Elective course of clinical training in the USA: My horrible experience!

Elective Reqest- Jameel Khaleel Hijazeen - Mu'tah University*** This is a imaginary letter to a person who will enter my Blog and help me accomplish a dream of mine. Time is runnig out and this dream is most likely not going to be fulfilled… What is most important to me is that when other friends of mine have accomplished this dream, I will not be angry or feeling sorry, simply because I will have asked for help from all those whom I thought they could offer it! My blog is my last place to seek help! What I am requesting might be hard… yes… it is a DREAM! ***

Sir,

My name is Jameel Hijazeen. I am a 5th-year Medical student in Mu’tah University. In the period of June-August 2012, I am required by my faculty to do “two-months of clinical training in two of the major branches of medicine” (Please, to see the elective request, click on the resized image above).

Worldwide, the most advanced country in Medicine is undoubtedly the United States. What is more, if you are a doctor who is to be accepted for residency in the USA, one of the things that will tremendously support your CV is having “US experience”. Therefore, a dream of mine is to do my two months of clinical training in internal medicine in the form of an elective in the United States.

 

How did it all begin?

Starting from exactly 8 months ago, I started searching for how a Jordanian medical student from Mu’tah University can obtain such training.

Soon after my search started, I realized how expensive, complicated, and demanding is such a “dream” is. These are the main reasons:

  1. Most universitieshospitals require expensive application fees and training fees. What is ‘interesting’ is that your application fees are ‘non-refundable’ even if you are not accepted.

  2. Most universitieshospitals require having finished a USMLE step.

  3. Most universitieshospitals require TOEFL (not required if you had finished a USMLE step or are recommended as a good English speaker)

  4. Few universitieshospitals accept students from outside the US (Sometimes, an exception can be made if you are recommended).

  5. Few universitieshospitals acknowledge Jordanian universities. Even fewer universities acknowledge Mu’tah University.

  6. Applying for these universitieshospitals requires hours of papers filing, preparation, and sending.

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What is the solution then?

I asked older students who know about this issue, all of them summarized the way in which someone can be accepted into two: Pure luck or having someone recommending you for acceptance. Till today, two students in my batch have already obtained an elective via the second way (one in the USA and another in France).  Via the first way, not a single students of the 5th year in Mu’tah University has obtained an acceptance; How surprised am I!.

For the above reasons, I did not contact any universityhospital. As a result, I was left with the second option.

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Here is a list of the people I contacted:

# My faculty: No formal programs are available that are meant for sending faculty students to western countries. Nonetheless, certain efforts have been given. I deduced that because Dr. Omar Nafia Al-Ajarmeh, the vice dean, thankfully, contacted a certain University in the USA to accept some of Mu’tah students. In an email reply hanged on one of the boards in the faculty, a part of the response was, “Your university is not recognized by (certain accreditation committee)… Therefore, students from Mu’tah University cannot be accepted for electives in our university”.

# An uncle of mine: A thoracic surgeon in a western country since the 1980s. He had performed more than 4,500 operations. My uncle apologized and denied the presence of any friends of him in the US who could help. He advised me to seek help from my faculty doctors!

# Dr. Nabil S: An American-Jordanian doctor whom I met in a medical conference that was held in Amman. I took a list of the doctors who participated in that conference and showed them to another Uncle of mine to see if he knew anyone of them. For my huge surprise, he turned out to know the brother of this Dr. Nabil S. My uncle contacted his brother. Dr. Nabil, to my happiness, emailed me showing his readiness to help me. From the beginning, unfortunately, it was a hard road full of multiple obstacles!

The first obstacle that face me was that his hospital only accept students for obeserverships not for electives (It is enough to know that if you are an observer, you are never allowed to be in the hospital unless your sponsoring doctor is. What is more humiliating, you can never touch or simply talk to a patient). Reluctantly, I agreed. Do I have any other options so as to refuse this “great opportunity”?

Nevertheless, things got even worst. The doctor sent an acceptance for a two-month observership in family medicine; a branch which my faculty does not accept. So, I asked for the observership to be changed. Because I thought that I am going to remain under the supervision of the same doctor, I did not specifically talk about my wish to be accepted in the internal medicine department. As a result, I was accepted in the surgery department and at the same time, was told by an administrative in the hospital that I can only be accepted for one month… How worst can things be more than this? I emaild my complaints for two times… Dr. Nabil never responded!

# An American young Jordanian doctor: All my information about this doctor are from a blog that he has. Despite realizing how hard it is for a young doctor to recommend others for such a hard thing as an elective, and despite my little knowledge of him, I rudely contacted him. With a big heart, he showed readiness to help (as I expected). Unfortunately, the hospital where he works did not offer electives. At that point, I decided to bother him no more and so sent him no further requests. If my faculty, my relatives, and the friends of my relatives could not help, why would I bother a person that does not know anything about me to help?

The above is a list of the persons whom I contacted. I do not carry any bad feelings about them for not being able to help. On the contrary, whenever I talked to anyone about my elective, I felt ashamed because of my consuming their time and efforts!

 

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p align=”center”>Can you help me get accepted for a two-month

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You might consider it a small favor, but with this “small” favor, you are changing the life of a doctor-to-be forever!… It is like the “small step” of Neil Armstrong:

“That’s one small step for [a] man, one giant leap for mankind”[1]

Neil Armstrong, 2:56 UTC July 21, 1969.

 

 

[1] Source: “Neil Armstrong”, http://en.wikipedia.org/wiki/Neil_Armstrong, retrieved: 07.02.2012.

Scientific Research in the Arab World: Reality or fiction?

imageLast year, during the period from June 26-30, I attended the 25th conference of NAAMA (National Arab American Medical Association) in Le Meridien Hotel in Amman. During the conference, I heard many Arab American doctors stressing the importance of Medical Research for medical students who want to pursuit their higher studies in the USA and other western countries.

Because of how much this subject was stressed, I went back to my faculty with the goal of starting a research in whatever field of medicine. I set up this goal only to be later on shocked by how unrealistic is such a goal!

Frankly speaking, my university curriculum does not require students neither to prepare nor to publish any medical research as part of their undergraduate studies. In the USA, on the other hand, it is a different story. Dr. Wael K. Al-Delaimy, an Iraqi-American professor told me during the same conference:

Dr. Wael K. Al-Delaimy

Dr. Wael K. Al-Delaimy

“In contrary to the situation in our Arab countries, before graduating, US students are required to prepare at least one research”

The above sad fact is the most important obstacle that faced me. Firstly, I will find hardship in finding a professor that will be available solely for the aim of helping me in doing a research. Secondly, the huge time that any student will spend in doing a research would not be compensated with marks. Certainly, this will affect the university marks of the students who will be subtracting time from studying their university curriculum and investing it in a research.

Dr. Aiman Hamdan, a Jordan Unviersity of Science and Technology graduate (second batch), who is now a cardiologist in the United States and certified with seven boards, had the following to say regarding this sad fact:

Dr. Aiman Hamdan

Dr. Aiman Hamdan

“During my University years in JUST, if my father knew that I am doing a research and not studying to get high marks, he would have KILLED me!”

Source: Dr. Aiman Hamdan said the above comment in a lecture he gave –with other Arab-American doctors- about studying in the USA in King Abdullah University Hospital in Irbid in June 2011 as part of the activities of NAAMA’s 25th conference.

Despite the hardship mentioned above, I enrolled in two researches; lucky me!

image“Finally,” I happily thought, “I will be doing what students in developed country are doing!”.  “But could this be a reality? Is that possible?” I found hardship in accepting this very happy piece of news. But at the end… Why should I not hope? How are students in Harvard university better than me?[3]

I felt like I was finally going to achieve something! I will not only be graduating with a certificate, but also, having mastered how to prepare and publish a research! I felt too proud of the notion of having my name on a published research in a medical journal. Can you imagine how important is this achievement?

imageMy happiness did not last long. The first research ended because we discovered that we were collecting “useless” data that no conclusions can be drawn from it [Update 09.04.2012: This was a wrong conclusion. Things went differently than I and my colleagues calculated… It is one of the times in which you are happy when your calculations turn out to be wrong! Read more!]

The second reserach was very succesfful. However, due to deduction of the amount of credit our supervising doctors will get from including us in the publication, I refused to be included in the publication “initially”. Still, the supervising doctor refused but to include us in the publication. “I have an enlightening plan!” The doctor said. “I came back from abroad with a main aim of letting you do what I was taught abroad”. Truthfully, this doctor is sacrificying a lot by including us in the publication. What he is doing would be normal where he studied abroad, but is the situation the same here in the Arab world? Do universities in the arab wrold care about scientific research? Do our universities provides incentives to both doctors and students to do scientific research?

Frankly speaking, it seems that we have a problem… a big problem… How did I come up with this conclusion? But most importantly, who is responsible?

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Every year, a report is published on the Academic ranking of World Universities (ARWU), commonly known as the Shanghai ranking. During the year 2011, the following statistics came out:

Universities that have been included in the top 500 world universities on the Shanghai ranking 2011:

Arab Universities[1]

Israeli Universities[2]

A. King Saud University (201-300)B. King Fahd University of Petroleum & Minerals (301-400)C. Cairo University (401-500) A. The Hebrew University of Jerusalem (57)B. Technion-Israel Institute of Technology (102-150)C. Tel Aviv University (102-150)

D. Weizmann Institute of Science (102-150)

E. Bar-Ilan University (301-400)

F. Ben-Gurion University of the Negev (301-400)

G. University of Haifa (401-500)

Total: 3 universities Total: 7 universities
Arab countries v.s. Israel

Arab countries v.s. Israel

To summarize the above table:
Israel, a country with less than 8 million people, has 7 universities among the top 500 universities in the world. While 22 Arab countries with 355 million people, have only 3 universities in the same list!

Finally, and again and again, the first step in solving any problem is to recognize its existence in the first place. Is there a problem in our universities in the Arab world? It is left to your judgment!

So… I belive it is too unfair to attribute the problem to a single doctor, a single university, or a single country! As you can read above, it is a problem of…

[1] “KSU ranked leading arab university by shanghai world rankings”, King Saud University, http://enews.ksu.edu.sa/2011/08/20/ksu-shanghai-world-ranking, retrieved: 05.02.2012

[2] Reuveni, R. “Israel’s Universities are among the 500 top universities in the world” http://thejewishpeopleandisrael-beesting.blogspot.com/2011/09/israels-universities-are-among-500-top.html, retrieved: 05.02.2011

[3] According to 2011 Shanghai Academic Ranking of World Universities, the world ranking of Harvard university is “1”!

What is the difference between direct and indirect ophthalmoscopes (ophthalmoscopy)?

This is a summary of the differences between direct and indirect ophthalmoscopes (ophthalmoscopy). I searched the internet for a page that answer this question adequately, but did not find any. Luckily, I found the answer in a book entitled: “Textbook of opthalmology” (2nd edition, 2001) by E. Ahmed. This is a table of the differences mentioned in this book only. I didn’t use any other source.

Update 15/01/2014:
This post is now a famous one in my Blog. It brings me a lot of visits (4465 visits so far). I need to thank the doctor who asked me to research this topic. Dr. Khalil Alsalem thanks a lot 🙂

Direct Ophthalmoscopy Indirect ophthalmoscopy
Magnification About 15 times 5 times when a +13D condensing lens is used
Diameter of the field of observationview Smaller (about 10o in diameter) Wider (about 37o in diameter)
Brightness There is relatively low brightness There is relatively greater brightness
Structures seen Central retina only Peripheral retina seen (by using a scleral depressor in addition to the indirect ophthalmoscopy itself)
Image of the fundus that is seen Virtual & erect image Real & inverted image
Stereopsis Image formed is not stereoscopic Binocular indirect ophthalmoscopy provides better stereopsis
Retina anterior to the equator Not well seen (seen with difficulty) Seen better
Scleral indentation Difficult Can be easily done in binocular indirect ophthalmoscopy
Visualization in hazy media Poor Better

Circumstantiality: Not any person can do it… Politicians are the best!

Can you think of a person that gives excessive amount of details when asked a question to the degree of not letting you arrive at an answer at the end of his/her length talk? That is to say, if you asked a certain person about their opinion about a political issue, for example, they will talk for hours without giving you a single sentence indicating their opinion. Is this indicative of a problem in such a person? Ff they are doing it voluntarily, then I don’t think that they have a problem!

In psychiatry, what such people do is described by a term called: “Circumstantiality”. Here is its definition according to Stedman’s Electronic Medical Dictionary (version 6.0, 2004):

circumstantiality:

A disturbance in the thought process, either voluntary or involuntary, in which one gives an excessive amount of detail (circumstances) that is often tangential, elaborate, and irrelevant, to avoid making a direct statement or answer to a question; observed in schizophrenia and in obsessional disorders. Cf. tangentiality.

Origin [L. circum-sto, pr. p. -stans, to stand around]

Reading the above definition, one can come up with two  news; a bad news and a good news. The bad news is that circumstantiality is found in two psychiatric disorders. So, if you have it, does this mean that you have a psychiatric disorder? Here comes the good news: The good news is that you are not necessarily a psychiatric patient if you have “circumstantiality”. As you can read, this “disturbance” in the though process is “either voluntary or involuntary”.

During my Psychiatry rotation, some of my fellow students refused the idea that circumstantiality can be “voluntary”. They even disagreed more when I told them that not anyone can voluntarily answer questions with “circumstantiality”! But why?

Many people, especially politicians, use circumstantiality in order to avoid answering hard, embarrassing, rude, or whatever question they dislike. Haven’t you been put in a situation in which you were asked a hard question that you did not know an answer of and answering “I don’t know” would have made you stupid? What about being asked a question about your political, religious, social, etc., views that you can never answer truthfully without getting yourself in a lot of troubles?

Are you a person who can always answer “I don’t know”? Are you a person who can always declare all of his personal opinions? If your answer is yes to the “I don’t know” part, then I don’t think that you have ever been asked an embarrassing question, for example, in front of a large group of people. If you answered “yes” to the “personal opinion” part, then I think that your opinions are similar to what the majority of people around you think! Can you imagine the consequences of criticizing authorities in non-democratic countries? The consequences of talking negatively about other people’s beliefs? The consequences of telling your frank opinions about people that you know?

The following video is a great example how politicians can sometime be circumstantial in order to avoid answering hard questions. In this video, senior Hamas official Mahmood Al-Zahar, is asked a ‘hard question’ by one of the members of the audience during a BBC program. Should he be circumatantial or answer the question directly and criminalize the organization that he represents? Well, it is politics. This reminds me of a quote about lawyers by a “Patrick Murray”: “A Lawyer will do anything to win a case, sometimes he will even tell the truth”.

[youtube http://www.youtube.com/watch?v=XRy1PMs3LgE]

[N.B. I disagree with what Hamas TV broadcasted simply because it was preaching ‘hatred’ just like I disagree with the Israeli examples that are mentioned by Mr. Alzahar].

To some people, answering “I don’t know” and declaring “your personal opinions” frankly is the ethical choice in “all” situations. To me, however, this is not always a good choice. Sometimes, I think that it is your right to be circumstantial in order to avoid answering certain questions. Or, as the BBC interviewer said, answering questions in a “round-about” way.

Finally, I think that circumstantiality is important because it prevents you from lying!

 

 

There is no “sin” in being circumstantial, is there?

الحكومة الأمريكية تحدد عام 2025 كحد أقصى لإكتشاف دواء لعلاج لمرض الزهايمر أو للوقاية منه… ولكن في نفس الوقت، طبيب عربي يتوصل إلى العلاج حسب الخبر الذي نشر في مئات لا بل آلاف الصحف والمواقع الإلكترونية العربية؟

بتاريخ 13.01.2012، نشرت  وكالة الأنباء الأردنية، بترا، الخبر التالي بعنوان: “طبيب أردني يتوصل إلى علاج مرض الزهايمر”. تالياً، الجزء الوحيد من المقالة الذي يتحدث عن هذا العلاج:

توصل مستشار أمراض الدماغ والأعصاب الدكتور عدنان العبدالات إلى علاج عشرين من مرضي الزهايمر.
وقال العبداللات وهو الطبيبي العربي الوحيد المسجل ضمن مشاهير الطب العالمي مع باركنسون واديسون والزهايمر في مقابلة مع وكالة الأنباء الأردنية أنه عالج عشرين مريضا مصابين بداء الزهايمر وتحسنت حالتهم الصحية بشكل كبير.

المصدر: وكالة الأنباء الأردنية بترا، http://www.petra.gov.jo/Public_News/Nws_NewsDetails.aspx?lang=1&site_id=2&NewsID=55684&Type=P

يبدأ الحديث عن هذا الإكتشاف العلمي بالفقرتين المقتضبتين المذكورتان أعلاه انتهى بهما. ولكن المصيبة ليست في أن الشرح عن هذا الإكتشاف مختصر في الفقرتين أعلاه، المصيبة هو أن المقالة تستمر للحديث عن مرض الزهايمر بشكل عام ثم عن أمر لا علاقه لا بالزهايمر لا من قريب أو من بعيد: الصداع النصفي (ما هو الصداع النصفي، الفرق بينه وبين الصداع العنقودي، طريقة العلاج، السن الذي ينتهي به…).

أفيعقل أن إكتشاف كهذا يتم وصفه ببضع الكلمات أعلاه؟ هل نحن معتادين على الإكتشافات العلمية لدرجة أن هكذا إكتشاف هو بسيط جدا حتى يكتب عنه ببضع كلمات؟

تنتهي المقالة بالتالي:

يشار إلى أن الدكتور العبداللات صنف رقم 90 في قائمة علماء الطب في العالم وهو مكتشف مرض متلازما العبداللات المسجل على 18 موقعا طبيا عالميا على الشبكة العنكبوتية.

لم أسمع في حياتي بشئ يسمى بـ: “قائمة علماء الطب في العالم” فبحثت في جوجل علي أجد هذا القائمة، فلم أجد (نظرت في أول 6 صفحات من النتائج). فما هي هذه القائمة؟ وما هي الجهة المسؤولة عن إصدارها؟ ماذا عن “18 موقعا طبيا عالميا”، ما هو المقصود بها؟ أخاف لو أطلت السؤال عن هذه التسميات والألقاب أن ينتهي الأمر بي في إحدى المحاكم بتهمت القذف والسب أو لا أعرف أي تهمة قد أجلب على نفسي لأني شخص شكاك لا يتقبل المعلومات دون التأكد من مصدرها ومن دون أن تكون مبنية على أبحاث ودراسات علمية.فلأصمت وليصمت كل الشكاكين الذين لا يثقون بالناس وإرائهم حتى لو كانت هذه الآراء تدعي الإكتشافات العلمية المبنية على “عشرين مريض” بعد أن “تحسنت حالتهم الصحية بشكل كبير“.

بالإضافة إلى الملاحظات أعلاه،  أهم الأسئلة التي كان يجب على كاتب المقالة المحترم أن يجاوب عنها: في أي مجلة علمية نشر هذا الإكتشاف؟ فهل تنشر الإكتشافات الطبية في الصحف قبل أن تنشر في المجلات العلمية المتخصصة؟ ماذا عن هذا الدواء: ما مقدار التحسن الذي حصل للمرضى؟ ما هي أعراضه الجانبية؟ ما مدى استمرارية التحسن الذي حصل للمرضى الذين تناولوا الدواء؟ هل العلاج استخدم فقط على الـ20 مريضا هؤلاء وجمعيعهم استجابوا له؟ أسئلة كثيرة أخرى يجب أن يجاوب عنها أي شخص في العالم يدعي أن أكتشف دواء لعلاج مرض ما!

تجاهلت الخبر… فمن أنا لأكتب عن هكذا إكتشاف؟ هل تعلمون حجم التغطية الإعلامية لهذا الإكتشاف؟ بإختصار هي كبيرة… كبيرة جدا… لمعرفة عدد المواقع التي تحدثت عن الخبر، بحثت في جوجل عن نفس عنوان المقال المنشور في وكالة الأنباء الأردنية: “طبيب أردني يتوصل إلى علاج مرض الزهايمر”. فكم عدد المواقع العربية التي نشرت نفس الخبر؟ يا سلام: 22,000 ألف موقع! أمر متوقع، فهكذا إكتشاف يحتاج لهذا العدد من المواقع لتتحدث عنه!

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فتخيلوا ماذا لو أنني قد كتبت عن الموضوع، فلا بد من أنه هناك من سيقرأ مقالي ويتهمني بإتهامات لا نهاية لها… وأنا متأكد من أن هكذا أشخاص سيبنون دفاعهم عن هذا الإكتشاف العلمي فقط على العاطفة لا على العلم والمنطق والشك الذي يفترض أن يتسلح به أي شخص يدعي إستخدامه للطريقة العلمية في تفسير ظواهر الكون!

اليوم وأثناء تصفحي لموقع أخبار جوجل الطبية باللغة الإنجليزية. وجدت الخبر التالي منشورا في موقع رويترز:

Analysis: Goal for Alzheimer’s drug by 2025 too ambitious?

(Reuters) – The U.S. government has set a deadline of 2025 for finding an effective way to treat or prevent Alzheimer’s disease, an ambitious target considering there is no cure on the horizon and one that sets a firm deadline unlike previous campaigns against cancer or AIDS… But some experts say the 2025 deadline is unrealistic.

Source: http://www.reuters.com/article/2012/01/20/us-alzheimers-idUSTRE80I1W320120120

فما بالك عزيزي القارئ أن حكومة الدولة الأولى عالميا في البحث العلمي تضع الحد الأقصى لإكتشاف الدواء بعد 13 سنة من الآن؟ المصيبة الأكبر أن الخبر يكمل ليؤكد أن بعض “الخبراء” يوكدون أن عام 2025 كحد أقصى هو “غير واقعي”. قراءتي لهذا الخبر كانت كافية لتشجيعي على الكتابة عن هذا الإكتشاف “العظيم”.

ولكن، مهلا، أليس من الممكن أن هناك مؤامرة في الموضوع؟ هل الحكومة الأمريكية تتجاهل إنجاز طبيب غير أمريكي لأسباب عنصرية يسهل إستنتاجها؟ نظرية مؤامرة أخرى؟

لن أطيل عليكم… بعد كتابتي لنصف هذه المقالة، وعندما أردت إكتشاف عدد المواقع التي تحدثت عن هذا الإكتشاف، وصلت مصادفة إلى الخبر التالي ليظهر مدى بعد مجتمعاتنا كل البعد عن التوصل إلى الحقائق بالشك والبحث لا عن طريق الآراء الشخصية والمسلمات. فكل عام وكل شخص لا يشك ليتوصل إلى الحقائق العلمية بخير وليتهنأ هكذا أشخاص بالجهل والتأخر الذي جلبوه على أنفسهم وعلى أوطانهم. أهدي الخبر التالي إلى هؤلاء الأشخاص، ولكن أهم أشخص أهدي له هذا الخبر، هو الصحفي الذي نشر خبرالإكتشاف لأول مرة ونقلته عنه وكالة الأنباء الأردنية  ثم نفلته عنه 5 من الصحف الأردنية اليومية[1]

الأطباء تنفي التوصل لدواء يشفي من الزهايمر

عمان – طارق الحميدي – نفت الجمعية الاردنية لأطباء الدماغ والاعصاب في نقابة الاطباء توفر علاج شاف لمرض الزهايمر مؤكدة ان الادوية الموجودة توفر نسبة معينة من التحسن عند بعض المرضى في احسن الاحوال وفي المراحل الاولى من المرض في معظم الاحيان.
وقال نقيب الاطباء الدكتور احمد العرموطي ان رئيس الجمعية التي يرأسها الدكتور خالد السالم قامت على اثر مانشر في وسائل الاعلام حول توصل طبيب اردني الى علاج للمرض بالاستعلام من الطبيب حول هذا العلاج، حيث أفاد أن العلاج عبارة عن عدة أدوية تستعمل منذ عدة سنوات من قبل أطباء أمراض الدماغ والاعصاب في المملكة وفي العالم بشكل روتيني.
واضاف العرموطي إن الطبيب اشار ايضا في رده على الجمعية إلى أن تلك الادوية متوفرة في مستشفيات وزارة الصحة والخدمات الطبية الملكية والمستشفيات الجامعية الخاصة منذ سنوات وهي من انتاج شركات عالمية معروفة، وانها «ليست من اختراعه»، وان تلك الأدوية تخفف من تطور المرض في احسن الاحوال وليس الشفاء التام.
وأشار العرموطي إلى أن الطبيب أكد انه «قد أسيء فهمه وانه قصد فقط انه استعمل الادوية الموجودة اصلا على عدد من المرضى -10 مرضى- وطرأ على إثر ذلك تحسن على حالتهم الصحية، وانه لم يكن يقصد على الاطلاق انه توصل الى علاج جديد».
وبينت الجمعية أن هناك العديد من الابحاث التي تجري في العديد من المراكز العالمية في العالم والتي تسعى الى اكتشاف السبب الرئيسي للمرض والنظر في العلاجات الناجعة له.
واعربت عن أملها مراجعة الجهات المعنية والرسمية عند نشر الاخبار المتعلقة بالتوصل لعلاجات جديدة، حتى يتم تجنب إرباك المواطنين او الاضرار بسمعة السياحة العلاجية في المملكة.

المصدر: جريدة الرأي، تاريخ النشر 18.02.2012، http://www.alrai.com/article/17025.html

ولكن في النهاية، لا ألوم هذا الصحفي الذي نشر الخبر لأول مرة. فهذه مشكلة كل الدول العربية ودول العالم الثالث إجمالا: تقديم المسلمات والآراء الشخصية على العلم والبحث والتقصي لتفسير العالم الذي نعيش به!

الخطوة الأول نحو تصحيح الأخطاء هو الإعتراف بوجود هذه الأخطاء أصلا! ولمن هو في الأسفل ويطمح بالوصول إلى المراتب العليا، عليه أن يعترف أولا أنه في الأسفل… تحت… تحت… تحت…


المراجع:

[1] جميع الصحف اليومية الأردنية –التي أعرفها- نشرت هذا الخبر. معها الـ22 ألف موقع عربي… 22 ألف شخص قرأوا الخبر وقرروا نشره في غضون أسبوع… يا سلام:

Generic names, trade names, and street names in Jordan for drugs of abuse الأسماء العلمية، والتجارية، والعامية لأدوية الإدمان (المخدرات) في الأردن

There are some drugs which are abused and therefore, some people become addicted to them. In Jordan, they have certain street names.

مستشفى المركز الوطني للصحة النفسية، الفحيص

مستشفى المركز الوطني للصحة النفسية، الفحيصPhoto0635Photo0623

During the psychiatry course that I am currently taking in the Pscyhiatry Hospital in Fuhis (مستشفى المركز الوطني للطب النفسي), the names of such drugs were mentioned more than once. We, as future doctors, will not be able to apply our medical knowledge if we did not know what the people in the streets are calling the drugs. If an addict tells me that he is taking “برازيلي”, then I should not expect him to tell me the generic name of this drug (Clonazepam). I need to know this information myself!!!

I tried to search for a webpage which summarizes the generic names, trade names, and street names; I didn’t find any. So I decided to publish one. I will not be only studying for my exam (in case I was asked about the topic), but also, creating what I hope is a helfpul page to my fellow Jordanian medical students who will be studying psychiatry and will be searching for the same information.

After much searching on the internet, in addition to the some information that I was given by my Psychiatry doctor (Dr. Mohammed Al-Debeh), I was able to arrive at the following summary. I included the references for the information written in the table below.

Generic (non-proprietary) Name
الاسم العلمي

Trade (proprietary)name
الاسم التجاري

Street name
الاسم العامي أو اسم الشارع

Clonazepam Rivotril ®

صليبا. سبب التسمية هو وجود شكل الصليب على أقراص هذا الدواء (4).لاحظ الصورة:Rivotril دواء صليبا

Clonazepam (Rivotril) دواء صليبا Clonazepam (Rivotril) دواء صليبا - لاحظ شكل الصليب وهو سبب التسمية العامية

Alprazolam Xanax ®, Prazin ® برازيلي. سبب التسمية هو تحوير أحد الأسماء التجارية لـAlprazolam وهذا الاسم هو Prazin. إذا كما يمكنك أن تلاحظ، فهناك تقارب بين لفظ كلمة Prazin ولفظ كلمة برازيل(1). اسم أخر هو رينالدو أو رونالدو (1)Alprazolam (Prazin) دواء برازيلي
Diazepam Valium ® فاليوم
Fenethylline (also spelled phenethylline) (3) Captagon ® كبت، كابتاغون، كبتاغونكبت، كابتاغون، كبتاغون كبت، كابتاغون، كبتاغون
Procylidine Kemadrin ®

كيمادرين، ويلكوم (ويلكم، welcome)، أبو حصان. سبب تسمية الدواء “أبو حصان” هو أن علبة الدواء تحتوي على شكل الحصان (لاحظ الصورة) (4)

كيمادرين، ويلكوم (ويلكم، welcome)، أبو حصان. سبب تسمية الدواء “أبو حصان”

كيمادرين، ويلكوم (ويلكم، welcome)، أبو حصان. سبب تسمية الدواء “أبو حصان”

Pethidine بيثيدين
Tramadol Tramal ® ترامالTramadol ترامالTramadol ترامالTramadol ترامالTramadol ترامال
??? ??? انجيكشن
??? ??? كومودور
??? ??? أرتين

المراجع:

(1) “…يتعاطى دواء اسمه »Brazine« اطلق من سبقه في تعاطيه عليه اسم لاعب كرة القدم البرازيلي »رينالدو« لجهة تقارب اسم الدواء مع كلمة البرازيل…” المصدر: “مدمنون صغار”، موقع إجبد الإلكتروني نقلا عن صحيفة العرب اليوم، 08.10.2010، http://ejjbed.com/viewPost.php?id=5143&sec_id=1#

(2) “… يشير الى ان أكثر الأنواع انتشارا من الحبوب بين الشباب هي “صليبا”، وهو الاسم الشعبي لعقار “التريفول” المهدئ، اضافة الى الارتين والبرازيلي (البرازاين)!” المصدر: “انتشار الحبوب المخدرة: إدمان وتعاط وتجارة رائجة تغزو شوارعنا”، ماجد توبة وغادة الشيخ، جريدة الغد، 25.07.2011. http://alghad.com/index.php/article/339449.html

(3) “Fenthylline”, wikipedia, http://en.wikipedia.org/wiki/Fenethylline, retrieved: 24.12.2011

(4) الدكتور محمد الذيبة، استشاري الطب النفسي، مستشفى المركز الوطني للصحة النفسية، الفحيص، الأردن.

USMLE step 2 cs: New patient note

I am subscribed a newsletter by the ECFMG. Once subscribed to this mailing list, you get the most updated information regarding the USMLE. On december the 20th, 2011, I received an email from them annoucing “CHANGES TO THE STEP 2 CLINICAL SKILLS (CS) EXAMINATION”.

The next important question after asking what are the changes is “when are they going to take place”. “These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.”

 

I like the new changes they are making to the patient note.

“In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports (or refutes) each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient’s possible diagnoses.”

Take a look at the new CS patient note:

image
image

 

For those who were not registered in the ECFMG mailing list, here is their full email:

 

The ECFMG(r) Reporter
An E-Newsletter for International Medical Graduates Pursuing Graduate Medical Education in the United States
Issue 180 – December 20, 2011
**********************************************
IN THIS ISSUE:
– CHANGES TO THE STEP 2 CLINICAL SKILLS (CS) EXAMINATION
**********************************************
CHANGES TO THE STEP 2 CLINICAL SKILLS (CS) EXAMINATION
One of the recommendations emerging from the Comprehensive Review of USMLE (CRU) process is that USMLE consider ways to further enhance the testing methods used in the Step 2 Clinical Skills (CS) examination. As previously announced in the 2012 Bulletin of Information, these enhancements are scheduled for implementation in mid-2012. These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.
The reporting schedule for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.
More information about the Step 2 CS score reporting dates for examinations delivered in 2012 is provided in the Step 2 CS Score Reporting Schedule at
http://www.ecfmg.org/news/2011/09/29/2011-schedule-and-2012-partial-schedule-for-reporting-step-2-cs-results/.
CHANGES TO THE ASSESSMENT OF COMMUNICATION AND INTERPERSONAL SKILLS (CIS)
The CIS subcomponent of Step 2 CS has been redesigned to assess a fuller range of competencies.  Background information about these changes is provided on pages 5-6 of the Fall 2010/Winter 2011 NBME Examiner at
http://www.nbme.org/PDF/Publications/Examiner-2010-Fall-Winter.pdf. The new approach divides communication skills into a series of functions. These functions have been further divided into sub-functions. Beginning June 17, 2012, the Communication and Interpersonal Skills (CIS) scale will focus on five functions:
1.      Fostering the relationship
2.      Gathering information
3.      Providing information
4.      Making decisions: basic
5.      Supporting emotions: basic
Several additional functions are still under development; these include making decisions: advanced; supporting emotions: advanced; and helping patients with behavior change. A list of the functions and sub-functions is available at
http://www.usmle.org/pdfs/step-2-cs/Assessment_of_Communication_Skills_Behavior_List.pdf.
CHANGES TO THE PATIENT NOTE
Also beginning June 17, 2012, a new patient note will be introduced. The patient note is completed by the Step 2 CS examinee after the encounter with the standardized patient. In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports (or refutes) each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient’s possible diagnoses. A sample of the new patient note is available for review at
http://www.usmle.org/pdfs/practice-materials/patient-note/new-cs-patient-note.pdf.
PRACTICE MATERIALS
Updated practice materials for Step 2 CS will be posted to the USMLE website in March 2012. These include the Step 2 CS Content Description and General Information Booklet, onsite orientation video, sample patient notes, and a simulation of the program for typing patient notes.
*********************************************
ABOUT THIS PUBLICATION
As an organization, ECFMG is committed to providing information on issues of importance to international medical graduates. We realize that many individuals would like updated information on developing issues related to ECFMG Certification and entry into graduate medical education in the United States. As a result, ECFMG has developed The ECFMG(r) Reporter to provide international medical graduates worldwide with timely, objective information on current topics of interest. It is our hope that this newsletter will allow physicians educated outside the United States and Canada to make informed choices on issues that shape their careers.
Previous issues of The ECFMG(r) Reporter are available on the ECFMG website. Subsequent issues will be posted to the ECFMG website as they are published. To access previous issues, visit the ECFMG website at
www.ecfmg.org/reporter/.
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Copyright (c) 2011 by the Educational Commission for Foreign Medical Graduates (ECFMG(r)). All rights reserved.