Archive for tag: tri 9

Intern Skills - Physical Therapies and Manual Manipulations

Hi, everyone!

I thought that, starting this week, I would share a bit about the therapies and skills required of each Intern before graduation.

This week, since we here at NUHS are historically a chiropractic school, I will start with the obvious requirements of physical therapies and manual manipulation (or adjustments) skills.

Physical therapies are any therapy for the body including soft tissue (muscle, tendon, fascial) therapies, ultrasound, cold laser, phonophoresis, or massage. These therapies can range from treating ganglion cysts, scars, sprains, strains, swelling or tissue damage.

Manual manipulations (adjusting the skeletal structure) include manual adjustments of the spine and extremities (arms and legs). We are taught a tremendous amount of physical medicine while here at NUHS and the training came in handy as one of my first patients as a ND intern required both physical medicine and manual adjustments.

I have been fortunate to complete all of my physical medicine and manual manipulation requirements after only fours weeks into 9th trimester. The opportunity to get this much practice with physical medicine prepares me thoroughly for understanding the proper feel of a patient's musculoskeletal structure, based upon their age, activity level and level of injury. I feel that this will give me a competitive advantage versus other NDs in the marketplace, based upon the scope of practice in the state where I settle.


I have shared another pic of the swan and duck families who have grown and thrived on Lake Janse this past summer. Soon, the ducks will migrate south and the swans will return to their winter lodgings to rest and get ready for another year of scaring away the flocks of geese that attempt to invade our little campus on their migrations.

Next week, I'll share more about the skills that naturopathic interns need to master prior to graduation. Until then, enjoy the newly birthed autumn season

Clinic Routine

Time to settle into the weekly routine again, albeit things are a bit different this trimester. With class and clinic rotations 5 days each week, along with work on the side during some mornings and each weekend, time is a precious commodity.

This is what a typical clinic schedule looks like for a 9th/10th trimester ND Intern.

Monday 1:00 p.m. - 7:00 p.m.
Tuesday 11:00 a.m. - 5:00 p.m.
Wednesday Noon (Grand Rounds); 1:00 p.m. - 7:00 p.m. (Clinic)
Thursday 1:00 p.m. - 7:00 p.m.
Friday 7:00 a.m. - Noon

During clinic, we sit down for "preview" each day to discuss upcoming patient cases and strategies for best helping our patients in a roundtable discussion. This is a "safe zone" to bounce ideas, debate the best strategy amongst peers and under the guidance of our clinicians. The idea is to share knowledge through discussion in a practical manner without judgment. This approach allows us to discuss all treatment modalities, their benefits, drawbacks and limitations, then move forward with the best overall treatment for our patients.

After preview, we see our patients, chart, research, develop and bring our suggested treatment plans to our clinicians, who vet the plans and approve or amend as required for the benefit of our patients. We must complete all of these tasks during our shifts as HIPPA regulations dictate that no patient records leave the premises. We learn quickly to be accurate, concise and have all work completed by the end of the day out of necessity.

Even though this seems like a lot of work, clinic is a fun, nurturing environment that I look forward to every day. The smiles on patients' faces when they begin to feel better, heal and share is priceless! The patience, knowledge, skill and care that our clinicians share with each intern on a daily basis set an excellent example for all of us as future doctors.

Me with Carrie (left) and Juanita (right), both 6th trimester ND students

The photo I'm sharing this week is of two friends and me. I was printing something at the library the other day and ran into them after having not seen either for about two months! This made me realize that I was separated from the rest of campus now that I'm in clinic and needed to visit my old friends still in their clinical courses. Challenge accepted...

Main Clinic

Hello to everyone! I hope you enjoyed your summer and are ready for what appears to be a great fall season!

I was able to relax a bit, recharge, hike some trails back home, and be the first person at the top of Mt. Mitchell (highest point east of the Mississippi at 6,683 feet) for sunrise one morning during a hike. The view was incredibly beautiful and being able to sit, think about the past few years of school, the challenges, rewards and decisions to come while watching the sun rise over the southern Appalachians was one of the more peaceful moments of the past few years of my life.


At the same time during the break, I caught up on some personal reading that I had put off for over two years as well as some reorganizing, consolidating and reducing for the inevitable move in about 8 months.

Now, for the homestretch in clinic!

Here is how the Naturopathic Clinic is currently structured:

  • 6th Trimester - Observation
  • 7th Trimester - Hydrotherapy Shift
  • 8th, 9th, 10th Trimesters - Main Clinic

Previously, 8th Trimester interns could only see other students, not the general public. This left many students with seeing a new intern every four months as ONLY 8th trimester students could see other students. So, when an Intern moved to 9th trimester, they would transition the student patient to a rising 8th trimester intern.

Now, students and the general public have the opportunity to see interns beginning in 8th trimester, and, if the condition warrants, remain with that intern for up to a full year. This helps to build rapport and trust with the patient as well as helps the Intern with seeing a resolution to more ailments than was previously possible.

Finally, the most appealing aspect to this new structure, in my opinion, is that now our naturopathic medicine students are spending half of their education in a clinical setting! Again, in my opinion, nothing trumps experience and "hands on" training when learning a new skill!

Time to get back to the books! Talk to you next week!