For my second rotation, I had the pleasure of being in Emergency Medicine at New York Presbyterian Queens. I really enjoyed my time in EM, more than I thought I would. I was very nervous to be on this rotation because I knew it would be very fast paced and the topics that come in this field are just so broad, so you really must have a wide and broad list of differentials. One of the things I quickly realized was that I needed to think of differential diagnoses before I even saw the patient. Initially I struggled with what to ask patients while interviewing them because I wasn’t thinking about what I was ruling in or out, but once I had that realization, it became a bit easier to guide the conversation. While I am not an expert yet, I think I’ll get better with practice and more exposure to patients as I continue on through clinical year.

Something I found very interesting while on this rotation is how widely ultrasound is used in the ED. They actually had an ultrasound team and one resident who would focus on doing FAST exams in trauma. However, they would use ultrasound even for minor things like foot or shoulder pain. We even found a pocket of fluid in someone’s foot and the resident talked me through the whole exam to explain what we structures we were looking at and what we were looking for. The experience of using ultrasound at bedside really proved to be useful to rule in and expedite certain cases. I hope that I get more exposure with ultrasounds in the future.

Going forward with clinical year, I also hope that I am more confident presenting cases to preceptors, as well as with my assessment and plan. I felt like I would second guess myself a lot and I didn’t feel like I demonstrated how much I prepared for the rotation. My plan for future rotations is to practice how I would present cases but either rehearse on my own or to my colleagues. I think practice makes perfect and it’s only up from here. I also think reviewing material and solidifying my knowledge will also help.

I will say that I would want my preceptor to know how much work and effort I put into the rotation. I got to my shifts early and never minded staying 30mins to an hour more; mainly because I found cases to be so interesting. I’d also like them to know that I felt confident about my suturing skills. I got a lot of practice repairing different types of lacerations in the ED. I may not be an expert, but I do think I was good at it.