1. How could the knowledge I’ve gained here be applicable in other rotations/disciplines?

Some of the knowledge that I gained in this rotation that can be applied is the ability to make sure that I should review the patient’s chart in its entirety before going to see the patient. There have been multiple examples during this rotation in which I was not able to properly assess patients previous problems that they came in for in previous visits. A specific example of this occurred when a patient came in for a follow up on their blood pressure but since I did not review the patients chart properly, I missed the colonoscopy report that was recently sent over to be able to discuss it with the patient. This also helps to maintain and develop good habits of continuing care.

2. Skills or situations that are difficult for you (e.g. presentations, focused H&Ps, performing specific types of procedures or specialized interview/pt. education situations) and how you can get better at them

A skill that is still difficult for me is being able to gauge when patient’s stories do not explain their symptoms. An example of this occurred when I was seeing a hypertensive diabetic that was know to the preceptor as being a poor compliance patient but I was not aware of this. Patient was already on several medications to control their DM and HTN but was still hypertensive and hyperglycemic. Upon interview of this patient I was told by the patient that they are very compliant with their medications but in reality, they were not. Working under these pretenses, I suggested to the preceptor that my plan would be to increase the dosage of this patients’ medications. The preceptor questioned me as to why I would do that and they pointed out that many patients will state they are compliant with their medications but really are not. I plan on being able to develop better interview skills that allow me to suspect that the patients are not compliant with recommended treatment.

3. Managing new types of patients and the challenges that arise from that

One of the new types of patients that I learned to manage were patients that were rnot compliant to medication or life style modifications. These patients were usually seen often in family medicine office and were well handled by the preceptor that they would state they would start being more compliant. I believe one of the best ways to accomplish this is to properly explain the patients their diseases and the sequela for not adequately managing it.

4. What do you want to improve on for the following rotations? What is your action plan to accomplish that?

For my next rotation I would like to improve on being bit more proactive in general. I believe that sometimes when I start out at a new rotation site it becomes daunting and I prevent myself from taking full advantage of the experience. One example of this is for family medicine rotation since I was too afraid I was confused for a week or two on what and how the preceptor wanted me to patients. I believe this can be rectified by initially speaking to the preceptor and knowing what they expect and how we can meet their expectations.

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