This site evaluation with Professor Melendez was conducted via webcam and in person. The first site evaluation was conducted via webcam due to conflicting schedules and the last one was done in person.

In total we had to present 2 H&P’s, one per site evaluation. For my first site evaluation I presented Ms. RR. who was a 32-year-old female patient G6P3023 LMP 06/01/2020 EGA 8w0d and EDD 03/08/2021 and no significant PMHx came in that day for vaginal bleeding. Bleeding had been going on for 3 days and was also associated with B/L lower abdominal pain. On physical exam, dilation of the cervical os was noted with heavy vaginal bleeding and partial passage of product of conception. Pelvic U/S was done next which showed 4cm by 3cm product of conception still present in the uterus. Ms. RR was diagnosed with incomplete spontaneous abortion and speculum and ring forceps were used to remove as much POC as possible. Pt was started on misoprostol and a urine culture was ordered to make sure there was no possible infections. CBC and differential and type and screen were ordered to see if pt was anemic due to recent blood loss. Pt was also tested for Rh immunity and antibodies to make sure that if she was negative then RhoGam would be started. For my second site evaluation, I presented Ms. ER who came in with complains of vulvar pruritus, vulvar erythema and dysuria that’s been going on for about a week. Physical exam noted thick and white cottage cheese like discharge all around the vaginal canal and cervical os as well as erythema around the vulvar. Pt most likely had Candida. To fully confirm the diagnosis microscopic test with KOH prep was done to look for hyphae or yeast and was positive for Candida. UA and urine culture were also ordered for further inspection since patient also presents with dysuria. Pt was started on terconazole vaginal cream 0.8% which helps treat vaginal yeast infection, vaginal burning, and itching. I received some great feedback from Professor Melendez. For the first H&P he suggested to work on my plan a bit more and include step by step the process of getting this pt from the ER to OBGYN clinic. For the second H&P he suggested to be a bit more descriptive for the pelvic exam. To add a bit more into it and describe the abnormal findings with a bit more details. Overall, he liked both H&Ps and gave some really important tips and suggestions which I will implement on my future H&P’s.

The article I selected to present to my site-evaluator was a double-blinded RCT and was published in 2010 with the title “Treatment of bacterial vaginosis: a multicenter, double-blind, double-dummy, randomized phase III study comparing secnidazole and metronidazole”. I decided to present this article because it did a good job in comparing the effectiveness of metronidazole vs secnidazole in non-pregnant women with bacterial vaginosis. The article was also a double- blinded RCT with a population size of 577 patients which was a reasonable population size. During my OBGYN rotation I did see quite a few pts with BV so I thought it was interesting to present this article to my preceptor.

For my 10 pharm cards, I tried to select all drug that I saw during my OBGYN rotation such as Methotrexate for ectopic pregnancy, Clomiphene for PCOS, Plan B for emergency contraception and SSRI for post-partum depression and as well as metformin for gestational diabetes.

Overall this was a great experience and I received very helpful tips and comments from my site-evaluator.

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