We met Professor Mohamed as a group for our mid-point rotation.  We first reviewed our pharmacology cards – each of us were required to bring five cards for our first meeting.  As we reviewed the cards with the group we expanded the conversation as to clinical uses we’ve seen the medications and how we applied them in our respective clinical settings.  Professor Mohamed was very helpful in sharing his own experiences and discussing the medications and things he’s seen in his experiences in the Emergency Department.  He also shared a lot of different ways he has utilized these medications and side effects he’s seen in his own encounters with patients.  Given the frequency for which I saw certain chief complaints during this rotation, I was very familiar with the indications for the medications I selected and spent some time discussing why I selected those medications and the feedback I was given from my preceptor.  I felt like this rotation was helpful to not only review medications I was comfortable with but also to review second line indications of medications for patients with multiple complaints in order to avoid prescribing more than one medication.  After reviewing the pharmacology cards, we each shared our first (of two) write-ups we were required to bring for the mid-point meeting.  I shared an H&P about a patient who had fallen down the stairs and wasn’t going to come in for evaluation but her husband brought her to rule out a foot fracture.  The patient was denying pain but agreed to come in and on X-Ray had a displaced fracture of her 5th metatarsal.  Professor Mohamed indicated that I’d done nicely in including the pertinent information and noted the only additional factors I should have made a point to include was whether or not the patient was taking any anti-coagulants, which may have changed the management.

For our end of rotation meeting, we met as a group again and first reviewed the remaining five pharmacology cards.  Again, we discussed the way we used our cards in the clinical setting and reviewed off-label uses for a few of the medications my classmates brought to discuss.  During this visit we presented our third H&P write-up and article that we selected to accompany the H&P.  The third H&P I presented discussed a patient that came in with a chief complaint of knee pain with a PMH including fibromyalgia.  The patient was accompanied by her daughter who was inquiring about Electrical Nerve Stimulation to help treat and manage the pain.  Given I was seeing this patient in an urgent care setting, we informed her that she should continue to discuss the treatment options with her Rheumatologist but ultimately decided to look into the topic to learn a bit more on the subject.  During this callback, we shared our respective articles and reviewed not only the pertinent findings but opted to highlight the limitations and flaws of the articles.  We discussed the importance of understanding the different flaws and limitations of a research article to ensure we were providing sound advice to our patients.  Before we separated after the meeting, we reviewed our procedure logs and discussed some of the ‘cooler’ procedures we got to accomplish throughout the five week rotation.  As I move into my next rotation, I would like to ensure I am prepared to start OBGYN and am able to learn from and have the best experience possible.

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