Clinical correlation sessions were very useful in helping me apply my medical knowledge and history-taking skills to real-world patient care situations. In the beginning, the content was easy to understand, but I was a bit lacking when it came to focusing on the most relevant information, especially during differential diagnosis. For most of the cases I went through, I was able to come up with 3–4 differentials in my head, but the challenge was knowing when to include or exclude something if the patient did not present with the classic symptoms. For example, for one of the cases I assumed that an abdominal aortic dissection would typically present with abdominal pain radiating to the back. I did not expect or consider that an abdominal exam could be unremarkable and that solely back pain radiating ipsilaterally to the buttocks could also point to a dissection.

From that case, I learned that it is important that diseases do not always show up the way textbooks describe them. Additionally, one obstacle I had to work on was avoiding tunnel vision and not letting it take away focus from other parts of the patient’s medical history, like in the aortic dissection case. Trying to get better at picking up on subtle signs and not just waiting for textbook presentations while getting in the habit of asking myself, what else could this be or where else can CVA tenderness present, so I can keep my differential broad and not miss anything serious.

As I moved forward in these sessions, I strengthened my critical thinking, particularly in developing differentials using a systematic head-to-toe approach. Compared to prior sessions, I now ask more targeted history questions guided by my differential rather than completing a broad review of systems first. Moving forward, I want to further improve my patient communication skills to ensure I am empathetic, clear, and compassionate when discussing difficult information.