During my site evaluation I chose to present H&Ps that were not only from different types of patients, but also interesting and unique cases. At the first site visit I presented an elderly patient with hypertensive urgency, and a young woman with sickle cell crisis and COVID-19. At the second visit I presented a diabetic patient with medication induced pancreatitis.

After the first site visit the feedback I received was to try and be the first person to interview a patient, this proved to be difficult because the patients who are admitted to the internal medicine floor often come from the emergency room or from another part of the hospital. It is rare for us to be the first place that a patient is seen within the hospital. The other feedback I received was to be more thorough with my physical exam findings, specifically in the context of the neuro exam in the patient with hypertensive urgency. This was an important part of the workup because we were making sure to rule out infarct or hemorrhage. I made sure to be more thorough when documenting the exam and imaging findings, and I plan to be more thorough when performing a neuro exam (or any exam) going forward.

I presented drug cards from medications that were most commonly used. Many were antibiotics, a few were used in all of the COVID-19 patients that were admitted with our team. Unsurprisingly, a lot of the medications overlapped with the 2 classmates that were also doing internal medicine. While the description and details of the medications was the same, there were a few surprising details when we were discussing the medications. 1 in particular that stood out for me was about Azithromycin. One of my classmates who was at the same site, on the same floor, but with a different team mentioned that they give this antibiotic to all of their COVID-19 patients. The team that I worked with did not do the same thing; often they would already be on this medication when they were admitted to the internal medicine floor however the attending that I worked with would discontinue this medication in favor of remdesivir and dexamethasone.

Going forward during my site evaluations I plan to be more succinct when presenting the noncontributory history, and as mentioned earlier plan to be more thorough with the physical exam. 

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