Twelve Steps to Proficiency in Diagnosis
- Avoid telephone diagnosis. Do not assume you know until you look.
- Implement a systematic approach to women who are symptomatic that you use every time.
- Take a targeted history. It may be more extensive than you think!
- Name things: the normal anatomy as you look at it and any lumps, bumps, and cracks or discoloration you see, using correct medical terminology. Document in the same way.
- Critically look at the anatomy and the skin, even in the asymptomatic patient, taking note of benign and abnormal changes.
- Learn the most common vulvar skin disorders so you can recognize them when you see them.
- Add vulvar biopsy to your skill list or recognize when to refer for biopsy.
- Add the “q-tip” test to exams to evaluate for pain syndromes and do not forget, in questions of pain, to test for tone of the pelvic floor.
- Improve microscope skills, understanding how pH fits into normal and abnormal findings.
- Understand which lab tests to order and which will not help you. Use yeast cultures more.
- Keep a list handy of appropriate treatments for the conditions you learn about.
- Look for combinations of disorders. Keep an open mind and evaluate objectively.
Review this website with dedication and you will become an expert!