Rotation | Student Health (University/College Setting)

Monday, October 22, 2018


I finished my last shift in at the UC Davis Student Health and Wellness Center two days ago. Although the student health center seemed to be pretty low acuity (for the most part), there were times when it did get busy. The learning was definitely abundant, especially since I worked with a much different population (college students) than the urgent care (people from the community who needed, well, urgent care).

You may have heard this before, and if you have not, let me tell you this now. The types of diagnoses, patients, and insurances you will work with really depend on the city/neighborhood, the type of clinic, and the specialty area.





Nicole's Clinical Tip: Before starting your clinical rotation, get to know the area, get to know the people, and network with other classmates who may have rotated through the site before you.









Nicole's Clinical Tip: Before starting your clinical rotation, reach out to your preceptor (if you have their contact information) and ask about the dress code, what the schedule will be like, if they have any tips to prepare, and some common diagnoses you should familiarize yourself with.





Ready to learn some of the more common conditions you should know before starting your rotation at the student health (university/college level) setting?





Conditions/Diagnoses/Symptoms





  • Birth Control Methods - Intrauterine Device (IUD), Medication
  • Sexually Transmitted Infections (STI's)/Sexually Transmitted Diseases (STD's)
  • Bedbugs
  • Scabies
  • Rashes - Pityriasis rosea
  • Acne
  • Medication Refills
  • Sports Physicals/Clearances
  • Back Pain
  • Muscle Strain/Sprain
  • Immunizations - Clearance for school, sports, travel. Checking to see if any immunizations are missing.
  • Gastroenteritis
  • Pre-Expoxure Prophylaxis (PrEP) for HIV - What this consists of, patient considerations, how to offer/present this option to patients
  • Acute Pharyngitis - Mainly viral, for this site
  • Otitis Media
  • Otitis Externa
  • Cerumen Impaction
  • Antibiotic Stewardship - Especially for students from foreign countries, who may have antibiotics as an over-the-counter type medication
  • Tuberculosis - Especially how to diagnose and what to do for latent
  • Contusion
  • Fracture
  • Trauma - Especially bicycle accidents (Get those referrals to ED ready and stat!)
  • Herpes Simplex
  • Conjunctivitis - Bacterial, Viral
  • Ehlers-Danlos Syndrome (Note: You will not be the one diagnosing this, but it may be a condition that the patient already has. Know how to manage these patients.)
  • Urinary Tract Infection
  • Acute Pain
  • Influenza
  • Transgender Care - Be mindful/thoughtful about pronouns the patient wishes to use. Know how to present medication options and side effects, and medication regimen management if starting.
  • Body Dysmorphic Disorders
  • Anorexia
  • Bulimia
  • Depression
  • Anxiety
  • Obsessive-compulsive Disorder (OCD)
  • Bacterial Vaginosis




Tests





  • Strep Swab Test - How to do and interpretation of results
  • Mono Spot Test - How to do and interpretation of results
  • Flu Swab Test - How to do and interpretation of results
  • Urinalysis - How to do and interpretation of results
  • Labs - How to order, how to interpret lab values, what labs to order
  • Point of Care Glucose Check - How to do and interpretation of results
  • Fluorescein Test - How to do and what you're looking for
  • Tuberculosis (TB) Test/Screen - How to read the results and next steps if result is positive
  • KOH Prep




Diagnostics





  • Emergency Protocol (ie. where to find the crash cart, process to follow when patient becomes non-responsive (aside from starting CPR))
  • X-ray - Knowing how to read x-ray results for chest, extremities, and hand (at a minimum)




Skills





  • Intrauterine Device (IUD) Placement (Note: This requires special training, which I did not have at the time, so I observed during my rotation.)
  • Ear Irrigation
  • Prescription Writing (Electronic at this facility)
  • Intramuscular and Intradermal Injections
  • Sports and School Physical Exams - Considerations
  • Microscopy - For KOH Prep
  • Papanicolaou (Pap) Smear Test (Note: This is sometimes the patient's first one, so do not get discouraged if your preceptor does not allow you to do this skill or if the patient does not want you (the student) in the room.)
  • Pelvic Exam




Phew! This was a lot and very different than the urgent care setting (although there probably may be some overlap that I did not get to experience during my rotation). As always, let me know if you have any suggestions for things to add to help other students or feel free to reach me with any questions via the contact form on the "Contact" tab! 





- Nicole G.
@nextwithnicole


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