During this rotation, one of the new things I was exposed to was managing geriatric patients with multiple comorbidities and symptoms that often had multifactorial causes. I learned that treatment strategies in this population are not always straightforward and require looking at many different factors such as medications, functional status, psychosocial factors, and normal age-related changes. For example, I saw patients with complaints such chronic dizziness and constipation where management is more than treating the symptoms. It also required identifying possible contributing factors and looking at the patient’s overall clinical picture such as consideration of medications, functional status, psychosocial factors, and age-related physiologic changes.

One challenge I experienced during this rotation involved working with a patient population where majority of patients primarily spoke Spanish. This limited my ability to independently perform full patient interviews, but I try to stay involved in patient care by participating in physical examinations with the attending and following along with the patient’s workup and management. Participating in physical examinations became a learning experience where my attending would explain the significance of different findings and how they related to disease processes or normal age-related changes. For example, I encountered patients with rib-to-hip contact, known as costoiliac syndrome, which can occur in patients with severe osteoporosis and vertebral compression fractures due to loss of height. During eye examinations, I also observed arcus senilis, a gray-white ring around the outer edge of the eye that is commonly seen as a normal finding with aging and does not affect vision. There were other findings throughout the rotation that helped me better connect physical exam findings to real clinical conditions.

One memorable experience during this rotation involved a discussion about healthcare proxy forms and advance care planning. My attending gave me a healthcare proxy form to keep and explained its importance, and I remember being confused because I had always thought healthcare proxies were mainly recommended for older adults. I was initially unsure why he gave me one to complete if I wanted to because I did not realize that they could also be important for younger individuals as well. This experience changed my perspective because it made me realize that unexpected medical situations can happen at any age and that planning for future healthcare decisions is not limited to the elderly population.This experience taught me that discussions regarding patient goals, preferences, future healthcare decisions, and preventive planning are important regardless of age. Before this experience, I mainly associated these conversations with older adults, but I realized that unexpected situations can occur at any stage of life. I learned that having these discussions early can help ensure that a patient’s wishes are understood and respected. I think this is something that will be important in future clinical practice because it emphasized that patient-centered care and planning should not be limited to a specific age group.

Throughout this rotation, I learned that care for geriatric patients often goes beyond treating medical conditions alone. Many patients had multiple comorbidities, but I also noticed that psychosocial factors, mental health, functional status, and quality of life frequently played important roles in their overall health and management. During this rotation, I also experienced some personal challenges that affected me both mentally and emotionally, which had a negative impact on my performance and overall engagement. Looking back, I can see that it affected my motivation, participation, and ability to be as proactive as I normally would have liked. This was reflected in the feedback I received tellong me to take more initiative and become more actively involved. Although receiving that feedback was difficult, it gave me an opportunity for self-reflection and helped me recognize areas where I still need to grow. Similar to what I observed in many geriatric patients, I learned that emotional and psychosocial factors can significantly influence overall functioning and well-being. Moving forward, I want to continue developing healthier ways to manage challenges and use this experience as an opportunity for growth so that I can continue becoming a better learner, provider, and teammate in future rotations and my future clinical practice.