My ambulatory medicine site evaluator was Professor Sajid Mohamed. During my first evaluation, I submitted two H&Ps and chose one to present. I presented my first H&P on a patient with intermittent palpitations, which I thought was an important topic to discuss for urgent care, as the provider must rule out any life-threatening and immediate concerns. I enjoyed being in another group Zoom setting for this evaluation, as I was able to learn about the cases that my colleagues also saw in their urgent care rotations. We discussed that it may have been beneficial to obtain a d-dimer on the patient, even though the palpitations were occurring for a month, just to rule-out a pulmonary embolism. I received feedback on both of my H&Ps prior to my second site evaluation, which was very helpful as it allowed me to improve for my second visit and gave me insight into how my site evaluator would work-up these patients. I also enjoyed including differentials in my H&Ps because it gave the opportunity to actively think about what I should be concerned about and what I believe is the most likely diagnosis. 

During the second group evaluation, I presented another H&P and a journal article relating to the third H&P. I presented a systematic review on multiple imaging modalities for scaphoid fractures in patients with negative plain radiographs. Even though this may be left for orthopedic clinicians, I wanted to understand the next-steps when determining if a patient has a scaphoid fracture, if the initial x-rays are negative. We discussed the steps usually taken for suspected scaphoid fractures, even if the x-ray is negative, such as placing the patient in a thumb spica splint and referral to orthopedics because of the risk of avascular necrosis with these fractures. Again, I enjoyed listening to my colleagues’ presentations and learning about the interesting cases they recently participated in as well as the conclusions they made from their researched articles. 

 My site evaluations for my ambulatory medicine rotation were extremely beneficial. The immediate feedback on my H&Ps provided me with more knowledge on what to include when seeing a certain complaint or patient. I felt comfortable presenting in front of the group, which I believe is because of the experience I now have presenting cases on a daily basis in front of multiple people. While I believe the history taking in my next rotation, long term care, will be more in-depth than the history taken at an urgent care, the knowledge I gained from these site evaluations will be valuable regardless as I continue with these rotations.