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!
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