Brampton Naturopathic Teaching Clinic

On Friday, I visited the Brampton Naturopathic Teaching Clinic. This is a new, second naturopathic teaching clinic located within the Brampton Civic Hospital. I shadowed the three fourth-year students on shift (there are normally six on, but some students were using up the last of their vacation) who were all under the supervision of a naturopathic doctor.

The Brampton Civic Hospital is quite new (built in 2007) and my school has acquired part of the outpatients portion of the hospital, on the third-floor of the main building of the hospital. The naturopathic teaching clinic is huge! Lots and lots of treatment rooms, a reception area, a large intern waiting area, and a massive patient waiting area). There is definitely room to grow (which is the ultimate goal if funding is acquired).

Unfortunately, it is very "hospital" like; so if you don't like hospitals, this isn't the place for you. For instance, there were three "code whites" while I was shadowing (code white means violent patient, FYI). I didn't like the treatment rooms at all; they are very medical-y, complete with icky hospital beds. I also much prefer the comfy chairs in my school's teaching clinic, the RSNC, to the plastic ones in the Brampton Clinic.

But there are plenty of positive aspects to the Brampton Clinic too. It's very busy (it's free for patients, which helps a lot!) and like I said, it is BIG. I'm sure my classmates who will be working there in May (I didn't apply) will really enjoy this new working environment.

If you live in the Brampton area, check out CCNM's second teaching clinic. Follow the link above to learn more!

Breast Feeding Preceptoring.

Image source here.

Today I preceptored at the breast feeding clinic located at CCNM.  Boy oh boy, all I can say is that I had no idea that breast feeding was so complicated!  I don't know much about breast feeding; probably next semester in my Maternal Care course I will learn a lot more and today, of course, I learned tons. The ladies working at the clinic were extremely knowledgeable and gave the new mothers all kinds of tips, advice, and encouragement. Any new mothers out there with any breast feeding concerns: please, please, please go and see a lactation consultant!  The consultant will help you and your baby with the whole feeding experience, very likely making it a million times better.

Happy Sixty-Fifth Wedding Anniversary, Gram and Gramp!  

Lots of love from your oh-so-proud and very-happy-for-you-two, granddaughter.

Exciting Things at CCNM.

Image source here.

Exciting things are happening at CCNM these days!  Here's a quick summary of some of the latest CCNM news:

- CCNM is going to open the first teaching clinic in a hospital in North America! The clinic will open in Winter of 2013 and will feature general naturopathic medicine shifts. That means I might be able to intern there during my fourth year of studies!

- In addition to the Sports Medicine, Cancer, and Pediatrics specialty shifts offered in the school's teaching clinic, two new shifts have been added: a fibromyalgia/chronic fatigue shift and LGBT/immigrant community-focused shift.

- Concerns with the preceptorship program (I've complained about this program before on the blog) are finally being addressed. In the word's of CCNM's dean "Students feel that a large number of NDs either rejected or ignored their request to precept with them" Yep, this has happened to me many times. As a result, the school is reducing the number of hours required (we did need 100 hours, which is simply too much).

- CCNM surveyed students who wrote NPLEX on August 7, 2012. The survey results found (according to the school's dean): "...that while certain areas of the NPLEX exams had improved, the exams were still testing minutia, that NPLEX I was not considered a fair assessment of biomedical knowledge and, most importantly, that there was a disconnect between what was being taught at CCNM and what was being tested". Agreed (I complained about these things already on the blog)!  Thankfully, NABNE---NPLEX's governing body---is looking into CCNM's concerns. Let's hope that the exam will be better for the second-year students who will have to write it this upcoming Summer.

Intro to Cosmetic Acupuncture.

Acupuncture needles. Image source here.

Yesterday, I saw a Naturopathic Doctor give a patient a cosmetic acupuncture treatment.  Cosmetic/facial acupuncture is a less-invasive way of reducing wrinkles, improving skin tone, and lifting the skin, for a more youthful-looking complexion.  It is the more natural option to Botox injections. Here in Toronto, cosmetic acupuncture is very popular amongst aging ladies (maybe amongst men too? Not too sure).

The treatment involves about fifty to one-hundred needles being inserted into the face (they are inserted mostly along wrinkle lines). Then, the patient is left to relax for 15 to 30 minutes while the needles 'do their work'. The needles are thought to stimulate blood flow to the face (rejuvenating it) and improve collagen synthesis (more collagen = fewer wrinkles). I'm sure the needles do more, I just haven't learned facial/cosmetic acupuncture yet, so I don't know the theory. I hope to learn this technique in my fourth year at CCNM by taking a continuing education course. Note: this technique/therapy is not a part of my program. CCNM teaches primary health care management, diagnosis, and treatments; beauty procedures do not fall under the umbrella of primary health care :P.  Nevertheless, CCNM facilitates the course on a weekend for an additional fee (i.e. it is not covered in the regular curriculum, nor is it covered by regular tuition).

If you are scared of needles, or worried about needles entering your face, never fear!  The needles used for facial acupuncture are even smaller than standard needles (they are circled in purple in the image above; note how they are the smallest needles shown).  They are so small, you probably won't even feel them, and you won't be covered with 'puncture holes' after the treatment.

If you are interested in cosmetic/facial acupuncture, talk to your Naturopathic Doctor, or seek out an Acupuncturist or Doctor of Traditional Chinese Medicine.

Life After NPLEX.

Sooooo my NPLEX exam was a week ago.  Now, what does a post-NPLEX-er do with all the free-time on her hands?

- Read. Sometimes literature, sometimes junk, sometimes educational. It's all about balance.
- Clean. I felt like it was Spring again, because I got my clean-on!  Summer cleaning is the new Spring cleaning.
- Organize school notes. My bookshelf and office area was in serious need of some TLC. Now all my NPLEX materials are stored away and my second-year notes have a home now too.
- Experiment with supplements a la Dr. Phil.  More on that in a future post...
- Enjoy more of the great outdoors. This past week I found myself at the beach!
- Complain about the NPLEX exam with classmates. This has been done about a million times since last Tuesday. 
- Hang out with said classmates.  Once we're done complaining, we tend to have a lot of fun ;)
- Stuff myself with amazing goodies.  Toronto is so lucky to have Bunner's Bake Shop.
- Work diligently on my cookbook (it WILL be published this Summer!).
- Preceptor with naturopathic doctors and dream about the future!

Phew, 'tis been a busy week.  Got to make the most of August before the craziness of year three begins!

Wishing you all productive yet fulfilling days this August! ...and thanks for making me a part of your day :)

Preceptoring Woes.

Yesterday, I had the wonderful opportunity to preceptor with a lovely Naturopathic Doctor in her equally lovely clinic.

What is preceptoring? It's basically job-shadowing; a student sits in the corner of the clinic/treatment room, acting as a fly-on-the-wall, not saying a word, just observing the doctor-patient interaction.

While I absolutely love hanging out in clinics, taking mental notes of treatment options, and watching the 'magic' of my profession unfold, I hate preceptoring! 

Now why on Earth would I hate preceptoring? Given the sentence written above, it sounds like I enjoy most aspects of the experience. But what I don't like---and thus makes me dislike preceptoring all together---is burdening Naturopathic Doctors and their patients.

First, the office of an ND is a very therapeutic space.  A space in which confidential information may be shared, uncomfortable physical exams may be preformed, needles may be inserted, and one in which deep emotional healing may finally occur. Every appointment is an opportunity for healing and growth, and thus I hate, hate, hate that I have to intrude!  Treat the individual is a naturopathic principle, yet I feel like patients are not given the space they need when there is a student lurking in the room.

Second, naturopathic doctors are busy, busy people. Their days are packed and there is little room to entertain a student for a day (or more!).

What's more? CCNM students need 100 hours of preceptoring hours before convocation! That's a lot of days spent stalking naturopathic doctors (and other health professionals) and their willing patients :P  One-hundred hours is over two weeks of full-time (8 hours per day) days spent in clinics.  As since most NDs accept students to come in for a day (or two), that means that it is possible to shadow over ten different practitioners to get the hours logged. Yes, it would be wonderful to see the clinics and techniques of ten different practitioners, but in city of Toronto, good luck finding ten willing healthcare providers to take you on (even for one day).

Thankfully, CCNM is looking into this steep requirement and (hopefully) based on student input, is going to change the policy.  Unfortunately, if the policy is changed, it will likely not affect me, but future CCNM students. Nonetheless, I definitely think that there is a problem with current preceptoring requirements and will be happy when some changes are made.

Alright, enough ranting.  See you tomorrow with something more up-beat :)

More Preceptoring.

I spent the day preceptoring another naturopathic doctor. It is quite a privilege to be let into the room while the patient discloses their health (and life-in-general) concerns to their doctor. The patient-doctor relationship is quite special: did you know that the everything a patient tells their doctor must remain confidential? (Only unless the doctor is asked to testify in the court of law regarding their patient or if the patient discloses information that is immediately harmful to him/her or to another person... but even in these situations it is tricky). Of course, I must keep all identifying details about the patients I see while preceptoring confidential as well.

Also, health is very personal and thus there must be quite a bit of trust between the them in order for the patient to open-up to their doctor. Doctors are often required to ask questions that are sometimes socially faux pas, such as discussing their patients' stool, mental-emotional woes, or even their sex life.

A doctor is not allowed to discuss a patient outside of their office. For instance, if your doctor saw you in the grocery store, they are able to talk to you, but they can't mention any of your health concerns. However, doctors can talk to colleagues or future medical students about patients but the doctor must refrain from using any identifying characteristics or details. Case studies are very valuable teaching tools; many of my classes this past year were based on the health of patients that my professors (who are doctors) had treated. On that note, I've been told that most of my learning will not occur in the classroom, but will happen in the clinic (either during my preceptoring or during my fourth-year as a clinic intern).
_____________

As an aside, I heard someone recently say that most MDs poke and pill their patients too much. MDs are accused of "poking" patients too much with vaccines, surgery, physical examinations, etc, and "pilling" patients too much in writing too many prescriptions for drugs. ...this a sentiment that I hear too often about MDs and one that NDs strive to never be described as!

Preceptoring.

As part of the naturopathic doctor (ND) program at the Canadian College of Naturopathic Medicine (CCNM), students are required to complete 50 hours preceptoring a senior ND. Preceptoring is basically job-shadowing: watching the doctor as he or she treats patients. Preceptoring also allows the student to learn more about practice management (aka running a business/practice). More importantly, preceptoring presents students with the rare opportunity to peer into the lives of complete strangers and to see how what is, and what isn't, healthy for them. We all have different bodies and thus different definitions of health, yet we tend to define health based on our own experiences alone. Therefore, as a future health caretaker, I think it is so important that I try to learn about as many definitions of health as I possibly can.

This Summer I have lined-up several preceptoring opportunities. I already preceptored with one doctor and have two more opportunities arranged for later this month. I really enjoy preceptoring because it lets me see that there is light at the end of this long tunnel of learning. Also, sometimes the thought of being a doctor and being (for the most part) responsible for the health of real human beings is very scary, yet the doctors I've seen in practice are confident, relaxed, and good at healing people. I hope that somewhere, amongst all of the years of training that I still have to acquire, lies a moment in which I "click" and am suddenly ready to take on the health of the world! An ambitious thought, but hey, it could happen :)