I met Professor Melendez at Woodhull after working in the OBGYN clinic one day! Given Professor Melendez is in OBGYN as well and taught our class we discussed a lot of the experiences I had throughout my first few weeks in the rotation and how they correlated back to some of the lectures he’d given during the didactic year. I presented my first five drug cards and discussed them in detail about how they apply to the clinical setting. I selected specific OBGYN drugs and we talked about how I’d seen them used in practice and other helpful things to remember as I begin my career. For me, it is definitely easier to remember these medications when relating them back to particular patients. I had unique experiences that allowed me to make memories about the patients and the medications they needed and tie it back to the clinical setting. I presented my first case during this evaluation as well. The case I initially presented was a consult I saw in the ED of a patient with postmenopausal bleeding. This patient had just arrived to the US 5 days prior and the evening before experienced an episode of vaginal bleeding, prompting her to come in for evaluation. Interestingly this patient had a cervical polyp and the resident removed it during the examination. I was able to learn about the technique to remove the polyp but also the process for which the pathology is tested and subsequent follow up is arranged. I discussed this case with Professor Melendez and reviewed the next steps and plan for this patient as well as other patients I’d seen during the first half of my rotation.

For my final site evaluation, I presented the remaining drug cards to Professor Melendez and again reviewed with him how I’d seen them used in practice. The patient I presented during my final site evaluation summary was another gynecological consult I’d seen in the ED. This patient was unique in that she’d had a D&C at another facility but followed up to the QHC ED with complaints of pain and vaginal bleeding after the procedure. I discussed the details of the case with Professor Melendez and highlighted the points of the exam and most importantly noted that this patient wasn’t adequately prepared for the aftercare necessary for this procedure. Professor Melendez and I discussed the importance of patient education and how necessary it is for a provider to ensure the patient understands the true risks / benefits of procedures and equally important what to expect afterwards. I also discussed other cases I’d seen as it relates to abortions (whether surgical or medical) and noted the various conversations that must occur with the various procedures. Additionally, I discussed an article with Professor Melendez about the use of adequate pain management in surgical abortion, which is the type of abortion the patient presented had earlier that week. The article ultimately highlighted the importance of customizing each patients pain care and truly highlighted how efficacious it can be in practice. As I have moved through my rotations, I feel as though I’ve gotten more confident in my knowledge and presentation skills and will continue to work to improve in my next rotation at Gouverneur.

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