u/Jweiss818052

I'm trying to figure out whether a recent medication error with my grandfather was just an unfortunate mishap, or if it reflects a problem with his endocrinologist's care that should lead us to consider switching providers.

Here's what happened:

My 87 y/o grandfather with type1 DM for 60 years was supposed to switch from Humalog to Novolog (both short-acting insulins) at the end of March, and at the same time start Soliqua as his basal insulin.

Instead, he ended up taking both Humalog and Novolog, thinking those were the two insulins he was supposed to be on, and never received/started the Soliqua. i.e. instead of a Basal-Bolus regimen, he was effectively taking two nearly identical short-acting insulins without basal coverage.

This medication change so happened to occur just before my grandmother was hospitalized, which is relevant both because he was likely inconsistent/variably compliant with his already-incorrect regiment for the month she was hospitalized, and also because I moved in last week to help care for her after discharge.

I'd never seen a continuous glucose monitor before and didn't even realize he had one (which, in hindsight, should've been obvious). So it wasn't until about 2 days in when I finally checked what in the world that incessant, annoying beeping was that I found the monitor flashing "danger: 37 BGL."

It happened again the next day, so I had him walk me through his regiment and proceeded to make an urgent appointment to his endo 3 days later, keys in hand ready to take him to ER if he became symptomatic. In that time his sugars swung wildly from 40s to 300+ daily. He thought it was normal, just treating the lows with honey and ignoring the highs. (Oh, and that was for when he actually heard it beeping, which was maybe 20% of the time since he stubbornly refuses to wear hearing aids and can't hear the damn thing).

If I hadn't been staying with them, the only way I see that being caught would've been either in the ER after a hypoglycemic emergency or if he made it the 6 more weeks until his next appointment.

I understand that medication errors happen and that responsibility is shared across patient, physician, and pharmacy. But this feels like the kind of error that shouldn't be able to happen, especially not one that goes undetected for over 2 months, essentially by chance.

Bottom line: Was this within the bounds of reasonable care, or does it suggest a gap in oversight that should factor into whether we continue with this endocrinologist?

Would really appreciate insight, especially from clinicians or pharmacists familiar with how these systems are supposed to work.

I’ve been thinking a lot about the gap between what people going through cancer, including those who care for them, experience and what others around them are able to understand or respond to. This subreddit has been so valuable in offering glimpses into those experiences, so I’d love to hear it directly from anyone open to sharing. For example:

What do you wish people around you really got?
What did they do that felt supportive, and what didn’t?

And maybe most importantly, What do you wish you could fully say to them, if there were no barriers?
I’d really value hearing anything you’re willing to share.

I’m a 4th-year IMG applying in the upcoming 2027 cycle, and I just found out something that honestly surprised me.

My school does not include 4th-year clinical electives (including U.S. rotations) in either the MSPE or the official transcript. That means that despite doing multiple U.S. rotations at strong academic institutions and receiving very strong evaluations, there’s no formal, centralized documentation of where I rotated or how I performed.

Therefore, As far as I understand, the only places this experience might show up are:
- Letters of recommendation
- My ERAS experiences section
- Maybe something I mention in my personal statement

I put a lot of effort into performing well at these institutions and even had extra weeks of rotation with the understanding that USCE is important for matching and and thus with the assumption that it would be formally reflected somewhere in my application, not only in my LOR.

How much do program directors actually value U.S. clinical experience if it’s not explicitly documented in MSPE/transcripts? Or are LOR essentially the only vehicle through which that experience “counts”?

Appreciates any and all insight/advice/perspective anyone has to offer. Hoping one of you has the Hail Mary insight that makes me feel less silly for having busted my butt for something that basically won’t show up anywhere in my application.