The past few days have been long and exhausting but I think they have been some of the most eye opening experiences I have had in Thailand thus far :)
Our perfect group of 8 was divided in to 2 groups as fairly as possible based on career interests! I had the chance to go to Ramathibodi Hospital which is both a tertiary excellence center facility and one of the two medical schools of Mahidol University in Thailand. After being taken to all three buildings that compose of the hospital and visiting all the large pharmacies that cover Family Medicine/Psychiatric, Dermatology/Orthopedic and Emergency Medicine respectively, Day 2 was all about rounding. We visited the various Pediatric, Oncology, Emergency, Transplant and Cardiac Care wards and met with clinical teams made up of one Doctor, two Residents, one Fellow and one Pharmacist that rounded to stay up to date with patient's in the ward and their updated treatment plan. My favorite part was visiting the pediatric ward and learning about the varied dosing regimens. Therapeutic drug monitoring is different in a child due to their larger Volume of Distribution, so certain trends that relate to how quickly to titrate a drug and how much of a drug to administer vary based on their weight and size, especially up until the age of 5. We saw that there was a high prevalence of pneumonia compounded with heart disease in many children in the PICU who all suffered from various severities of respiratory failure in the ward. In addition to those medications, the use of Fentanyl was also used commonly in pediatric patients for agitation due to its fast onset and shorter duration of action. Although this isa only a small portion of our day, I had the most fun learning about how similar the Thai and American system of medicine are so similar! However, the Thai clinicians, despite how advanced they are, rely highly on manual forms of documentation more than electronic which I think is unique to us but very effective! Thanks to the clinical staff who shared their insight with us - Lindsey, Michael and I were able to see what working in a hospital setting will be like!
Seema
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