My site evaluator was Professor Mohammad Sajid. At the first evaluation I presented the following case.

ID is a 45 y/o reliable man, with no past medical history, who presents to the clinic with a complaint a left clogged ear for two days. Patient states that he woke up with his left ear feeling full. Patient states that this progressed to pain in his left ear. The patient rates the pain a 6/10 and characterizes it as a sharp pain. Patient states that the pain does not radiate anywhere. Patient has taken Tylenol which seems to have helped the symptoms slightly. Patient states that it is worse when he touches his left ear and when he tries to put in headphones. Patient admits to fever last night (100.6 F) and aural fullness. Patient states that he developed a mild headache but it also resolved with the Tylenol. Patient denies tinnitus, hearing loss, dizziness and imbalance. Patient denies right ear pain. Patient denies chills, nausea, vomiting and diarrhea. Patient has not traveled anywhere recently and also has not been in contact with anyone who has been sick. Symmetrical and normal size. Left ear canal is positive for edema and erythema with exudate. Right ear canal is clear with mild cerumen. No lesions, masses or trauma on external ears. No foreign bodies in external auditory canals AU. Tenderness upon palpation of the tragus. Tympanic membrane pearly white/intact with cone of light in normal position AU.

The plan of care:

1. Acute diffuse otitis externa of the left ear
   1. Start Ciprodex suspension, 0.3-0.1%, 4 drops into the affected ear, twice a day, for ten days.
2. Discharge instructions reviewed and discussed with the patient
3. Continue medication as prescribed, side effects reviewed and discussed
4. Avoid getting the ear wet until symptoms fully resolve and treatment completed.
5. Patient advised to proceed to ER if pus or blood drains from ear, spike in fever, redness behind the ear, ringing in the ear, dizziness, loss of hearing or other concerning symptoms arise.
6. Patient advised to follow up with PCP

Professor Sajid provided me with really great constructive criticism on how to properly assess the patient. He also showed me what to edit in my physical write up so that I would be able to have a clearer presentation in the future.