As I began my family medicine rotation, I was unsure of what to expect in terms of both patient volume and the types of chief complaints I would encounter. By the end of the rotation, I was exposed to a variety of visit types, including follow-up appointments, annual physical exams, sick visits/same-day emergencies, bloodwork, and initial visits. Although many of the follow-up visits were relatively brief, I found them particularly valuable. During these appointments, I was often able to review and interpret patients’ lab results before discussing them with the physician and the patient. This experience helped strengthen my understanding of lab medicine, as I learned to identify abnormal values and interpret them within the context of each patient’s clinical picture. One of the most common issues I encountered was elevated blood glucose levels and HgA1C values. Through these encounters, I became much more familiar with diabetes management and glycemic control. I also gained confidence in providing patient education, particularly regarding the risks associated with poor adherence to diabetes treatment and lifestyle recommendations.

Sick visits/same-day emergency appointments were where I was really able to apply my patient interviewing skills and clinical knowledge to develop differential diagnoses. These encounters allowed me to practice targeted history-taking and clinical reasoning in real time. Over the course of the rotation, I became very familiar with common presentations such as UTIs and back pain, and I now feel more confident asking the appropriate, focused questions that help guide the diagnostic process.

Additionally, I performed physical exams on all patients coming in for annual physicals, sick visits, and initial visits, including EENT, abdomen, heart, and lungs. In the beginning, there was some uncertainty about what the “normal” physical exam was, however my preceptor was very willing to teach, and by the end of the rotation I became more comfortable recognizing abnormal findings. For example, an 82 year old patient who had not seen a PCP in over 6 years presented to the clinic with “an itchy feeling on his tongue.” He did not report any medical history, was not taking any medications, and had an unintentional 20 pound weight loss in the past couple of years. His history prompted a thorough physical exam. While auscultating his heart, I immediately noticed that something was abnormal. He had a very loud heart murmur, and although I was not unsure of the specific type, I was able to recognize that the finding was clearly not normal. My preceptor assured me what the patient had a crescendo-decrescendo murmur. Another patient presented for her annual physical exam without any specific complaints. During the abdominal exam, I noticed that her lower abdomen felt firmer than what I had felt on other patients. Although I was not positive that this finding was abnormal, I brought it to my preceptor’s attention. After examining the patient, she agreed that the abdomen was distended, and the patient was referred for an abdominal US.

Although there were not many procedures to perform in family medicine, I became particularly confident in doing venipunctures, as I performed them almost everyday for patients coming in for bloodwork. I learned that successful venipuncture is not always about visibly identifying a vein, but often about palpating and recognizing a vein is present. Repeated practice helped improve both my technique and confidence.

Overall, my family medicine rotation went well, as I was exposed to a wide variety of patient ages, complaints, and physical exam findings. One aspect that initially surprised me was the pace of the clinic. Family medicine was much faster-paced and busier than I expected, and at times it felt stressful. When I first began seeing patients, I created a step-by-step method to ensure I addressed all necessary components of the patient encounter and documentation in the chart. However, there were times this process was disrupted by the need for the physician to see patients efficiently and keep the schedule moving. As the rotation progressed, I learned to adapt to this pace by becoming more efficient with my history taking, focusing on the most relevant questions, and improving my ability to document while maintaining a smooth patient interaction. This adjustment helped me balance thoroughness with efficiency, allowing me to keep up with the clinic workflow while still gathering the information needed to provide quality patient care.