On my second rotation in Family Medicine, my site evaluator was Janetta PA-C. I presented H&Ps written up on patients I had seen at Dr. Smalls Office a family practice in Jamaica. On my mid-rotation evaluation site visit, the first H&P case was of a 42 year-old female who presented to the clinic complaining of a left eyelid drooping and facial weakness. The reason I chose to present on this case was because it was one of the first cases I saw. I thought it was unique also because my mom has had Bell Palsy twice and she never was properly diagnosed nor treated. For this case, I automatically knew what it was and I told the doctor and she was impressed. We tested various cranial nerves and the patient clearly had acute symptoms that made the diagnosis clearer. Upon presenting, some of the differentials I mentioned were stroke, MS, otitis media, Guillain Barre, Ramsay Hunt syndrome, and Lyme disease which Janetta concurred on. One advice Janetta gave in terms of my presentation was stating the NIH score, such that the audience knows for sure that was stroke was ruled out. During the visit, Janetta tested us on pharm cards, one recommendation she gave was the importance of knowing contraindications, because there are many drugs for an illness but knowing what can and cannot be given is also important for the safety of the patient. Other cases I presented on was influenza and tinea corporis. We got immediate feedback on our presentations, Janetta said I did a good job, she advised to write out abbreviations unless they were medical abbreviations, so that any person reading our HPI would have a good knowledge about the case. On our final site visit, I presented on a patient with flu like symptoms. This patient was started on Tamiflu but we had another patient we started on the one dose Xofluza which my journal paper was about and it was an interesting discussion we had on that.
The other students I presented with was Merin who was rotating in Surgery at QHC. It was nice to see a familiar face, because presenting my H&Ps became a bit less anxiety provoking, however I think I am getting better at making eye contact and using my voice to emphasize certain elements. Merin does an amazing job at presenting her patients. It was interesting to see because her HP consisted of a full thorough assessment and plan, since the patient was eventually taken for surgery after presenting with acute pancreatitis, it was interesting to hear about that continuous care as well.
Going forth to my next rotation in OB/GYN, to better myself I will make sure to be consistent in terms of history and physical. Since I will be focusing my physicals in one area, I want to be as thorough as possible, when asking pertinent information such that I know what the differential will be. Also, when presenting I would like to be more detailed so the reader/audience understands what is going on as well. I will be looking up more differentials and treatment plans, because in a hospital setting things can be more fast paced and I want to make sure I am not missing anything.