Site Evaluation Presentation Summary

For my final site evaluation, I presented on a case of a 27 year old female with PMHx syphilis treated in 2015 who came into the ED c/o lower abdominal pain for the past day. The pain was associated with nonbilious, nonbloody vomiting 10x. CT abdomen and pelvis with contrast revealed no evidence of acute appendicitis and was only remarkable for a small amount of free fluid in the pelvis with a right adnexal cyst measuring about 2cm. All of her symptoms were acute and the patient experienced similar episodes in the past. Of note, she smokes about “a dime of marijuana” daily for the past 15 years.

In the ED, we gave her pepcide, zofran, and toradol for pain control. On examination, the patient had diffuse tenderness all throughout her abdomen, slightly more tender in the RLQ and LLQ. All other special manuvers were negative. Given the results found on the CT, we decided to consult OBGYN to see if they had any further advice for management and treatment. GYN recommended a GC culture, ceftriaxone, zithromax, and to follow up in the OBGYN clinic as patient was already aware of this ovarian cyst and is following up with her own providers.

During the site evaluation, Prof. Stephens stated that my classmates and I did really well on all of our H&Ps, which is a good sign since we are all going to be practicing PAs soon. I also felt confident in presenting my H&Ps, whether it was to Prof. Stephens or other PAs/attendings that I am working with during my rotations. Additionally, since this was our last evaluation (since this is our last rotation), we discussed when we are taking the boards, study tips in regards to that, and emergency departments in various hospitals to see if they are new grad friendly. I appreciated how Prof. Stephens took the time to explain how the emergency department is at Jamaica Hospital and what PAs are able to do there since York students do not rotate there. Overall, it feels bittersweet that this will be the last site evaluation before graduation, but I am looking forward to finally going into the field!

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