My very first rotation is with a PA at a family medicine clinic! I am so so thankful that this was my first rotation, because I am learning a lot about many different areas of medicine and I am getting lots of practice talking to and examining patients.

A typical day for me in family medicine starts around 8:30 AM. I get to the clinic and log in to the computer to review the day’s schedule- usually there is a patient about ready to be seen by the time I am logged in and ready to go. If there isn’t a patient to see right away, I can review charts from the day before to see if there’s anything that needs to be added to them, or I can make notes on new lab results to make it easier for the PA to review them later. For my first few days at the clinic, I mainly shadowed the PA and learned her routine. I watched how she interacted with patients, what kind of physical exam maneuvers she did, and I learned how/what to chart for each type of visit. After the first few days, I started seeing patients on my own before the PA and I saw them together. 

Before talking to a patient, we will review their chart and determine if there’s any previous history for the problem they’re coming in for, or we will review preventative medicine and medical history for a wellness visit. Then I go in and interview the patient and perform an appropriate physical exam. For a physical, this mainly consists of listening to heart and lungs, doing an abdominal exam, feeling thyroid and lymph nodes, looking into eyes and ears, and examining the skin for any lesions, swelling, or other abnormalities. 

I’ve learned that it is VERY IMPORTANT to ask the patient if they have any questions or concerns SEVERAL TIMES before you leave the room. Inevitably, but the time I’ve presented the patient to the PA and we come into the room together, the patient has thought of something else they want to talk to her about that they never brought up to me. If we hadn’t come back in the room, that issue would never have been addressed! When presenting the patient to the PA, I summarize what we talked about (HPI), what I’m thinking might be the issue, and we talk about what we might do about it. 

After that, I pretty much shadow the PA while she finishes up the appointment and put as much into the chart as I can. There’s not a whole lot of time for charting throughout the day- most of it gets done during lunch or if we finish early for the day. In our spare time, I also will continue reviewing labs or talk through phone messages that the PA receives. The day ends around 5:00! 

Studying comes later- I will make another post soon talking about how I study and what resources I’m using for this rotation!

Here are some of the diagnoses I have seen so far:

• Wellness Exams
• Well Woman Exams
• Well Child Checks
• Sports Physicals
• Diabetes management
• Hypertension management
• Depression/anxiety management
• Hyperlipidemia management
• ADD/ADHD management
• Seizure control
• Migraine control
• Atopic Dermatitis
• Psoriasis
• Shave biopsy of mole
• Punch biopsy of mole
• Osgood Schlatter’s Disease
• Umbilical Hernia
• GERD
• Mitral Valve Prolapse
• Urinary Tract Infection
• Shoulder Injury
• Back Injury
• Knee Injury
• Acute Otitis Media/Externa 
• Upper Respiratory Infection
• COVID
• Abscess Drainage
• Wound management
• Cryotherapy wart removal
• Dysmenorrhea
• Dyspareunia
• Constipation
• STD Screening
• Cellulitis
• Breast mass
• Nipple discharge
• Tinea versicolor
• Tinea corporis
• Atrophic vaginitis
• Ovarian Cysts
• Uterine Fibroids
• Abnormal uterine bleeding
• Cyst removal