Rotation 7 Reflection

Ambulatory medicine, or urgent care was one of the most enjoyable rotations yet. I learned a great deal about common illnesses and how to examine and treat them quickly and efficiently. I was also able to start tackling one of my biggest weaknesses – forming assessments and plans on my own.

Working at the Crown Heights location of Statcare was very fast paced and required enough stamina and diligence to last 13 hours. It wasn’t uncommon to see upwards of 300 patients, the majority of which were there for Covid 19 screening. I frequently helped the medical assistants and scribes with these rapid and PCR tests in between seeing the urgent care patients. This was also my first experience working with a scribe, whereby I would see a patient and they would document some information in the HPI that I would edit afterwards. I also learned how to document short and concise HPIs and physical exam findings, that would hopefully leave no room for misunderstandings when read by other providers.

            Urgent care was also a great rotation to work on my number one weakness – formulating plans and treatments. There are some things that seem simple and obvious but aren’t necessarily taught in class, and they’re instead acquired through clinical experience. Knowing which medications to prescribe for a condition may resemble our vignettes and scenarios from class, but knowing the dosage, the number of days, and when to have a patient follow-up is something that takes many hours of practice. I found myself excusing myself out of the room in order to go look up the typical first line medication course for basic things like urinary tract infections or persistent cough. I knew which medications I wanted to use, but beyond that I felt clueless. After seeing roughly 35 urgent care patients a day however, I think I gained more perspective and ability to know roughly when the patient should be seen again by a provider.

            Urgent care was also a great place to practice focused exams and some procedures. I managed to do blood draws, laceration repairs, administered dozens of intramuscular and subcutaneous injections, and strep throat swabs.

            I really enjoyed my urgent care rotation, and I can fully appreciate the difficult task that these PAs face, as there are no attendings around to ask for advice like in the emergency room or internal medicine. I’ve observed that the PAs have a great deal of autonomy and practical skills obtained from previous work in the ER or through many hours of experience.

            I would like for my colleagues and preceptor to realize that I did my best to see as many patients and do as many exams as possible, and that I’ll continue to diligently research current recommended treatment plans.