Learning dosing: In class or at rotations/residency

[aldolase]

For the practicing pharmacists out there, did you learn the dosing on the go during rotations/residency or memorized in didactic classes. There are just too many conditions to memorize dosing/titrations so was looking for advice. Especially from a clinical pharmacist point of view since I am planning to do residency.

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[pharmdpharmd]

Neither. You learn dosing by staffing in a hospital or working in retail. If you are a resident and have to look up every single dose, you will quickly fall behind. Didactic lectures are a complete waste to learn doses from (you can memorize them, but will forget them very quickly if you are not using them)

Most programs in residency will make you solely staff for the first month though and some will make you do it even 2-3 months. So you learn a lot then. But nothing replaces actual work experience though.

 

[Sparda29]

Most normal doses I learned simply by working as a tech/intern at CVS and the LTC pharmacy where I worked after leaving CVS. Rest of them I learned on the job working as a hospital staff pharmacist.

 

[pharm B]

Most programs in residency will make you solely staff for the first month though and some will make you do it even 2-3 months. So you learn a lot then. But nothing replaces actual work experience though.

Is this accurate? I don't think most put their residents to staffing for a month after getting licensed. Granted, the number of programs I'm familiar with is small, but I didn't think there was that much time dedicated to staffing for the majority of residents. In my small program (so not generally applicable), we only staff weekends as scheduled (and we get trained on weekends).

Neither. You learn dosing by staffing in a hospital or working in retail. If you are a resident and have to look up every single dose, you will quickly fall behind. Didactic lectures are a complete waste to learn doses from (you can memorize them, but will forget them very quickly if you are not using them)

I always hated when professors wanted us to know dosing for obscure drugs. I think it's more important (in general) to know where to look and when dosing is different (based on condition being treated, renal status, etc). On rotation, being familiar with/knowing dosing for a lot of medications just comes with time.

That being said, if a medication is used all the time, know the dosing strategy. In school or on rotation, commit it to memory.

 

[pharmdpharmd]

I was counting before licensure as well

 

[PharMed2016]

After graduation, when your a practicing pharmacist.

 

[confettiflyer]

Both - I expect my rotating inpatient students to have a baseline knowledge of kinetics for staples like vanco, aminoglycosides, and warfarin.

I'll spend a few days giving them the practical/quick and dirty way it's actually done then hone in on the clinical judgment aspect of it (aka treat the patient, not the number kinda thing).

By week 6, I expect full proficiency in the whole process such that I just have to sign my name to the chart docs.

Most of my students will start residency (or, less commonly now, staffing) just needing a week to learn the local protocols and quirks

Unfortunately, I have to contend with a) having students with a poor baseline or b) poor capacity to incorporate what I'm teaching.



baseline

 

[confettiflyer]

Oh, for general dosing (not part of a traditional kinetic service)....it's hard to explain as everyone's baseline is different. I knew a **** ton about neuroleptics and antipsychotic medications but knew jack squat about warfarin and aminoglycosides (no one used the damn things while I was around) coming out of school.

I filled in the gaps through a combination of resident rotations and staffing.

There's still a bunch that I don't know, so I look it up, there's just too many. I find that after looking it up 3 times, it just sticks.