"Worst Drug in History"

February 2, 2011 — An estimated 10 million patients have used the pain reliever propoxyphene and were sent scrambling to doctors' offices when it was recently pulled from the market. Many physicians are still dealing with the aftermath of the product, first approved by the US Food and Drug Administration (FDA) in 1957.

"Propoxyphene is the worst drug in history," Ulf Jonasson, doctor of public health, from the Nordic School in Gothenburg, Sweden, told Medscape Medical News. The researcher played a role in the decision to stop the pain reliever in the United Kingdom, Sweden, and later in the entire European Union.

"No single drug has ever caused so many deaths," Dr. Jonasson said.

Clinicians are now prescribing analgesic alternatives to propoxyphene.

Propoxyphene was banned in the United Kingdom 5 years ago because of its risk for suicide. It was taken off the market in Europe in 2009 over concerns about fatal overdoses and now in the United States for arrhythmias.

"I agree that propoxyphene is among the worst drugs in history," Eduardo Fraifeld, MD, president of the American Academy of Pain Medicine, said in an interview. "I'm surprised it stayed on the market so long. It's addictive, in my experience not very effective, and toxic."

Surviving Medical School

PhotoCredit: drsharma.ca 

Remember when you were a premedical student in college? It seems like a century ago for many of us who have just completed the first year of medical school. It feels that way because our lives have changed dramatically. Normal life seems to have vanished, and suddenly, 24 hours in a day are not enough to get through the enormous volumes of information that we are expected to learn for every exam. It seems virtually impossible. We barely have time to eat or sleep.

Medical school is not the end of the world. Take it from us, 2 students who have been there, when we say that medical school is what you make of it. Do not let medicine define you; instead, you should tailor medicine to your lifestyle. Otherwise, you might become overwhelmed by the demands of your new life and lose the sense of why you chose medicine in the first place.

Studying Tips

"I hate studying," admits Carl Streed Jr., a student at Johns Hopkins University School of Medicine in Baltimore, Maryland. "I don't know how to do it well," he continues. "And apparently it's required in medical school."

Streed lamented his difficulties with studying on The Differential, a popular Medscape blog for medical students. He asked other students how they master the large volume of material that begins to accumulate on the first day of medical school, and he invited them to share their thoughts on the discussion board. Over 220 readers responded.


Many students offered their own secrets to studying. Of course, studying efficiently is partly a matter of getting motivated, as many hinted. There is no single best technique to study: rather, the method you choose will depend on what sort of learner you are, what type of material is presented in class, and how interested you are in the topic. The main challenge is to figure out what works best for you.

That said, you may find some of their specific advice very helpful:

Job Satisfaction in Geriatrics

I am often asked by my patients, medical students, residents, and even my colleagues, "Why did you choose to go into geriatrics?" The answer is not simple. Much like the patients I care for, my reasons for practicing geriatrics are complex and nuanced. They have a great deal to do with my underlying values as a physician. That said, I will do my best to describe why I chose Geriatrics and why medical trainees should consider it as a career path.

The oldest of the US "baby boomers" generation turned 65 on January 1, 2010. Every day for the next 19 years thereafter, another 10,000 baby boomers will turn 65. To put this in perspective, this is the equivalent of a Boeing 747 airplane full of baby boomers turning 65 every hour. By 2030, the country's population of "senior boomers" will double to an estimated 71 million individuals.

Making Most of Surgery Rotations

Question

When rotating on a busy surgical service, how can I be helpful and show that I am interested without getting in the way?

Response from Sarah N. Bernstein, MD Resident, Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital, New York, NY

In the surgical subspecialties, physicians are usually busy from dawn until dusk, and you may find it difficult to find your place and understand the expectations of the rotation. Just remember that your primary goal is to learn and get as much exposure to the subject as possible. If it is not an area of interest, remember that this may be the only time in your career when you observe particular aspects of this area of medicine. Therefore, you should still try to see as much as possible. If you plan to pursue surgery as your specialty, this is your time to learn the basics and show your enthusiasm. I'm sure each teaching hospital is a little different, but here are some general pointers:

Scheduling Your 3rd Year Clerkship

Question

In what order should I schedule my rotations? What are the best strategies?

Response from Megan L. Fix, MD Assistant Professor, Tufts University School of Medicine; Director, Medical Student Education, Maine Medical Center, Portland, Maine

Your third year of medical school can be exciting and also daunting. Many students ask what the "best" schedule is for their third-year clerkships. Although there is no right answer, there are a few guidelines that can be helpful.

The Forsaken Specialty

PhotoCredit: guardian.co.uk

Abstract and Introduction
Introduction

As a medical student I found that most other students thought that psychiatry was not a true profession—the consultants sit and sip tea, talk nonsense, and nobody ever seems to gets better. No blood test confirms what is wrong. No imaging shows the diagnosis. Simply put, ward rounds that consist of sitting in a room and chatting just didn't seem like "real medicine" to most of my peers. Psychiatric patients were people to be mocked, feared ("you were left alone with them?"), or ignored. Revision for objective structured clinical exams and written papers was left to the last minute because it was "only psych."

I don't know why I thought this would be different when I qualified. Perhaps the "doctor" title would equate to being surrounded by those who understand, appreciate, and respect psychiatry? Goes to show that a label does not define how you act.