I really enjoyed the Ambulatory Medicine rotation and I feel like a learned a lot. I have never worked in an urgent care before and the flow was unfamiliar to me. This was different from my previous rotations because it was at an outpatient urgent care office whereas all of my prior rotations were at a hospital. It was also different because I spent the majority of the 4 weeks working exclusively with 1 provider, only 3 of the days were with other providers. At my other rotations there was often a larger team and a handful of different providers that I would work with and learn from. Working with the same provider every day was very helpful because I was able to get feedback and apply it to future patients. It also allowed for rapport and trust to see patients more autonomously.
I was trusted as a part of the team to see, evaluate, assess, and form plans for patients. This allowed me to grow as a provider because I was able to independently assess patients. The urgent care office I was at had patients with a variety of different complaints and problems and I was able to do a lot more procedures than I did in my past rotations. The preceptor would always ask me about the plan first before adding or changing based on his knowledge and experience. At first I wasn’t always comfortable with my assessment and plan, as the rotation went on and I saw more patients I became more confident in my ability to develop a differential and plan for every patient.
I was able to do procedures including suturing, suture removal, staple removal, splinting, blood draws, IM/subq/intradermal injections, joint aspirations, ear lavage, fluorescein stain, nasopharyngeal swabs, throat culture, PPD placement, urinalysis, X-ray interpretation and EKG interpretation. The preceptor I was with made sure to teach me the optimal technique to accurately and safely perform these procedures and I was able to do many of them multiple times over several shifts. I feel that my physical exam and procedure skills improved greatly over the course of this rotation. Because I saw so many patients independently and did a variety of procedures I feel more prepared for when I have my ED rotation September.
My next rotation is surgery at Woodhull Hospital. As with most rotations, I am a little intimidated before starting but I am looking forward to the challenges ahead. I will continue to work on my clinical skills including history taking, physical exam, and assessment when evaluating patients in the clinic before and after their procedures and I hope to continue working on my procedure skills as well.

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