【學海計畫 — 實習心得】(English) 科羅拉多大學安舒茲校區 （CU Anschutz）：林旻柔
計畫：學海築夢
國外實習機構：科羅拉多大學安舒茲校區 (University of Colorado Anschutz Medical Campus)
學生：林旻柔
臺北醫學大學 藥學系 博士班 ㄧ年級
一、緣起
My primary research area has been in genomics studies. As a pharmacist, I have always wanted to combine my academic passion with clinical practice. When I discussed this vision with Dr. Shawn, she introduced me to Dr. Lee, who is a clinical pharmacist specialized in pharmacogenomics at University of Colorado Anschutz Medical Campus. Dr. Shawn recognized the potential synergy between my research interests and Dr. Lee's expertise, and she played a pivotal role in initiating this collaborative program. With Dr. Lee's guidance and support, we have embarked on a journey to integrate genomics into my pharmacy practice, and I am enthusiastic about the opportunities and advancements this partnership will bring to our field.
二、國外實習機構簡介
The University of Colorado Anschutz Medical Campus is the largest academic health center in the Rocky Mountain region. It is globally recognized for its comprehensive research, teaching and clinical programs in medicine, dentistry, pharmacy, public health, physical therapy and nursing. UCHealth is a Colorado Front Range health system that includes 13 hospitals serving Colorado regions and has 1.4 million outpatient visits per year.
三、國外實習企業或機構之學習心得
My learning objective is to learn the fundamentals of clinical pharmacogenomics (PGx) implementation, teaching and research. During my 2 months program, I’ve attended the AACP annual conference to present my poster and learned a lot about pharmacy education in the US. The conference covered multiple issues related to pharmacy education, and they talked about the update of COEPA (Curricular Outcomes and Entrustable Professional Activities), which is a crucial framework for defining and assessing the core competencies and practical skills expected from pharmacy students as they prepare to enter the profession. I felt honored to have my poster selected as the best in the graduate student category, and I was presented with a certificate along with a monetary prize.
I also had one month of PGx clinical rotation which I was allowed to see patients with Dr. Lee. Here, the PGx service was established in 2018 for executives and self-referred individuals. I had the valuable opportunity to observe the operations of a PGx clinic, learning about various aspects such as establishing the visit structure, effective patient communication, doctor interactions, selection criteria for testing companies, considerations in choosing the right company, and insights into the billing model, among other essential aspects. I spent time shadowing Dr. Lee as part of my learning experience.
During this time, I observed patients in either their first or second visit and helped prepare reports about their PGx tests. In just a month, I interacted with 9 patients. Three were healthy and curious about their genetic results. Four were taking psychiatric medications and experiencing side effects or ineffectiveness. One had polyneuropathy, and one identified as a hypermetabolizer. To better understand the test results, I studied guidelines from CPIC (Clinical Pharmacogenetics Implementation Consortium) related to cardiovascular health, psychiatry, pain management, gastroenterology, and hypersensitivity reactions. I also got acquainted with resources like PharmGKB and PharmVAR to gather comprehensive PGx information and learned about CYP2D6 phenoconversion. While my research typically focuses on genomics and immunogenetics, my clinical skills had become rusty as I hadn't practiced pharmacy in years. This opportunity to apply PGx in a clinical setting was incredibly valuable for me. It also sparked my interest in the idea of starting a PGx clinic in Taiwan.
In addition to my PGx clinical rotation, I successfully completed several mini-projects. These included conducting comparisons between various PGx testing companies, performing statistical analyses using R and curating data for various purposes. I also conducted literature searches on topics such as SSRI (selective serotonin reuptake inhibitor) medications, warfarin algorithms, the KIF6 genetic variant and statin response, and studies related to PGx in Taiwan.
四、國外實習之生活體驗
I made a lot of new friends in the United States, including PhD students on campus, roommates, and friends of my new acquaintances. We had a fantastic time exploring the country together. We went hiking in beautiful natural parks, enjoyed camping adventures under the starry skies, explored the vibrant downtown areas, and indulged in delicious local cuisine. These shared experiences deepened our friendships and created lasting memories.
【與課程教授和同學一同觀賞洛杉磯道奇隊與洛杉磯天使隊棒球賽】
五、國外實習之具體效益
During my study period in the United States, I gained a lot of new insights and, at the same time, experienced cultural differences. While interacting with locals, I often felt the distinctions between Asian and Western cultures. After the pandemic, many work patterns in the United States shifted to remote work. I appreciate their emphasis on online meetings and punctuality, as they show a great respect for each other's time. Their clear delineation of responsibilities and flexible working hours for students, along with more egalitarian relationships with professors, are aspects I believe Asian societies can learn from. On the flip side, there is a strong emphasis on individualism in the United States. People are less likely to compromise their own ideas, which can sometimes lead to a need to assert oneself in interpersonal relationships, potentially lacking in consideration for others. Nevertheless, I gained valuable insights from this. It allowed me to broaden my perspective and appreciate the unique strengths and weaknesses of both Asian and Western cultures. These experiences have not only enriched my academic journey but have also equipped me with a more nuanced understanding of cultural diversity and its impact on various aspects of life, both personally and professionally.
Furthermore, this wonderful experience has sparked my consideration of the possibility of working in the United States after graduation. I aim to dedicate one or two years to serve as a postdoctoral researcher, with the goal of enriching my research skills, contributing to publications, and fully immersing myself in a new cultural environment to draw inspiration from these experiences. This opportunity has proven to be exceptionally valuable, providing me with the chance to gain fresh insights into the implementation of PGx. As a result, I've developed a profound appreciation for international academic and cultural exchanges, and I'm eagerly anticipating the chance to continue enriching my academic journey through similar opportunities in the future.
