For my first site evaluation we met on zoom along with another classmate who was also rotating in internal medicine. During this visit, we discussed what procedures we had done and our experience at the site thus far. We proceeded to each present our first H&P. For my first case I presented on a patient with cellulitis of the breast s/p a mechanical fall. I chose this case because I was able to follow this patient over multiple days until her day of discharge. We discussed possibly broadening my differential to include domestic violence and what types of questions or clinical signs/symptoms may lead us towards excluding or including that differential.

For my final site evaluation we met in person and I presented by 10 drug cards, an additional H&P and a journal article relating to my patient case. The way I was quizzed on these drug cards was a bit different because I was given the drug name and instructed to recite everything I recalled about the drug. I was asked additional questions such as why certain drugs are contraindicated in certain groups. For my H&P I presented on a patient who originally arrived at the ED for a traumatic fall but was found to have a third degree heart block on ekg and thus his hospital stay was complicated by the need for a pacemaker placement. I thought this case was interesting because it had multiple components to it. During the visit we discussed what important things can be relayed to the patient regarding a pacemaker placement procedure. For my journal article I chose an article relating to the use of prophylactic antibiotics to prevent sinusitis in the case of maxillary sinus fractures. We discussed the findings and the choice of the specialists to prescribe antibiotics for my patient. Overall, I gained valuable feedback and was able to learn a lot about different specialities including internal medicine from my site evaluator.