Ambulatory Medicine was my first rotation at Nao Medical in Hicksville. The site is fast paced but I was lucky to work with the same preceptor for most of my shifts. While a lot of the cases were acute URIs, I was able to see some unique presentations. For example, I saw acute cholecystitis, foreign bodies in various places, as well as a hand laceration. I was able to practice basic skills like history taking, performing focused physical exams, venipuncture, and immunizations. I was lucky to see a very diverse population of patients. There are also limitations on what we can do for patients at an urgent care, which warrants an ER referral for things like positive EKG findings, severe lacerations, or altered mental status. This urgent care sees a lot of employment physicals for HHA, CDL, and other, so not every patient that walks through the door is “sick.” Something very unique is their Suboxone program, which treats patients who are in opioid abuse remission. These can sometimes be challenging cases because there are strict protocols for participation in the program. It was challenging to disqualify patients due to multiple infarcts, such as lack of adherence or finding trace of other drugs in their urinalysis. Next rotation, I hope to feel more confident in my ability to do procedures with guidance, such as suturing or removing a foreign body. Overall, I am very grateful for the way my preceptor encouraged me to see patients on my own, present to him, and then participate in the patient’s care plan or any procedure that had to be done. I hope to use the skills I’ve learned to perform even better on my next rotation – Pediatrics at QHC.

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