During my recent long-term care geriatrics rotation at Metropolitan Hospital, I had the privilege of experiencing firsthand the unique challenges and complexities of caring for older adults. This rotation was a rich learning experience, exposing me to learn about the many geriatric syndromes and providing insight into the numerous physical, cognitive, and social issues that patients face as they age. Working with Dr. Kotchev, an internal medicine and geriatrics specialist, was an invaluable part of this experience. Not only is he highly knowledgeable, but his dedication to teaching and patience in explaining complex concepts was truly inspiring. His thorough approach to the geriatric assessment and the physical exam impressed upon me the importance of a detailed examination, a skill that, in my view, has become something of a “lost art” in medicine.
Under Dr. Kotchev’s guidance, I performed a cardiovascular exam, neuro exam, and musculoskeletal assessment each day. Observing his methodical approach helped me appreciate the significance of these exams in identifying subtle yet impactful health changes in geriatric patients. I particularly valued the opportunity to strengthen my own physical exam skills and gain deeper insights into common geriatric challenges, such as polypharmacy and the management of chronic conditions like diabetes, hypertension, and hyperlipidemia. Dr. Kotchev emphasized the importance of ambulation and gait assessment, which are crucial for helping patients maintain independence in their daily lives.
This rotation also highlighted areas I need to develop further. For example, creating a treatment plan on the spot remains a challenge for me, though I am confident this skill will improve with time and experience. Throughout the rotation, I practiced history-taking, comprehensive reviews of systems, and performing head-to-toe exams, all of which reinforced my understanding of differential diagnoses. As I reflect on my time in geriatrics, I feel I am becoming a more well-rounded student, with a stronger foundation in the fundamentals of patient care. The rotation was very inspirational and deepened my appreciation for the complexity of geriatric medicine.
Overall, I am incredibly grateful for the opportunity to complete this rotation. It was an experience that not only strengthened my clinical abilities but also deepened my commitment to providing thoughtful and thorough care to patients, especially those facing the unique challenges of aging.
