My OBGYN rotation at Woodhull Hospital offered a large variety of experiences. Throughout my time there, I rotated through the clinic, OB call and GYN call. Although being present at several cesarean sections and deliveries was fascinating, I also appreciated the hands-on experience I gained while caring for the average GYN and OB patient in the clinic. A large majority of the patients were Spanish speaking. This added a level of complexity to the patient interviews and office visits. I found that over time I became increasingly skilled at connecting to the patient even when it was through an interpreter. Throughout my time at Woodhull, I gained experience in a large variety of procedures. By the time the five-week rotation was over I felt very comfortable performing both breast and pelvic exams. Additionally, I had the opportunity to observe and assist in several IUD removal and insertions as well as an endometrial biopsy. During this rotation, there was one patient in particular that stuck with me and taught me the importance of accurate documentation. The patient was a 78-year-old G0P0 female that presented for an endometrial biopsy. The patient had presented to the ED several weeks back for a UTI and hematuria. There was no sign of vaginal bleeding, but nevertheless the ED provider sent her home with a diagnosis of UTI r/o postmenopausal bleeding. Pt then followed up at the GYN clinic and got a pelvic US which showed no endometrial hyperplasia. Her endometrial thickness was only 2mm. When the patient presented to the clinic that day, she stated that she never had any vaginal bleeding, and the hematuria resolved after her UTI was treated. At that point we told the patient that she probably didn’t need the biopsy, because there were no indicators of endometrial cancer. Since she was in the clinic already, she wanted to undergo the procedure anyway. As it turns out, the procedure ended up being extremely painful for the patient and it couldn’t be completed because she had a pinpoint os secondary to nulliparity. We ended up sending her home with an order for a repeat pelvic US in 6 months, just to be safe. This patient made me realize how defensive medicine can really hurt patients. She had cystitis and ended up being subjected to the discomfort of an endometrial biopsy, even though she really didn’t need it.  A pelvic exam was done at the initial ED visit and no blood was aver visualized. Additionally, we knew she had a UTI, which explained the blood in the urine. As I enter my last rotation in PA school, I aim to keep in mind the importance of doing right by your patient and not subjecting them to unnecessary and painful testing when not indicated.

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