I remember the very first patient I interviewed for an H&P, she was an elderly woman admitted to internal medicine because she had recurrent UTI’s. I remember how lost I was when witting the HPI, putting down every little positive finding in the ROS as a pertinent positive. I was obviously lost. With that being said, I think I have made a lot of improvement in figuring out what belongs in the HPI and what does not. There is no doubt that I still need loads of work to make my HPI better, but I think have come a long way from my first H&P and I hope to progress even further. I think there is this huge barrier when it comes to interviewing patients in Internal Medicine because they are already diagnosed with something and are usually being treated. So for many all three of the patients, I had in internal medicine, it was very difficult for the patient to recall their symptoms upon admission to the hospital, thus when asked about their pain, they would not be able to give me specific information, making my HPI weak. We all know that the HPI is the most important part of the H&P and I feel like I would have liked to be more criticized in this section, so I would be able to work upon it. There really isn’t much that could be said about the review of systems. For the Physical Exam, everything was straightforward as well, except for the fact when something abnormal would be found, I wouldn’t be sure if I just wasn’t sure what normal was, so I wasn’t able to compare, or if there was something wrong, the patient should know if they are in Internal Medicine or in PAT, so why didn’t they tell me, or why wasn’t it a concern, but I guess I over thought things. Overall, I think I did improve, maybe not to the best of my abilities, but hopefully, as the clinical year progresses, I will become better at HPI’s and H&P’s overall.

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