Meeting with my site evaluator during my rotation gave me the opportunity to reflect on my clinical reasoning and recognize gaps in my approach as a student. Through our discussions, I became more aware of how easily important details can be overlooked and to think broadly when evaluating patients.

One of the H&Ps I presented involved a patient with chest pain whose symptoms were consistent with GERD, but the patient herself was concerned about a possible cardiac cause. Hearing “chest pain” often immediately brings myocardial infarction to mind; however, this case reinforced the importance of fully exploring the history, including the onset, duration, quality, and associated symptoms, as chest pain has a wide range of differentials. After reviewing the case with my site evaluator, I better understood the importance of including a patient’s family history of coronary artery disease in the HPI. Even when symptoms appear benign, serious conditions such as an MI can present atypically, making it essential to ask thorough and targeted questions.

In another case involving a patient presenting with neck swelling, I realized I had missed an important and potentially life-threatening differential diagnosis: Ludwig’s angina. Although the patient was stable and did not exhibit concerning symptoms at the time, this discussion highlighted the importance of always considering serious conditions, regardless of how stable a patient may initially appear. It reinforced the need to remain prepared and maintain a broad differential, as patient status can change at any time. These meetings helped me become more intentional in how I gather and present patient information, particularly the importance of including pertinent positives and negatives and thinking critically through possible diagnoses.

For my journal article, I presented on weight loss medications and the updated WHO guidelines. This topic was especially relevant during my family medicine rotation, as weight management was frequently discussed in clinic and many patients were willing to share their concerns and fears regarding their health. Some patients were already on weight loss medications, but this experience emphasized that medication alone is not sufficient. As a provider in training, I learned the importance of educating patients on lifestyle changes and offering ongoing guidance and support throughout their weight loss journey.