I learned many important lessons and skills throughout my Internal Medicine rotation. Each day I worked with a new PA than the day before. One of the immediate lessons that I learned was the importance of being flexible and willing to learn from everyone. No matter the PA or their approach to medicine, I found that each of them had something to bring to the table and educate me on a matter that they were well versed in. One such example was on one of my overnight shifts when I was rounding with the PA. One of the patients that we saw was clearly agitated and demanded higher pain medications. The medical team in charge of his care were suspicious that he was drug seeking. I learned how to deal with complex patients through observing the patient yet firm manner in which the PA responded to his requests. I also had the opportunity to listen to the conversations that the PA and attending physician had as they discussed whether or not it was appropriate to provide the patient with higher doses of pain medications. Another area in which I was able to develop my skills was placing IVs and drawing blood. I had the opportunity to follow around nurses in the ER and improve my efficiency and success rate. One of the nurses that I was with took great care to guide me in gathering the right equipment and accurately identify the best vein to aim for. Similarly, I had many opportunities to practice conducting a physical exam. I was pleased to see that after watching the PAs complete multiple neurological exams, I was able to start conducting them on my own. However, I do believe that I continue to require further practice particularly in this area. During my next rotation, I hope to have the opportunity to practice various physical exams. In particular, I would like to improve my skills when auscultating the heart and lungs. While I definitely have noticed improvement in my ability to discern and recognize different sounds, I still lack the assurance that I am hearing correctly. Another memorable experience from my rotation occurred during my week on the stroke team. A patient was found unconscious in front of a door and EMS was called to bring her to the ER. Upon arrival to the ER the patient was worked up for a stroke and the decision was made to deliver Tenecteplase. Tenecteplase is dosed based upon the patient’s weight, a factor that was unknown for this patient. Typically the hospital beds have a scale feature, however the battery in her bed was no longer working. While some of the medical providers wanted to estimate her weight, I was concerned for the patient and her small frame and insisted that the patient be switched to an alternate bed and weighed accurately. This lesson taught me to remain strong in my beliefs and always insist on the safety and accuracy of patient care. Throughout my career as a PA I hope to continue develop a sense of responsibility for each of my patients and ensure that each one is tended to with the most attention and care.