Today is my last day of rotations at National Taiwan University Hospital. It's amazing how fast 6 weeks fly by. I was a bit apprehensive at first because even though I can speak Mandarin, I can't really read Chinese characters. This proved to be a little difficult in the beginning because you need to be able to read Chinese characters in order to navigate through the EMR. However, after around a week, I was able to navigate through the system more effectively and find the relevant information that I needed.
For my first 3 weeks, I was in the pediatric ICU in the Children's Hospital. The learning curve was definitely steeper at this time because it was my first pediatrics and ICU rotation. This made it more difficult to compare how the two countries differed in terms of medication therapy mainly because everything was new to me. In addition to rounding with the medical team in the morning, I also attended morning meetings and prepared patient case presentations. I also had the opportunity to spend one afternoon in the compounding room turning ursodiol tablets into a powder formulation for the pediatrics population! Finally, for my end of my rotation I did a 30 minute presentation on Extracorporeal Membrane Oxygenation (ECMO) Dosing Adjustments.
For the next 3 weeks, I was in family medicine. This is somewhat similar to our general medicine rotations in the US. However in NTUH, there are many different subspeciality departments so the population of patients that we saw was not as broad as in a general medicine ward. In the family medicine ward, most of the patients I saw had a UTI or cellulitis. I also had the opportunity to go on rounds with the Emergency ICU team and to see how warfarin clinics are run in Taiwan. One of the interesting things that I learned on this rotation was that the hospital has no specific guidelines for antimicrobial dosing in obese patients. It just so happened that during my rotation, I had two patients that were obese (BMI ~40) and were being treated for cellulitis. Not many people are obese in Taiwan, so often times the doctors end up contacting the pharnacy to ask how to adjust for this specific patient population. Overall, this rotation was a nice change from PICU and I was able to see how medication therapy differs between Taiwan and the US in the adult population.
Aside of the differences in medication therapy, I found the cultural differences and how the Taiwanese population viewmedications to be very interesting. Ony of my preceptors mentioned that patient compliance is definitely an area that needs improvement. She was saying that from the patient's perspective, they think that the doctor will always prescribe more medication than is necessary so they might consider taking less. However, from the doctor's perspective, they think that the patient will likely take less medication so they might consider prescribing more. In a way it's a catch 22. I think this situation can be bypassed if there was more of an emphasis on patient education. My preceptor did mention that this was an area that they are actively trying to improve.
Overall I had an amazing 6 weeks at NTUH. It was definitely an eye opening experience and I able to see how pharmacy is practiced in a different country.
Group picture with the current and incoming NTU masters of pharmacy students
*If you're interested in reading another perspective, check out my classmate Johnny's blog! Click Here!