My emergency medicine rotation at Metropolitan Hospital overall went very well. First I was greeted by Professor Seligson and she gave us an orientation of the hospital. Some days I was scheduled in To be emergency room and other days “Fast Track” which served as urgent care for lower acuity patients.

 In the fast track, I mainly saw patients with dental pain, rashes, URI, and musculoskeletal complaints. I would see patients on my own, develop a DDX, assessment, and plan, then present it to my preceptor. I felt very comfortable doing this due to my previous experience in urgent care. Most of the time patients would be discharged but sometimes they were referred to the dental clinic, or upgraded to the Emergency Room floor.

Days I was in the emergency room, I was on the floor with 6 providers. Some were PA’s but most were residents. Most of the time I tagged along with a resident for the whole shift and learned the different styles, and workflows of each resident. Since my last rotation was all paper charts, I had to get accustomed to using Epic which I like because it reminded me of pertinent questions for the patient. Often times I would forget to ask the patient something and would have to go back to ask them. Overall I enjoyed my experience at Metro but I wish I saw more trauma patients. There was a limited amount because Harlem Hospital is nearby and is a trauma 2 hospital.

One case that stuck with me was a patient with hepatorenal syndrome who had ascites that I could see from across the ER. The patient was an alcoholic who weighed probably 95 pounds and her stomach was very distended We called 2 critical care residents to perform a paracentesis. They explained they were going to test the fluid for a neutrophil count of 250. This was a full circle moment because I remember a similar question on an emergency medicine test.

I enjoyed my time at Metropolitan Hospital and it further solidified emergency medicine as my goal in my first job.