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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by ed_uk on December 5, 2004, at 12:35:09
In reply to Re: Just to talk about effexor, posted by Stryker88 on December 5, 2004, at 4:43:50
Should medical students have to learn more about pharmacology at med school? Personally, I think they don't learn enough. A high propotion of the knowledge of some doctors appears to come from drug reps! ..... this may be followed by inappropriate prescribing and a poor appreciation of drug toxicity. (Delusions such as 'SSRIs hardly ever cause side effects' may result from this inadequate situation.)
Opinions/Votes please!
Ed.
Posted by Racer on December 5, 2004, at 12:35:10
In reply to Re:Vote! Do med students study enough pharmacology, posted by ed_uk on December 5, 2004, at 5:20:57
Yes, I agree that many doctors do not learn enough solid information about meds.
I also believe, though, that many of the doctors who do not learn enough about the meds also do not learn enough about, say, the differences between male and female reactions to meds or illnesses -- did you know that most women do not have pain in the left arm when having a heart attack? -- or the importance of body weight in dosing, or any number of other things -- THEY'RE JUST LAZY! They don't bother to learn this stuff, because they're lazy. I don't think you can blame med schools not teaching them enough, I think you have to say that some of them are more dedicated than others.
As for "believing that SSRIs hardly have side effects" -- I don't know that many of them really believe this anymore. Sure, some do. Most, though, I think know that SSRIs have side effects -- but the side effects are not nearly as severe as other classes of ADs and -- this is important, so pay attention -- THEY ONLY HAVE THE TOOLS THAT THEY HAVE. If the SSRIs are the best tool that they have to use, that's what they're gonna use. They have to make the best of it. Guess what? Making the best of a suboptimal situation is part of being non-depressed. And the more the doctors tell patients, "well, this drug really sucks, and it might make you feel a bit better but you'll be so miserable because of the side effects..." Patients would never recover, would they?
Keep in mind, this place does not attract the run of the mill SSRI user. Most people on SSRIs get them from a GP, take them as long as they take them, and then stop. They don't think of them beyond remembering to take them every day. We here on this board have tried more than one, with limited success, from a pdoc, etc. We're a different population.
Here's a project for someone: what is the average number of medications tried by posters on this board? I'd be very interested.
Posted by cubic_me on December 5, 2004, at 14:14:17
In reply to Another perspective » ed_uk, posted by Racer on December 5, 2004, at 10:46:10
I'm at med school in the UK, and it is true that we don't learn enough about meds, especially at the university I am at. Racer, I think that it is a little unfair to say that we are lazy - some of us are simply not given the time to learn. I am in my 4th year of med school and have had a total of 3 one hour lectures on pharmacology. On the wards doctors joke about how little pharmacology knowledge we have, and that definately has to be rectified.
There are hundreds and hundreds of drugs out there - too many for every doctor to learn the actions, indications, contraindications and side effects of all of them. Of course the common ones should be known thoroughly and most known at surface level, but I think that the specialist drugs only need to be learned in detail by those who are going to prescribe them - and if you don't know about them, you have no business prescribing them. I think some docs have trouble referring people when the problem is outside thier expertese.
Medicals students have *alot* to learn - apparently there are approximately 5000 new words that we learn in the medical curriculum for a start. Sometimes we may need to refer to a book to refresh our minds, who wouldn't?
I'm sorry for being a bit defensive about the laziness issue Racer, I'm not having a go at you. I just feel that I work really hard, but haven't been given the resources to learn pharmacology adequatley.
Posted by ghost on December 5, 2004, at 15:33:09
In reply to Re:Vote! Do med students study enough pharmacology, posted by ed_uk on December 5, 2004, at 5:20:57
my pharmacists generally know more about the drugs activity and side effects than the prescribing doctor. this has always bothered me. (but made me happy the pharmacists knew what was up, at least!)
Posted by vwoolf on December 6, 2004, at 5:50:12
In reply to no, they don't., posted by ghost on December 5, 2004, at 15:33:09
I think another huge issue doctors face is that pharmacology changes so much so rapidly. Just think of your average 50 year old GP - he probably graduated about 25 years ago, in say 1979. Very little of his original knowledge will be of any use in the highly complicated field of medicines, and unless he attends frequent professional development courses, his only up to date knowledge will be from medical reps. Which is very scary.
How many of your private GP's attend these courses? Probably doctors working in clinics and hospitals are pressured into ongoing training, but most doctors in private practices are reluctant to take the time out.
This is the end of the thread.
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