My family medicine rotation was very different from my previous two rotations, and it was also my first outpatient setting I was able to work in. My first week was the toughest week as I was instructed to take blood, ekg, urea breath test, urine drug screens and it had been awhile since i’ve done these. I was also with the patient the majority of the time and was put in situations where I was the primary and would write the HPIs and even come up with a plan . By the end of the rotation though, I was much more comfortable in every working up and building an assessment and plan for the patients.

As I was stating before I gained a lot of experience in this rotation as I was able to perform Ekgs, venipunctures etc. Which I’ve learned how to do but because of my last two rotations I wasn’t able to do many of them. In this rotation I did see and then perform Urea breath tests being done on my patients as well. The overall process consisted of having the patient blow into two bags. One before with no drink before hand and then the second with  13C-urea tablet and citric acid powder. Besides that I was able to perform multiple ekgs and now feel very comfortable performing each.  The same could be said about venipunctures as I did try doing some in my previous rotations but would sometimes miss a vein. With the amount Ive done at this rotation, I definitely am less anxious when trying to take someone’s blood

Being in an outpatient setting was also a very new experience for me as well since my last two rotations were both inpatient. But I was still able to follow up with my patients as well which added to my experience. For example when my patients would complain about shoulder or abdominal pain, I would send them out to get either an ultrasound or x-ray. With a follow up set to about 1-2 weeks, I was able to get the charts for the diagnostic imaging and speak to my patients about the results of those same images. From there I would add this information into my assessment and plan.

I think I definitely improved on my overall PE throughout this rotation as well. Even though they were mainly focused on PE throughout my time there, I improved and even refreshed my memory on some of the special exams that can be done on patients. I was very surprised to see how often patients with lumbar radiculopathy would have a positive straight leg raise test.Even though we are taught this in books, actually seeing patients elicit pain as I would do this exam was fascinating to see. 

My next rotation is long term care, and my goal is to learn more into managing chronic conditions and making care more comfortable for the patient population. I’ve had some opportunities at FM rotation to look over some patients with chronic condition and have seen how in-depth you must go to address the multiple complaints that these patients may present with.