Family Medicine Clinical Rotation

POP QUIZ: What's the most common cause of chest pain?

     For Family Medicine, our program has two four-week rotations. While it's ideal that we do both rotations at the same clinic, that's not always an option. I am at an Urgent Care clinic for my 1st rotation, and I'll be at a Family Practice Clinic for my 2nd rotation in the Spring semester.

     At the Urgent Care, you see a wide variety of age groups and complaints. From infants a month old to a 98-year-old woman (yes, you read that correctly) who's more active than I am!! It's much more fast-paced than traditional family medicine, and you don't get to focus much on the preventative side of medicine. A patient comes in with a complaint, you diagnose the complaint, and you treat the complaint. It's a "greet em, treat em & street em" way of  looking at medicine.

     Common complaints/diagnoses I saw while working:

• streptococcal pharyngitis (strep throat), influenza A&B, upper respiratory viruses, seasonal allergies, chronic bronchitis exacerbations, depression, cuts/scrapes, and orthopaedic injuries (my personal favorite!).

     I got to have a little fun at the office for college football opening day! Yes, I am based in Lexington at the University of Kentucky and do most of my rotations in Wildcat Country, but I will always be a Georgia Bulldawg at heart. I got some flak for wearing this to the clinic, but I was born in GA and went to undergrad there! I will always support the Kentucky Wildcats.....except when they play the Dawgs! #GoDawgs

     I did learn an interesting new technique for wound care, that I'd personally never seen before! It was actually for the 98-year-old mentioned earlier who injured herself while tending to her garden! When dealing with scrapes, try use as much of the patient's leftover skin to cover the wound. The BEST band-aid is your own skin, so we spent plenty of time trying to cover up the patient's wound with her own skin and then using steri-strips to hold it in place before dealing with the remaining open wound. This took plenty of patience as the scraped skin loves to roll up on itself! It's best with two sterile cotton swabs and some normal saline. Use one of the cotton swabs underneath the skin and twist the swab away from you to help unroll the skin before placing down to cover the wound. This ensures the most amount of skin possible is being used to cover the wound. It was definitely an interesting approach to wound care I'd never seen before, but it makes so much sense!! So if you have a big wound, try NOT picking off the skin before getting seen by a medical professional.

     Our program uses PAEA Exams, and they post a topic list and blueprint for each exam. Below are those categories if you want to see what we are responsible for (the FM topic list is a beast):

• FM Topic List
• FM Exam Blueprint

     Books that helped me ROCK this exam include (the latter two are books for all PANCE topics, not just FM):

• CURRENT Practice Guidelines in Primary Care
• The Green Book
• PANCE Prep Pearls

POP QUIZ ANSWER: Chest wall pain, AKA muscle soreness.

Characterized by at least 2 of the following: Localized muscle tension; Stinging pain; Pain is reproducible by palpation; Absence of cough.