I remember feeling overwhelmed and stressed over the thought of rotations. I thought to myself what if I don’t know anything, what if I am just an imposter. What a relief it was to realize that these thoughts were just all part of my imagination. I was surprised by how much I knew coming into the rotation and how much I learned throughout this rotation. I used to do practice questions and hope I got the question right. As this rotation progressed my confidence increased. I now do practice questions and can say with confidence this is definitely the right answer.

I came into this rotation thinking I can take a history easily, but I quickly learned that the OBGYN history is different. My first few histories I took on patients were missing important information. The clinicians around me pointed out my mistakes, which has helped me to improve. I now can take a complete accurate history for OBGYN.

I had the privilege to work in Queens Hospital, which has allowed me to work with an underserved community. I have gained a deeper understanding of the challenges facing this community. Many of the patients I worked with don’t have health insurance, which limits them to where they can go for medical care, and what procedures and tests they can have done. Additionally, many of the patients I worked with don’t speak English well, and many don’t fully understand what is available to them. This creates a challenge when trying to provide them with the optimal care. I have the learned the importance of taking the time to explain to them their options and on educating them on the importance of their health. For example, I saw one patient who had her first prenatal visit at 22 weeks. She was sent for a sonogram which she didn’t show up for, not realizing how important it was. When she showed up at 36 weeks the baby was shown to have what was believed to be intrauterine growth restriction. However, the clinicians weren’t sure if the babies actual age was accurate because the sonogram was never performed. This created many issues for the patient and her baby. The patient was likely unaware of the importance of following up for her sonogram and prenatal appointments. This taught me it is important not only to explain to the patient why they must come back, but also to make sure they understand. One skill that I learned in didactic year that could address this issue was the teach back method. If this patient would have had to explain to the clinicians what she needed to do and why the clinicians would have known if she understood. This could have saved a lot of heart ache and would have led to better patient outcomes.

I have not had many opportunities to practice my clinical skills, during this rotation. There are still many clinical skills I can improve on such as, but not limited to; suturing, drawing arterial blood gasses, performing catheterizations etc.. I hope to work on these skills in my upcoming rotations. 

Overall I have learned a lot from this rotation. I plan to take this information to become a better physician assistant in the future.