This past week I had two exams and gave two presentations. The exams were in Advanced Technique and Jurisprudence. The advanced technique exam was an open-ended clinically oriented exam, in which the questions were how we would diagnose and treat a patient who presents with a specific set of symptoms. When I first started the program at NUHS, these kinds of questions were pretty difficult, but now that I am in clinic I am able to put all the information I have learned over the past 6.5 years of post-secondary education to use. My clinician has been giving me feedback on what I need to do better and because of that I now understand how some things that may be overlooked in a history, could actually be vital to the diagnosis. I earned an ‘A’ on that exam, and I credit the constructive criticism I have been receiving in clinic for excelling in the clinically based case study questions.
The other exam was in Jurisprudence, a class that is all about the laws and regulations that affect chiropractors at the national and state levels. The exam covered practice guidelines, license requirements for the state of Florida, record keeping, coding/billing, and patient consent. The curriculum at NUHS really covers all the bases from how to be an effective diagnostician, to the finite details of running a practice in accordance with the law. I don’t know how I did on the exam yet but I do know I have learned a lot in that class and there is still more to know.
In Clinical Natural Medicine, we were each required to give case presentations from chiropractic offices. I used a case from my chiropractor at home that was an excellent lesson we could all benefit from. The case was about a man who came in while the doctor had a full waiting room. The patient appeared to have a normal shoulder injury and associated neck pain, but when the doctor heard the history he knew something was going on. The patient had lost his balance and bumped into the wall. When I mentioned that to the class everyone was interested by it and wondered why one would lose their balance.
I then told them the next detail the doctor heard, the patient wet the bed the night before and stumbled out of bed when this happened causing him to fall on an out-stretched arm. The patient was injured but the question was how was he injured? Why did he lose his balance? The doctor consulted the patient’s primary care doctor and referred him to the ER because he suspected a neurological problem caused his loss of balance and continence. The patient went to the emergency room and he had emergency surgery to remove a brain tumor. Despite a full waiting room and a typical shoulder injury presentation, the history made him aware there was something else going on. My colleagues made the same conclusion as my chiropractor that the patient needed a referral for possible SOL.
It was a great lesson. The professor was able to relate to the case, and said in real life, abnormal conditions will present in your office when you least expect it. One cannot let a full waiting room and insignificant physical presentation lead a physician to a quick diagnosis. NUHS has done its due diligence since everyone would have made the same call as the doctor and saved that patient’s life.
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