My emergency medicine rotation was completed at Metropolitan Hospital. I spent 5 weeks rotating through the main adult ER and fast track. During these weeks I was able to see a good variety of patients and complaints.

In comparison to previous rotations I was able to participate in more codes and do a lot more procedures during this time. I was able to help in bagging patients post intubation and inserting NG tubes in intubated patients. I was able to perform IVs and venipunctures and find a method that worked best for me. I was also able to refresh myself on previously encountered procedures such as speculum exams, culture collection, etc. One of the procedures I enjoyed performing for the first time was an I&D on a patient who presented with an abscess on his axilla. I was able to insert the local anesthesia to numb the area and perform the incision. I enjoyed the wide variety of procedures I was exposed to during this time and am glad I was able to encounter them.

One thing I also enjoyed during this rotation were the Wednesday conferences. This block focused on pediatrics, which I feel like is one of my weaker areas. We were able to go in depth on pediatric rashes and learn different mnemonics to help us remember how different rashes present. I also enjoyed the sim cases we had where we were split into groups and given a patient scenario. During these cases we were able to work up a sepsis case and practice intubating on mannequins which was a nice refresher.

It was a shift from the slower paced internal medicine to the faster paced emergency medicine, however I feel like I was able to quickly adjust. I was able to follow up with the patients during their time in the ER and reassess their symptoms/pain, bring them to xray, perform any procedures or line insertions they needed, etc. Participating in different aspects of the patient’s care helped me to holistically learn the case. I also got to see bedside echos, abdominal ultrasounds, etc. It was a good learning experience to learn how to use bedside ultrasounds and be able to identify the anatomy on the screen.

I think my presentation skills improved a lot. There was a strong emphasis on presentations and I was able to present to PAs, residents and attendings during my time here. I was given helpful feedback and was able to see my presentation growth over the course of the 5 weeks I was there. Due to the heavy hispanic population, my spanish use has also grown over the time.

My final rotation will be in psychiatry. I think this is a good transition, as we had a good number of psychiatric patients in the ED. While in the ED I was able to see alcohol withdrawal, drug overdose, panic disorder, schizophrenia, etc. This will help me in transitioning to my time in psychiatry and hopefully help me in knowing how to treat some of the cases I will encounter. My goal for my final rotation will be to focus more on the patient interview. Since procedures and physical exams are limited in the psychiatry setting, I think this will be a good time to place more emphasis on the patient interview. I would also like to get better at performing the mini mental status exam during this time.