In the mid-rotation evaluation site visit, I presented two patients’ SOAP Notes, including initial admission note and post-operative note. My first case is an incisional hernia repair. For this patient, she is a 73-year-old female presents prior to scheduled Laparoscopic Incisional Hernia Repair. My second case is a 72-year-old female presents for lumpectomy. My site evaluator discussed the post-operative patient care, such as DVT prevention, incentive spirometry using for atelectasis prevention, as well as, the pain management, which I found to be very helpful.

In the final evaluation site visit, I presented three cases, one is on cholecystectomy, the second one is on incisional hernia repair, and the last one is on appendectomy. Professor Rachwalski and I talked about the indication of Hartmann’s procedure, treatment for perforated appendicitis with abscess. We also discussed the function of heparin, and the difference between heparin drips and heparin subcutaneous injection. After the case presentation, I also presented an article which aims to assess in-hospital delay before surgery as risk factor for complicated appendicitis and postoperative morbidity in patients with acute appendicitis. I chose to present this article because it was related to my appendectomy case and explained why attending in that case decided to delay the operation.

My site evaluator did not comment much on the way I presented my SOAP note HPI. However, he gave a lot of useful comments on the physical exam write up, such as how to document drains, and how to descript hernia. This will be very beneficial and applicable to my future rotations when I report the significant physical findings.