During my family medicine rotation I was exposed to a number of new treatment strategies and diagnostic tools. One area I learned a lot about was sexually transmitted infection management. Prior to this rotation, I was unfamiliar with Mycoplasma genitalium and was surprised to learn how similar it can present to chlamydia while also being more difficult to treat due to resistance patterns. I also learned that in patients treated for chlamydia, repeat testing is not typically done immediately after they finish antibiotics, but rather around 3 months later to evaluate for reinfection. This was a helpful distinction because it showed me that treatment does not end with simply prescribing antibiotics, but also involves knowing the proper follow-up and counseling.

I was also introduced to TM Flow testing, which I found especially interesting in the management of diabetic patients. I had not previously seen a tool that combines sudomotor function testing, ankle-brachial index, and photoplethysmography to help detect early peripheral arterial disease, neuropathy, and broader cardiovascular risk. Seeing this done in the outpatient setting gave me a greater appreciation for how family medicine is not just about treating overt disease, but also about identifying complications early before they become more serious. Overall, these new exposures went well and made me realize how broad primary care truly is, especially when it comes to preventive care, risk stratification, and long-term management.

One of the interpersonal challenges during this rotation was adapting to a clinical environment with a relatively low patient volume while also rotating alongside an NP student and a medical student. Because of this, we had to be mindful of each other’s learning opportunities and work collaboratively so that everyone was still gaining meaningful clinical exposure. We often coordinated who would see which patient, and if it was a patient one of us had already followed before, we would usually agree that it made sense for that same student to see them again for continuity. We also discussed cases with each other in between patients, which helped reinforce learning and made the experience more collaborative rather than competitive. I think this taught me an important lesson about being adaptable and remaining professional in the clinical space.

Another challenge I encountered was learning how to keep patient encounters focused. In family medicine, many patients understandably come in with multiple concerns, and I found that early on I had difficulty when patients began listing numerous complaints that could not all realistically be addressed in one appointment. With my preceptor’s guidance, I gradually improved at identifying the most pressing issue, acknowledging the patient’s other concerns, and helping set expectations that lower-acuity complaints could be addressed at a future visit. This was important because it taught me how to prioritize while still making patients feel heard.

Another difficulty for me was time management. During this rotation I was often responsible for writing HPIs for my preceptor, directing the MAs when patients needed labs or urine studies, and also making sure patients had the appropriate imaging orders, referral forms, or blood pressure log sheets before leaving the office. This required me to juggle several responsibilities at once and keep pace with the clinic workflow. Over time I improved by becoming more forward thinking about mentally organizing the plan before leaving the room, writing down key tasks immediately, and trying to anticipate what my preceptor would want done next. I learned that outpatient medicine requires not only clinical reasoning, but also a certain level of efficiency and organization.

The patients I found most challenging during this rotation were elderly patients, as they often had multiple medical problems and at times were not the best historians. These encounters taught me the importance of patience and knowing how to adjust the types of questions that I ask. I also learned the value of collateral information, medication lists, and chart review in helping complete the story when the history provided isn’t the best. In addition, there were situations in which I introduced myself as a PA student and a patient stated that they would rather just see the provider. Initially this was uncomfortable, but I learned that many patients became more agreeable when I calmly explained that my initial history would help the provider and make the visit more efficient. This helped me become more confident and professional in how I introduce my role.

Going forward, I would still like to improve my history taking, oral presentations, and documentation. I did get a lot of valuable practice writing HPIs, placing imaging and medication orders, and presenting focused cases to my preceptor, but I know these are skills that improve with repetition and feedback. My action plan is to continue asking future preceptors for specific feedback on my presentations and documentation, pay closer attention to how experienced clinicians structure their histories, and keep adjusting my approach based on those observations. I also want to continue involving myself in the workflow of patient visits at my future sites early on so that I can keep building upon my efficiency and pacing.

One memorable case from this rotation involved a patient who had been found to have atrial fibrillation with rapid ventricular response in the office and was sent to the emergency room. When he later came in for follow-up, I took a focused history and learned that he had not been started on anticoagulation, which initially seemed surprising to me. When I presented the case to my preceptor, she immediately directed me to calculate the CHA₂DS₂-VASc score, which in his case was zero. This clarified that his annual stroke risk was low enough that anticoagulation was not indicated. This was a memorable experience because it reinforced the importance of not relying solely on instinct, but instead using validated clinical decision-making tools to guide management. The knowledge gained from this case is applicable even outside of family medicine. Clinical decision rules are used in every aspect of medicine and this case reminded me that good clinical practice is goes beyond diagnosis and treatment but also involves knowing how to tailor care to the patients needs.

During this 5-week rotation, I learned that I genuinely enjoy building rapport with patients and seeing the progression of their care over time. I liked being able to follow up on patients, see whether prior interventions were helping. Because the office was multispecialty, I also learned that I enjoy collaborating with other disciplines and appreciate how valuable it is to have immediate access to colleagues with different perspectives. My perspective changed during this rotation because I developed a deeper appreciation for the role of primary care. Before this experience, I understood family medicine as broad and important, but this rotation made me see more clearly how essential it is in early disease detection, chronic disease stabilization, preventive screening, and ongoing maintenance of health. If there is one thing I would want my preceptor or colleagues to notice about my work during this rotation, it is that I approach each case as an opportunity to learn and improve. If I spend a long time with a patient, it is usually because I want to make sure I leave the room with a good understanding of the case and atleast an idea of a plan before presenting it. I would also want them to notice that I am open to criticism and genuinely value feedback because I know it is necessary for growth.