Diagnosis

With a diagnosis of sinusitis in a 43 year old man complaining about congestion and coughing, we completed our adult preceptorship. We walked into our preceptor's office just a year ago.

While spending time in an Allergist's office, I have seen my share of inflamed noses, heard all sorts of wheezes in lungs of patients with asthma, seen all shades of prurulent discharge on the back of patient's mouths and observed the prednisone injections. And I have met real patients from the community, so different from the standardized patients we are accustomed to seeing in the clinical skills center.

I have learned to take a full history and perform a directed physical exam (mostly for an upper respiratory infection). I have become versed in the language of immunology as it relates to asthma and allergies. I know to check for nystagmus anytime I suspect a eustachian tube obstruction.

I appreciate the time my preceptor took to teach me and for allowing me to enter his office.

Making a final diagnosis was a great culmination of preceptorship and a nice preview of what awaits us in the spring, when we venture into the wards.

From here, we move to working with "little people," as we soon start our pediatrics preceptorship. I am looking forward to the adventures that await us in the next phase of our medical training.