Self Reflection (Rotation 2)

My second rotation was at NYPQ for Internal Medicine and my overall experience at my second rotation was great. My first rotation was in a private office, and while this rotation was at a hospital. Although these are my first two rotations, I think my experience so far has added confirmation to my interest in working in a hospital setting.

During this second rotation, I had the opportunity to meet different types of patients with different case presentations (my first rotation was outpatient and, in a PCP setting so many of the patients came in for things such as routine physicals and vaccinations, but this made sense as the population was also pediatric, and many did not have profound issues.) At some point, the plan for care became quite redundant and repetitive as the majority of the presentations were routine care. I think my second rotation gave me more opportunities to see different cases and the opportunity to think more critically about patient presentation, care, and approach to treatment. I also had the opportunity to spend a week seeing stroke patients which was quite interesting. I was required to obtain certification for the NIH stroke scale which is something I have now added to my portfolio. I was able to conduct NIHSS assessments on patients in addition to the overall physical exam. The doctors and PAs on the stroke team also took the time to teach me about the different types of strokes and patient presentation as well as what to look for and see in imaging. It was both a very hands-on and educational experience.

For some cases, I was able to see patients right from their presentation to the ED, so this also gave me the opportunity to start from the initial patient presentation to draw up my own differentials and plan for acute care and care during admissions. I enjoyed these cases more because I got to be engaged from the very beginning. I am aware that continuing care for a patient is very important, but I felt that in some cases the suspected diagnosis was already either established and, in some cases, continuing care involved continuing the plan that was established. Nevertheless, I know there is still ongoing monitoring and treatment for these patients as their condition could also suddenly deteriorate or a new finding may present itself. I think I just more so enjoyed being present from the start (and sometimes to the finish) during the care of a patient.

I truly enjoyed this rotation because I had the opportunity to follow many different PAs (assigned and unassigned). The PAs were also very willing and happy to invite us, students, to come to watch, participate in or perform different procedures (including lumbar punctures) which was great. I appreciated having the opportunities to work on my procedural skills and I appreciated the constructive criticism and positive feedback from the preceptor and PAs. The PAs were also very willing to explain and educate me where needed which I enjoyed. I enjoyed the opportunity to learn from the PAs and even nurses.

My experience at this rotation increased my confidence in my abilities (such as critical thinking, procedural skills, patient interaction, etc.) and gave me more confidence in taking on more initiative and approaching patients without supervision. It also motivated me to want to learn more, ask more questions and help the teams to ensure patients and their loved ones are being properly cared for as it can also be a scary experience for family members, spouses, and friends to see their loved ones in a vulnerable position.

Lastly, I also got to work with EPIC which I hadn’t done before this rotation, so I am happy about also being able to expand my experience with the use of other EMR systems. Overall, I think this rotation was enriching for me in many ways as mentioned above and it gave me a much-needed confidence boost in my capabilities and skills. I hope that with my next rotations I will be able to apply what I have learned here and be able to take on more responsibility and initiative when caring for patients.