, it might possibly be easier for them to believe that they have done all they were trained to do for their patients and no one could expect more of them.
And, the conventional treatment protocols do seem to work for a percentage of the population. However, the majority of patients that come to naturopathic medicine have not been successfully treated with conventional approaches and they are in need of something to address the root of their problems. At times I wish there were more standards of care algorithms for ND's but, then I also hope that as our medicine continues to be supported by science that practitioners never utilize a canned approach.
This is a sharp contrast to conventional medicine which has an established algorithm or standard of care for most medical diagnoses. I can't say for sure, but, when an MD leaves the office, it might possibly be easier for them to believe that they have done all they were trained to do for their patients and no one could expect more of them.
And, the conventional treatment protocols do seem to work for a percentage of the population. However, the majority of patients that come to naturopathic medicine have not been successfully treated with conventional approaches and they are in need of something to address the root of their problems. At times I wish there were more standards of care algorithms for ND's but, then I also hope that as our medicine continues to be supported by science that practitioners never utilize a canned approach.
Tuesday, March 22, 2011
OSCE time of year again
I would not ever want to be in the third year's shoes during the OSCE's (Objective Structured Clinical Examination). I can clearly remember my experience last year and seeing the faces of some of the people after their exams, I feel their pain! (My post last year stated that it was almost fun, but even after a year of seeing patients, it would take a lot of adrenalin for it to feel fun).
One of my colleagues in 4th year took it upon herself to organize several mock OSCE's, which we nicknamed the "Moski's", in order to better prepare students for this important test. Now, even the 2nd years do an OSCE that tests their physical and clinical diagnosis skills before they enter 3rd year. I was happy to teach at each event and was impressed with the level of confidence some people have developed.
The OSCE's ensure a standard of safety in Primary Care and as stressful as it is having your every word and move scrutinized, they are a necessity in order to make ND's the best primary care doctors they can be.
One of my colleagues in 4th year took it upon herself to organize several mock OSCE's, which we nicknamed the "Moski's", in order to better prepare students for this important test. Now, even the 2nd years do an OSCE that tests their physical and clinical diagnosis skills before they enter 3rd year. I was happy to teach at each event and was impressed with the level of confidence some people have developed.
The OSCE's ensure a standard of safety in Primary Care and as stressful as it is having your every word and move scrutinized, they are a necessity in order to make ND's the best primary care doctors they can be.
Thursday, March 10, 2011
CCNM Growing Pains
The fact that school at the Canadian College of Naturopathic Medicine (CCNM) is very difficult is something I've written about several times before. It has been argued by some students at CCNM (who have other medical degrees) that the diversity of material in the naturopathic program adds an additional challenge on top of the tremendous course load making it one of the most difficult medical programs. Additionally, although CCNM is over 30 years old, it still growing to an ever expanding profession. Furthermore, to accommodate a January enrollment, CCNM has long days of class packed into one of the shortest school years of all the accredited colleges. So, as I've written before, this can be a recipe for exhaustion and burn-out.
At first, the thought of burn-out at a 'holistic' school may seem ironic but it certainly happens. Then, I thought this would change after getting into clinic. But after treating patients for almost a year, I realized that it can still be very easy to take home an exceptional amount of stress. Stress and burn-out is common place in well established schools too. I subscribe to Medscape (which sends me a weekly email about the latest topics in conventional medicine along with blog posts from students and professors) and see there too that conventional medical students also frequently complain about the unrelenting difficulty of their programs. One thing I notice though, is that they do not blame their school.
In contrast, at CCNM, the school administration and curriculum seems to take the brunt of the blame from students; and it may be warranted in some cases. Yes, there are a lot of tedious requirements and it is difficult for the curriculum to address every naturopathic perspective in depth. However, I can't help but wonder if some of the the students have taken the school's willingness to change as a sign of weakness instead of a sign of consideration for the students? And, have some students perceived the never-ending onslaught of rules and requirements as an attempt to needlessly evaluate them instead of an effort to maintain credibility in a growing field? Maybe this will be much in the same way as some people who did not appreciate their parents until leaving the nest. While growing up they had perceptions of endless tasks and rules to adhere too, parents not allowing enough of this activity or that, and not until looking back did they realize their parents actually knew what was really best for them.
I think the naturopathic program should be longer and not streamlined into focused training on one modality. From my experience, being able to use whatever is best and most indicated for patients, not being religiously stuck on one modality, is the ultimate difference a naturopathic doctor can offer. I believe this is an advantage ND's have over any other primary care doctor. The naturopathic profession is growing at a tremendous rate and CCNM grows correspondingly. Ultimately, graduating from CCNM is no easy feat and will be something I remember for the rest of my life...seven weeks to go!
At first, the thought of burn-out at a 'holistic' school may seem ironic but it certainly happens. Then, I thought this would change after getting into clinic. But after treating patients for almost a year, I realized that it can still be very easy to take home an exceptional amount of stress. Stress and burn-out is common place in well established schools too. I subscribe to Medscape (which sends me a weekly email about the latest topics in conventional medicine along with blog posts from students and professors) and see there too that conventional medical students also frequently complain about the unrelenting difficulty of their programs. One thing I notice though, is that they do not blame their school.
In contrast, at CCNM, the school administration and curriculum seems to take the brunt of the blame from students; and it may be warranted in some cases. Yes, there are a lot of tedious requirements and it is difficult for the curriculum to address every naturopathic perspective in depth. However, I can't help but wonder if some of the the students have taken the school's willingness to change as a sign of weakness instead of a sign of consideration for the students? And, have some students perceived the never-ending onslaught of rules and requirements as an attempt to needlessly evaluate them instead of an effort to maintain credibility in a growing field? Maybe this will be much in the same way as some people who did not appreciate their parents until leaving the nest. While growing up they had perceptions of endless tasks and rules to adhere too, parents not allowing enough of this activity or that, and not until looking back did they realize their parents actually knew what was really best for them.
I think the naturopathic program should be longer and not streamlined into focused training on one modality. From my experience, being able to use whatever is best and most indicated for patients, not being religiously stuck on one modality, is the ultimate difference a naturopathic doctor can offer. I believe this is an advantage ND's have over any other primary care doctor. The naturopathic profession is growing at a tremendous rate and CCNM grows correspondingly. Ultimately, graduating from CCNM is no easy feat and will be something I remember for the rest of my life...seven weeks to go!
Wednesday, March 2, 2011
From Green to Transparency
One of the most powerful agents for change happens each time we buy a product - we vote with our dollars by supporting companies. Over the past year I have noticed an explosion in the number of companies vying for customers by jumping on the "green" bandwagon. The increased awareness and urgency of environmental issues has created public pressure on companies to make more environmentally conscious products. But are they?
Products in the grocery store, clothing manufacturers, many vehicles claiming to have best fuel economy in their class, even Coca cola is coming out with a 30% plant based plastic bottle. My first inspiration for writing this post actually came from watching the Canadian Association of Petroleum Producers TV advertisement that made it sound like they leave no environmental impact at the oil sands in northern Alberta, and yet it doesn't take much searching to find out that the water available to surrounding native populations is not drinkable due to heavy metals and toxic hydrochemicals.
Many companies may claim to be green, but if they were truly transparent we would see that unfortunately money is their prime motivation, not real environmental protection. So, be skeptical! If a product claim doesn't make sense, it is probably not as green as it sounds. Even if what the label or TV commercial says is true, what is the company not telling you? As consumers continue to choose true green products, and these companies become successful, this will raise the bar for those companies who still believe that they can't make a profit without cutting corners.
Products in the grocery store, clothing manufacturers, many vehicles claiming to have best fuel economy in their class, even Coca cola is coming out with a 30% plant based plastic bottle. My first inspiration for writing this post actually came from watching the Canadian Association of Petroleum Producers TV advertisement that made it sound like they leave no environmental impact at the oil sands in northern Alberta, and yet it doesn't take much searching to find out that the water available to surrounding native populations is not drinkable due to heavy metals and toxic hydrochemicals.
Many companies may claim to be green, but if they were truly transparent we would see that unfortunately money is their prime motivation, not real environmental protection. So, be skeptical! If a product claim doesn't make sense, it is probably not as green as it sounds. Even if what the label or TV commercial says is true, what is the company not telling you? As consumers continue to choose true green products, and these companies become successful, this will raise the bar for those companies who still believe that they can't make a profit without cutting corners.
Tuesday, March 1, 2011
Saturday, February 26, 2011
Book Review 11
Hippocrates' Shadow. Secretes from the house of Medicine by David H. Newman, M.D.
Anyone who is currently, or plans to practice, as a health care provider should read this book. With that said, I would not recommend this book to everyone (even though my caution may inadvertently assist in perpetuating some of the medical secrets and pseudo axioms the author illuminates) as the author boldly presents some issues of huge magnitude with the potential to shake an ardent believers trust in western medicine.
However, for those in the healthcare field, this book exposes the history behind "schools of thought" in medicine and the steps that lead to many common assumptions about the practice of medicine. The author, who practiced as an emergency medicine doctor, runs a clinical research program and teaches at Columbia University, boldly asks if certain segments of medical education is spent teaching material that is incorrect.
The book has a great layout as most chapters begins with an ER room scenario that leads to a discussion. A thought provoking read that is a must for health care providers.
Anyone who is currently, or plans to practice, as a health care provider should read this book. With that said, I would not recommend this book to everyone (even though my caution may inadvertently assist in perpetuating some of the medical secrets and pseudo axioms the author illuminates) as the author boldly presents some issues of huge magnitude with the potential to shake an ardent believers trust in western medicine.
However, for those in the healthcare field, this book exposes the history behind "schools of thought" in medicine and the steps that lead to many common assumptions about the practice of medicine. The author, who practiced as an emergency medicine doctor, runs a clinical research program and teaches at Columbia University, boldly asks if certain segments of medical education is spent teaching material that is incorrect.
The book has a great layout as most chapters begins with an ER room scenario that leads to a discussion. A thought provoking read that is a must for health care providers.
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