For my fifth rotation, I had the opportunity to rotate at Centers Urgent Care for Ambulatory Medicine. I really enjoyed this rotation because it was sort of a step down from Emergency Medicine. The pace was great and the patient was load was just right, not too much but not too little either. The PAs and staff were also really nice to work with; it was a great work environment. I also learned a lot while on this rotation.

Rotating in Ambulatory Medicine gave me the opportunity to work on my clinical skills. There were many procedures to perform every day. One of the main procedures I performed was suturing. I’ve always enjoyed suturing, and I was able to use this experience to perfect my skills. I was also able to refresh my memory on what suture material to use for different types of lacerations and when to have the patient follow-up for suture removal. One issue I did run into for one finger pad laceration was that the patient kept feeling pain whenever I attempted to suture near the joint line of the DIP joint even after local anesthetization. From this experience, I learned how do to a digital block which would numb the entire finger. Digital blocks are something to keep in my mind next time I have a finger laceration as it would save the patient from unnecessary pain injecting them more than once with local lidocaine without epinephrine.

Another thing I really appreciated about this rotation is the fact that we were allowed to chart for patients we saw. I would see a patient, then document the HPI, ROS and physical exam. By doing so, I was able to get feedback from my preceptor on each patient I documented for. The constant feedback allowed me to pinpoint areas in which I could improve on. For instance, there were a lot of dermatologic cases that I struggled with knowing how exactly to write the physical exam. Getting the description down well enough to describe a patient’s rash was more difficult than I imagined, and it is something I continue to work on. Going forward in my rotations, I will try to present on more cases that require descriptions of rashes, lesions or lacerations to get more practice.

During this rotation, I also had the chance to work with many different providers. Each provider had their own way of approaching patients and management. It was interesting to see how each provider had their own style and go-to treatment options. While there are first-line treatments for certain conditions, there isn’t always a definitive treatment for everything. I was able to learn something new from each provider I worked with. I’ve learned that there isn’t necessarily a right or wrong way to do things, however, as a student it is important to do your own research and to question methods for the purpose of your own education and knowledge. My hope as a future physician assistant is to provide the best possible care to patients and to never be afraid to ask for help if needed for the sake of the patient; you never know if someone else may have a better approach regarding management. 

As a student rotating in ambulatory care, patient cases became very repetitive. Towards the end of my rotation, I definitely felt more confident about seeing patients on my own. I also felt confident developing my assessment, plan, and treatment for patients. This rotation solidified to me that practice is key. We saw so many patients throughout the day which allowed me to see a lot of the same type of cases. By the end of the rotation, I really felt like I knew what I was doing, although, I know there is still a lot more to learn going forward. My plan is to carry this new-found confidence with me into upcoming rotations to help me grow into the provider I always hoped I would be.