Hello from Montana!

I'm so, so sorry I didn't post sooner! I was really busy getting settled in, and then the hours in the clinic this first week were pretty long and demanding, so by the time the day was over I just didn't have it in me to write anything.

So! Let me first explain the setup here. There is a nursing home facility with about 50 residents, a six-bed hospital, a two-bed ER, and a fully functioning clinic all located within the same building. The medical professionals in charge of this facility are one doctor, one PA, and one nurse practitioner. That means they do everything! They are simultaneously internists, pediatricians, gynecologists, ER providers, and long-term care providers. These three people are basically responsible for everything and everyone within a 90-mile radius, because that's how far it is to the nearest larger town. As the only student, this is an amazing opportunity!! Yes, I'm technically here for family practice and pediatrics rotations, but I'm also getting to brush off my ER skills and getting to learn some long-term management skills.

I'm mostly in the clinic, as are the providers. A typical day there lasts from 9 to 5ish, plus then finishing any lingering paperwork, and we see about 12-15 patients per day. I really like this patient load, because it gives you plenty of time to talk to patients and make sure you're really taking care of them well. So far, most visits have been for seasonal sicknesses - flu, sinusitis, bronchitis, etc. - and there are occasional checkups or follow-ups. I see a pretty good mixture of adults and kids, which is good - I have zero knowledge of how to interact with small kids in a medical setting! I think that will definitely be my biggest challenge while I'm here. It's an intricate dance of making sure the child feels comfortable around you so they let you do the exam, and also making sure the parents trust what you're doing and saying. Hopefully I'll be much better at it by the time I leave!

Most clinic visits aren't super exciting, but I have been able to do a fair number of procedure-type stuff in just the first week! I got to staple someone's head after they slipped on ice and fell and hit their head on stairs, and I got to suture a thumb that got sliced open by a carpet cutter at work. I've also done pelvic exams and Pap smears! Really, this rotation is kind of functioning as a review of most rotations I've had so far, plus adding the pediatric element. It's great!

Everyone here, patients and providers alike, is super nice and I think I'll really enjoy being here for the next two months or so. It's definitely a small community, though, and I can't really even go to the grocery store or the post office with that small degree of anonymity that you take for granted in suburban or urban life. Everywhere I go, people know that I'm not from there, and most times they even know that I'm the PA student at the clinic, because they heard one was coming and I don't look familiar! But that's okay, everyone is very welcoming and they seem happy to have me here. :)