| Course | PA 610 Clinical Clerkship - Family Medicine |
|---|---|
| Week | 4 |
| Paper type | Medication reconciliation memo |
| Length | About 520 words, 4 pages |
| Format | Memo with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 610 Week 4
Memorandum
To: Supervising PA, family medicine clinic
From: PA student, family medicine clerkship
Date: January 14, 2026
Re: Medication reconciliation for T.B.: chart list against pharmacy fill record, three differences and one left open
Two Declared Sources
Source A: the clinic chart medication list, last updated June 2025. Source B: the pharmacy's fill record for the past 12 months, faxed January 14, 2026. T.B. was asked about each item by phone the same day.
The Comparison, Then the Exceptions
Table 1
Chart Against Pharmacy, January 14
| Medication | Chart list | Pharmacy record | Agreement |
|---|---|---|---|
| Lisinopril | 10 mg daily | 20 mg daily, filled monthly since September 2025 | Differs |
| Atorvastatin | 20 mg daily | 20 mg daily, filled every 90 days | Agrees |
| Ibuprofen | Not listed | Not dispensed; over the counter | Differs |
| Omeprazole | 20 mg daily | Last filled March 2025 | Differs |
| Fish oil | Not listed | Not dispensed | No record in either |
Note. Note. Over-the-counter products appear only if the patient reports them.
Four Elements per Difference
Lisinopril. What each source says: chart 10 mg, pharmacy 20 mg. Which is true: the pharmacy record, confirmed by T.B. Why it matters: increasing the "10 mg" dose today would have meant 40 mg. Action: chart corrected to 20 mg by me today; dose decision deferred to the next visit.
Ibuprofen. What each source says: absent from both; T.B. reports 400 mg twice a day for knee pain for about a year. Which is true: T.B.'s report. Why it matters: daily anti-inflammatory pills tend to push pressure up and weaken what an ACE inhibitor does, and the hypertension guideline lists NSAIDs among drugs to review when blood pressure is uncontrolled (Whelton et al., 2018). Action: T.B. agreed to stop; acetaminophen offered; ibuprofen added to the chart as "stopped January 14."
Omeprazole. What each source says: chart lists it as active; pharmacy last filled it ten months ago. Which is true: T.B. stopped it last spring when heartburn resolved. Why it matters: an inactive drug on the list misleads the next prescriber. Action: removed from the active list, recorded as discontinued by patient.
Unresolved, Said Out Loud
Fish oil: T.B. mentions "a fish oil my wife buys," dose unknown. It appears in neither source. I have not added it to the list until T.B. reads the label at the next visit. It is recorded in the note as "unconfirmed supplement."
An Action With an Owner
Chart list correction: done by me, January 14. Lisinopril dose review: supervising PA at the February 10 visit. Fish oil label: T.B., to bring the bottle February 10. Reconciliation will be repeated at that visit using the same two sources plus T.B.'s bottles.
Why Two Sources
Neither list alone was correct. The chart missed a dose change made by a specialist's covering clinician last September, and the pharmacy could not know about over-the-counter use. In one cardiology outpatient practice, 76 percent of patients had at least one discrepancy between the recorded list and what they reported taking, most often a medication taken but not recorded (Bedell et al., 2000), which is why reconciliation compares sources rather than trusting one.
References
Bedell, S. E., Jabbour, S., Goldberg, R., Glaser, H., Gobble, S., Young-Xu, Y., Graboys, T. B., & Ravid, S. (2000). Discrepancies in the use of medications: Their extent and predictors in an outpatient practice. Archives of Internal Medicine, 160(14), 2129-2134. https://doi.org/10.1001/archinte.160.14.2129
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Jr., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., Sr., . . . Wright, J. T., Jr. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065
Reading the PA 610 Week 4 instructions
The fourth week asks for a short memo reconciling medications from two declared sources, usually the chart list and a pharmacy record or the patient's bottles. State both sources and their dates in the header. Lay out the comparison so agreement and disagreement can be seen at a glance, usually in a table, then write up only the exceptions. Each difference should carry four elements: what each source says, which is true and how you know, why the difference matters and the action taken. Items you could not resolve should be said out loud rather than quietly added or dropped. Every action needs an owner. The memo can be built around your own medication list if your section allows it. Cite evidence that supports the actions taken.
How the PA 610 Week 4 example is put together
The memo is dated January 14, 2026, from the PA student to the supervising PA. It declares the chart list of June 2025 and the pharmacy's 12-month fill record. A table compares lisinopril, atorvastatin, ibuprofen, omeprazole and fish oil. Three differences follow with four elements each: lisinopril 10 mg on the chart against 20 mg filled since September, corrected without changing the dose; ibuprofen taken twice daily but recorded nowhere, stopped because NSAIDs can raise blood pressure, citing Whelton et al. (2018); and omeprazole listed but not filled for ten months, removed as discontinued. Fish oil of unknown dose stays unconfirmed. Owners and dates are assigned for the chart correction, the dose review and the label check. A closing section cites Bedell et al. (2000) for discrepancies in 76 percent of outpatients.
Where the points sit in the PA 610 Week 4 rubric
Reconciliation memos lose the most when they compare one list against the patient's memory without declaring sources, which makes the result unverifiable. Next comes a long narrative with no table, so agreement and disagreement cannot be seen. Graders deduct for differences missing any of the four elements, especially "which is true and how you know." Faculty reward an unresolved item said out loud instead of silently added. Every action needs an owner and date. Recognizing over-the-counter drugs, which appear in no pharmacy record, earns credit. Memo format and citation of supporting evidence in APA form complete the rubric.
PA 610 Week 4 help: mistakes that cost points
Reconciliation memos most often fall short by listing current medications without comparing anything. Another common problem is updating the chart to match the pharmacy without asking the patient, which misses over-the-counter use. Some memos also leave unconfirmed supplements on the list as fact. If your patient's lists differ in other ways, send both sources; a memo prepared for you would declare the sources, tabulate agreement and difference, give each difference its four elements, state what remains unresolved and assign each action to someone. If your section uses a specific reconciliation form, the memo would follow its fields while keeping the four elements.
Get a PA-610 Week 4 example written to your instructions
Paste in this week's assignment and the rubric, along with whatever list format your classroom requires, and a custom reconciliation memo is written to it and returned inside 24-48h, the first one free. Every drug, dose and source in the sample is invented to make the comparison legible, and your own entries replace them.
More PA 610 papers and MPAS samples
- PA 610 Week 1: Family Medicine Difference Post
- PA 610 Week 2: Family History Pedigree Map
- PA 610 Week 3: Interval History Write-Up
- PA 610 Week 5: Preventive Care Opportunity Brief
- PA 610 Week 6: Encounter Log Gap Review
- PA 610 Week 7: Take-home Instruction Sheet
- PA 610 Week 8: Continuity Case Report
- PA 608 Week 4: Missed Item Review
- PA 604 Week 4: Practice Agreement Outline
- PA 603 Week 4: Credentialing CV Draft
- PA 602 Week 4: Error Disclosure Conversation Draft
PA 610 Week 4 questions, answered
Does the memo need a table?
Most sections expect one, and even where a rubric does not require it a table is what makes the comparison readable. What matters is that the differences are lifted out of the table into prose. A memo that ends at the display has done the clerical half and skipped the graded half, which is the reasoning attached to each mismatch.
What counts as a difference worth writing up?
Anything a reader would act on differently: a drug in one source and not the other, a changed dose or strength, a frequency that does not match, a duplicate under two names, and anything stopped. Formatting differences are not worth a line. Classrooms differ on whether supplements and over the counter items belong in the count, so follow the rubric row.
Can the sample be written around my own medication list?
It can if you send one, and that is often the most useful version, because the differences then match what you actually have to explain. Names and identifying detail are stripped before anything is written. If you would rather not send it, the sample is built from invented entries arranged to produce the same categories of mismatch your week is asking about.
Where can I find a free PA 610 Week 4 sample paper?
The full PA 610 Week 4 medication reconciliation memo comparing a chart list with a pharmacy fill record is on this page.
Which difference changes the plan in the PA 610 Week 4 sample?
The lisinopril dose, which the chart listed as 10 mg though 20 mg had been filled for months, so a planned increase was stopped.