Angela Shih OB-GYN W3D1

Today was my first day in Ob-Gyn with Christine. We met Dr. Cao (Director of Ob-Gyn unit) in the outpatient department and observed him for the morning. In the OPD, we saw all different kinds of cases such as candidiasis infections, Trichomonas infection, dysmenorrhea, ovarian cysts, PCOD....etc. Dr. Cao saw over 30 patients in a little under 3 hours and more than 1/3 of the patients were in for a pap smear.

During our observation in the outpatient department, we learned several tips in reading ultrasounds. For instance, black=water density, gray=soft tissue density, and white= bone density. We were able to observe normal uterus and bladder anatomy vs. diseased ones. Dr. Cao mentioned that ultrasound is a very simple diagnostic tool to use at bedside because it is so fast and easy. In ultrasound, the most common abnormalities observed are tumors, cysts, and abscesses. According to Dr. Cao, the most common soft tissue masses observed on US are myomas (uterine fibroids) and the most common water density masses are ovarian cysts. If a cyst becomes infected, it can develop in to an abscess.

Christine and I saw MANY pap smears performed today. I was surprised at how willing these women were to allowing two strangers observe the procedure. Considering most of the women were middle aged and older, I had expected them to be more conservative. I was also surprised so many women were getting pap smears for cervical cancer screening so I asked Dr. Cao the reason. He explained that in Taiwan, women over 30 could receive pap smears for cervical cancer screening for free. In addition, the hospital offered a free dish or laundry detergent if they got a pap smear. That alone was quite a good incentive already, but they also mentioned they could get another free detergent if they got a mammogram done in the hospital. I thought that was a fun and great way to help get women more interested in their health. In the US, women are encouraged to get pap smears starting at age 21 and once every 3 years once they are 30. However, women in Taiwan are mostly encouraged to start getting pap smears annually starting at age 30.

Another interesting thing I learned with Dr. Cao today was the difference in terms used in Taiwan vs. US. For instance, white discharge caused by candidiasis infections is called cheesy discharge in the US. However, in Taiwan they call it tofu bits discharge.

Also, the generic drug names used in Taiwan were also different. For ex: Dafrin is the trade name for a hydrocortisone drug used to treat yeast infections. Dafrin is only used in Taiwan.

The day ended with a presentation by Dr. Cao on the most common Ob-Gyn diseases. It was really nice of him to take time out of his schedule to teach us. It was especially helpful as we have not yet learned too much about the reproductive system.