Clinical pharmacology is typically taught at medical school in Japan for around three months out of a six-year undergraduate programme. From a foreign-trained clinician's viewpoint, this is insufficient training for junior doctors. Many junior doctors struggle with using chemical (generic) names of drugs and instead, default to using trade names. This means that they do not readily recognise drugs within the same class because of the aforementioned use of trade names.
Junior doctors also struggle with the mode of action of medications in general. There is almost no instruction in terms:
1) drug mode of action
2) drug metabolism
3) drug excretion
4) dosing and titration
5) drug side effects
6) drug-drug interactions
7) polypharmacy and how to reduce it
Patients sometimes have reams of medications, some of which have been commenced by various specialists plus those from clinic doctors. Sometimes there are several drugs prescribed in the same class e.g. two loop diuretics, two NSAIDs, two calcium channel blockers, etc. This leads to polypharmacy, and such problems can lead to adverse events in patients.
Clearly things need improving. That can only occur by challenging the current status quo and pushing for change. Doctors’ education needs improving for the very patients that they are supposed to be serving. But by staying the same without change, nothing can improve.
Please join Dr. Branch's online teaching sessions that directly deal the above listed concepts. Such sessions look at patient problems as a whole, rather than in separate subspecialty segments. Dr. Branch actually becomes a simulated patient and takes questions from the attendees so that they can build up the history and physical examination to lead them to the diagnosis and correct pharmacological treatment.
The only way to truly know how to treat the patient is to know the patient as a whole.
JB @ Dr. Branch’s Bedside BootCamp