SOAP: a map for your progress

You may be familiar with the SOAP system of charting: Subjective, Objective, Assessment and Plan. You can also think of this as a metaphor for your progress through your clinical education. In your third year, you should first focus on Subjective and Objective: getting vivid and accurate histories from patients, and conducting effective physical examinations. Toward the end of third year, and all through fourth year, you should focus on Assessment: developing your skills at putting the information together into a perceptive diagnosis. In residency, you will focus on the Plan: what treatments to apply and how to apply them. You must be well-grounded in the S and the O before you can do any A or P. Your extensive knowledge of all the different ACE-inhibitors, their doses, uses, side effects, etc, will be worthless if you cannot recognize congestive heart failure when your patient comes in with a chief complaint that he could only plant half his garden this year.