How I Approach Diagnosis in Sexual and Reproductive Health
When I was a 3rd year medical student, I received some advice from a preceptor that changed the way I approach clinical evaluation. I had just seen a patient and came back to the office to report my findings. I was able summarize the history of present illness and the physical exam easily enough, but once I got to the “Assessment and Plan” section, I stalled. My preceptor, a man in his mid-40s with salt-and-pepper hair and kind eyes behind his glasses, prompted me to differential diagnosis. I tried to . . . poorly. I rambled, naming individual condiions proceeded to do this in a completely disorganized fashion as they popped into my head. Suddenly, I sounded scattered and unsure.
After a minute, he stopped me and offered a piece of advice that’s stuck with me ever since: “Be a lumper, not a splitter”.
Instead of scrambling for individual causes, he encouraged me to think in broad diagnostic categories that could fit the clinical presentation and then use the patient’s history, clinical exam findings, and test results to narrow things down.
It’s a method that helps you remember more by organizing better, and it turns your patient encounters into focused, thoughtful, collaborative care.
I’ve used this approach with patients ever since - whether they come in with bleeding or pelvic pain - and I will use it on this page too.
I don’t jump to conclusions or rush to label, and I don’t throw tests or ultrasounds at symptoms just to “do something.” Diagnosis, done right, is thoughtful and deliberate. It’s a process of asking smart questions, ruling out the scary stuff, and making patients feel heard along the way.
On this page, we’ll tackle common OBGYN concerns. For each one I’ll share
a lumped differential diagnosis
a breakdown of key history and physical findings to look for
tests that actually help your patients feel head and make your a rockstar with your colleagues and consultants.
Curious what that looks like in practice?
Scroll through the posts for real examples, case breakdowns, and diagnostic insights.
Thanks for reading! Have thoughts, questions, suggestions for future posts, or your own story to share? Drop a comment below - I’d love to hear from you. And if you enjoy our content or find it helpful, hit subscribe to stay in the loop!