Ambulatory medicine was a great rotation where I learned a lot. It was a great rotation to follow my emergency medicine rotation, because I got to utilize many of the skills I had learned on my emergency medicine rotation. I was also able to gain new skills, and see new types of patients that I had not yet seen in previous rotations.

I saw a wide variety of cases including cerumen impaction, candidal vulvovaginitis, sinus infection, dog bites, rashes, headaches, vision changes, eye trauma, syphilis, skin infections, allergic reactions, abdominal pain, tick bite, back pain, aphthous ulcers, and UTIs. The wide variety of cases I saw contributed to my learning. I was able to take history and physical on all the patients that came in. After taking a history and performing a physical I would present the case to my preceptor. He would ask me what I thought it was and what I thought we should do. For most of my rotation I worked with the same provider which I really enjoyed. As I went through the rotation, I received his feedback and made changes to the way I approached patients (for example the first few patients I saw with UTI symptoms I did not ask about STIs and he taught me that you should consider STI as a cause of irritative voiding symptoms).  Working with the same provider also meant that he trusted me more as I continued to see patients and learn and he gave me more autonomy as time went on. 

The provider I worked with on this rotation made sure I was able to do a variety of procedures. On this rotation I learned how to perform a fluorescein stain, cerumen removal and ear irrigation, I did several blood draws, injections, performed and interpreted ECGs, interpreted urinalysis, and did many nasopharyngeal swabs. Several of these procedures were new for me, so I appreciated the opportunity to be taught them by my preceptor and as I got to do them several times, feeling more comfortable performing them. 

For future rotations I want to continue working on my differential diagnosis. The best way for me to do that is to continue reviewing clinical medicine, the more I know about how different diseases present, the more differentials I will be able to include. Reviewing clinical medicine will also help me become better at making plans for patients such as knowing what tests to order or what treatments to give. I also want to get more confident performing procedures, and the best way to do that is to continue to ask for the opportunity to be taught how to do new procedures, and perform procedures that I have done already. 

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