My family medicine site evaluator was Professor Sadat. I submitted three history and physicals, ten pharm cards and a journal article with summary. During the site visits, I was with two other colleagues, one who was also in family medicine and another who was in ambulatory care. It was beneficial to be able to listen to other colleague’s experiences, especially the classmate who was also in family medicine in another office. I debated what cases I should present for this rotation, as I wanted my cases to reflect what I was seeing and doing in the office. One of the cases I decided to present was regarding a patient who presented for an annual visit. The patient had annual laboratory tests done such as complete blood count, comprehensive metabolic panel, lipid profile and urinalysis. While this does may not have been an “interesting” case, it allowed me to discuss an important discussion in family medicine/primary care of lifestyle modifications as this patient’s cholesterol and glucose were elevated. Preventative measures and lifestyle changes are preferred over starting medications such as statins, especially initially, which is why I chose this case. Additionally, many patients may not understand what cholesterol is or how to change certain dietary or exercise behaviors, so being able to provide adequate resources can help the patient be successful in making the necessary changes.

Another case that I discussed was a patient who presented with signs and symptoms of depression. This is another vital topic in primary care, as screening for depression with PHQ-2 is standard. Once again, I discussed the importance of being able to spend time with the patient and discuss their options, such as but not limited to medication, therapy referral and psychiatry referrals. As a primary care provider, you may have to identify and start treating the condition prior to the patient seeing a specialist, as it may be weeks before the next appointment. For the patient in this case, we started a selective serotonin reuptake inhibitor with close follow up to assess the efficacy of the medication. My journal article that I presented was related to my first case, which was a patient that had back and neck pain after a motor vehicle accident. The patient was prescribed NSAIDs only, without a muscle relaxant, and I therefore decided to do my journal article on the effectiveness of muscle relaxers for acute, nontraumatic, nonradicular back pain. Throughout these presentations, I appreciated the questions my site evaluator had and the discussions we were able to engage in regarding these preventative and important measures that must be assessed by a primary care provider.

My family medicine evaluations were very educational. I appreciated listening to and engaging with my colleagues and listening to their cases, pharm cards and journal articles. Additionally, I valued the feedback from my site evaluator on additional information that could be included in my cases. As this was my final site visit of PA school, I will continue to take recommendations on taking a history, performing a physical, charting and providing differentials from Sadat and from my previous evaluators as I begin my career.