Self Reflection

My family medicine rotation was for 5 weeks at Citi-Med. It was not the typical family medicine rotation but, in some ways, had aspects of what one would see in a normal family medicine rotation. Many of the cases I saw were musculoskeletal cases usually involving some form of trauma and legal aspect. I did have some positive experiences from this rotation which I believe were beneficial to my growth as a young PA student.

At this rotation, I had more “independent” practice with patients than in some other rotations where I was shadowing and was partially involved with patients. During this rotation, I was allowed to see patients and conduct the entire interview process and physical exams independently. After seeing the patient, I would then present the case to my preceptor who would then come over and review the things I did and repeat the physical exam on the patient to confirm my findings. In addition, I was also able to learn to make assessments and plans for the patient which would either be approved or modified by my preceptor as needed.

I enjoyed being able to work independently during this rotation because I have been wanting an opportunity to challenge my critical thinking skills and develop my ability to create a suitable plan of care for patients I see. As a student, it is important for us to have guidance, especially at the start of our rotations, but I feel that if we are mostly guided all the time through the patient cases (even later on in our rotations after much experience) it does not give us the opportunity to provide full patient care. To explain what I mean, I will use one of my previous rotations as an example. Much earlier during my second rotation I was mostly shadowing preceptors and assisting with patient care which was a great experience as I was still new and learning. While working together with my preceptors I thought I had a grasp of forming differential and creating assessments and plans for patients, but I realized when given the opportunity to evaluate a patient fully on my own I did not have a solid idea of what I was doing and why. I had difficulty forming my own differentials and developing my own assessment and plan independently. It was at that time I realized I needed to find more opportunities to work independently ever so often so that I can have enough confidence and knowledge to understand the patient presentations and form my own thoughts and plans. I was able to get more opportunities to do this at my family med rotation.

Lastly, as is the case with family medicine, I was able to provide care to the same patients while on this rotation and was able to follow up on their improvement and needs as they were being cared for within and outside this facility. I was also able to make and send referrals for patients to be seen at other specialty facilities as needed. So, although this was not a normal family rotation where I got to see a variety of patient cases with different disease processes (such as infectious disease, GI disorders, etc.). I was still able to have some aspects of family medicine and provide some important aspects of care such as counseling etc.

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