CAPSules

Not everything is fun and games down in the “Big Easy.”

From December 4th to 8th, pharmacy students from around the nation converged on New Orleans, LA for the 46th ASHP Midyear Clinical Meeting and Exhibition.  This provided our 150 UNC ESOP students in attendance a great opportunity to network, learn, and advance their knowledge of pharmacy in a unique and vibrant setting.  But meetings are not just about work, as UNC held a lively reception at the House of Blues for those in attendance.  Make sue to attend next year, when ASHP takes over one of the world’s most exciting convention and meeting destinations: Las Vegas, NV.

Katie Morgan, PY4 Student

Student Name: Katie Morgan                       
Site: National Institutes of Health, Clinical Center
Location: Bethesda, MD   

Description of Average day of rotation:
During the rotation we rounded on half of the service on Monday, Wednesday, and Friday. We typically rounded on patients who were admitted over night or were severely ill and needed to be followed closely by the team. We rounded with a group of about 20-25 people who consisted of physicians, medical residents, nurses, primary investigators for the clinical trial the patient was on, pharmacists and students, it was very interesting to see the attending physicians at work, because since many of the drug therapy choices were not evidence based, discussions went on on a daily basis between them about what the best course would be. Rounding would take the entire morning, then after lunch we would have topic discussions about each type of antibiotic class. On Tuesdays and Thursdays we would usually have drug information questions from the nurses or physicians in the mornings, which we would answer based on the best evidence available, since sometimes there was minimal data to answer the questions. On Thursday I attended lectures given by the attending’s for the medical residents. Often in the afternoons, I would be assigned some drug information questions that came up in rounds the day before that would facilitate my learning of the therapeutic choice, a drug interaction or a potential alternative treatment option. Throughout the rotation I followed about 5 patients, I also did two journal clubs, and an update on endocarditis guidelines.

Favorite thing about rotation thus far:
My favorite thing about this rotation is being in the presence of world renowned physicians. Dr. Fauci, the director of the National Institute of Allergy and Infectious Disease (NIAID) often rounded with us and he was a great teacher and a presence to be around. I was able to interact often with Dr. Olivier, one of the authors of the non-tuberculosis mycobacterium guidelines by the IDSA, I also had the opportunity to attended his lecture on pulmonary MAC. Some of the other physicians were the people who actually discovered the diseases that our patients were being treated for, so being able to hear them talk about how they discovered it and how they continue to find new things about the disease was fascinating.

Type of people you interact with and what to expect on a day to day basis:
The patients were usually patients who had a specific immune deficiency, Chronic Granulomatous Disease (CGD), STAT 3 mutation or Job’s Syndrome, DOC 8 mutation, or a disease called monoMAC or patients with a GATA 2 deficiency. Some of the CGD patients had undergone bone marrow transplants to treat an invasive fungal infection or CGD associated colitis, so often times we would have a lot of transplant related therapy as well as infectious disease related therapy. All of these patients with immunedeficiencies were susceptible to a specific set of infections so it was important to know the bacteria and fungus the patients usually are susceptible to and the best way to treat it. We also saw patients who were infected with molds or non-pathogenic bacteria who’s underlying immune deficiency has not be identified yet.

What do you do for fun on weekends or down time at your site?
Bethesda is a really nice city. There is a lot to do right near the NIH, plenty of restaurants, shopping, and movie theatres. DC is also very close to the NIH and you can get there by metro, which is very cheap! There are many restaurants, museums, and lots more to do in DC.  So there are many things close by to keep you occupied on the weekends, if you don’t have enough to do for rotation!

Advice for younger students:
Before coming to this rotation I would have liked to know that for this particular site, it is more an observational rotation than a hands on inpatient rotation. Understandably, many of the recommendations are not evidence based and as a student you are just trying to keep up! But the clinical pharmacist does have a huge impact on drug interactions, dosing recommendations and therapeutic drug monitoring.