My surgery rotation site evaluator was Professor Michael Rachwalski. I presented eight SOAP notes and discussed my experience at Woodhull during each visit. I was given feedback on my SOAP notes, such as how to revise my subjective portion to get to the reason why we, as the general surgery team, were seeing the patient. I discussed how I am often still programmed to write my notes from an emergency medicine perspective, as I was a scribe in the ED previously, and how I have difficulty deciding at what point in the story I should begin. In some of my SOAP notes, I would start the presentation from when they arrived in the ED a few days ago, when instead the note should begin with why surgery was consulted or have taken this patient onto their service. We discussed how it is not always necessary to include all of the PMHx, PSHx etc., in the subjective portion in these SOAP notes, as this is often a progression of the patient, and not all of these details are needed in each note. Even though I did not encounter the fishbone for documenting labs during my rotation, I used it in my SOAP notes so that I could practice remembering the layout and each value. Additionally, I received constructive feedback on how to further elaborate on the plan portion of my note, such as discussing what medications could be used for pain management or documenting DVT or GI prophylaxis when indicated. We also discussed different diagnoses for some of the cases, such as a patient status post a cholecystectomy with epigastric pain, which was extremely beneficial in allowing me to expand my thought process.

I also presented a journal article about complications after splenectomies, as I scrubbed into a case of trauma patient who had a splenectomy. I wanted to learn more about the long-term complications of this procedure, which includes infections from encapsulated bacteria and thromboembolic events. Additionally, I made ten pharm cards that were related to my surgery rotation, including antibiotics and pain medications.

I really enjoyed my site evaluations, as we were able to discuss the roles of PAs in surgery, as well as the differences between medical and PA students. This gave me further insight into understanding a PAs role in a hospital setting, and how this can be very different depending on the hospital or practice where you work.  I plan to continue to work on my SOAP notes, as this is one aspect I do not feel completely comfortable with, and continue to say yes to trying a procedure, so I can learn from any of my mistakes.