YOUR FIRST CLINICAL SHIFT
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April
07Dear future Naturopathic Interns,
It’s APRIL and that means you have only a couple more weeks of classes before entering your very last crazy exam period of your LIFE! WAHOO! This also means that Clinic is right around the corner and as soon as exams are done you will want to think about preparing yourself for your first day on shift. I’ve written up a list of things that I would have liked to have known prior to starting clinic and I hope you find it helpful. Also check out “WHAT’S IN MY CLINIC BINDER?” for other great tips.
The Preparation:
- If you are starting clinic in May, ENJOY YOUR ONE WEEK OFF POST-EXAMS
- Talk to various interns and NDs to see what style of charting and handout formats work for you. If you’d like an example of “What’s in my Clinic Binder” please read a former post HERE.
- Don’t over do it… clinic is the time to figure out what handouts, resources, clinic bags/ binders/ clip boards work for you
- Get familiar with PAX
- Say hello to the Receptionists, Ornella, and Tara. They will be critical in the interactions with your patients and the ease of bookings/ patient requests
- Go to Orientation. You may not learn too much from the information but it will help to shake the jitters and feel excited for clinic
The First Visit:
- Be confident but honest… If you don’t know the answer take the time to research and get back to your patients.
- Be humble
Compounding Shift
- Avoid assumptions
- Ask the pertinent “Red Flag” questions and perform the focused physical exams
- Look at the whole person
- Think for yourself and don’t rely on other people’s research
- Make a plan based on patient’s goals and realistic time frame to see changes
- Ground yourself. Avoid the temptation to “fix” your patients
- Listen to your patients
The Research:
- Read the patient’s file
- Do your research! If it’s a transfer patient, don’t just follow what the previous intern’s protocol was. Especially in the Summer term when clinic is a slightly slower period, put the time in to really solidify conditions and treatment
- Initial Research– Try using lots of different resources:
- First Consult/ MD Consult
- Med Scape
- Natural Standards Database
- Natural Medicine Comprehensive Database
- ND Assist
- Advanced Health Assessment & Clinical Diagnosis in Primary Care, 4e
- Pub Med
- eCPS
- Mosby’s Manual of Diagnostic and Laboratory Tests, 4e
- To find the medical physician’s fax and address to requisition for laboratory work-up use CPSO (College of Physicians and Surgeons of Ontario)
- Modality specific references (figure out your favorites, some of mine are below):
Nutrition-
- Principles and Practices of Naturopathic Clinical Nutrition (with Errata)
by Jonathan Prousky
- Dr. Rouchotas’ class notes
Botanical Medicine-
- Principles and Practices of Naturopathic Botanical Medicine: Volume 1: Botanical Medicine Monographs
by Paul Saunders, Anthony Godfrey, Kerry Barlow, and Matt Gowan
- The Ultimate Herbal Compendium: A Desktop Guide for Herbal Prescribers
by Kerry Bone
- Medical Herbalism
by David Hoffmann
- Botanical Tincture Calculator by Chris Roberts (utilizes what is actually in the RSNC compounding lab)
Homeopathy-
- Desktop Guide: To Keynotes and Confirmatory Symptoms
by Roger Morrison
- Desktop Companion to Physical Pathology
by Roger Morrison
- Mac Rep
- Reference Works
Traditional Chinese Medicine-
- Kassam’s class notes
- The Foundations of Chinese Medicine: A Comprehensive Text, 2e
by Giovanni Maciocia
- Acupuncture Desk Reference
by David Kuoch
Supplementation
- Nutritional Medicine by Alan Gaby
Psychological Counselling
- Mind Over Mood: Change How You Feel by Changing the Way You Think
by Dennis Greenberger and Christine Padesky
Integrative Medicine
- Clinical Naturopathy: An evidence-based guide to practice, 1e
by Jerome Sarris and Jon Wardle
- Especially for complex cases, bring it back to the basics. Remember your Therapeutic Order!
This is a general starting point to build and specialize your interests upon. If you have any favorites to add to my list please send them to info@DrAlisonChen.com. Good luck and have fun in clinic! It will be the most rewarding year at CCNM!