The fine art of diagnosis is still a mystery to me at this point in my med career. There are gaps in my knowledge and tricks or the trade that I simply haven’t learned yet. There is a component of medicine that is not taught in my classes and not covered in any text; that is – how experienced Doctors make decisions. At this point the art of diagnosis is simply pattern recognition – that is to say, that I am taking what I have learned so far, the clusters of symptoms and associated signs, and applying these to patients. If they fit into the clinical picture then I can confirm with further testing. If the tests do not support what I believe the problem to be, I then have to start over. Unfortunately, there is more to diagnosis than this, there is a logically organized thought process which I haven’t learned yet, which hasn’t necessarily been taught in school. It was therefore interesting to see then that there are those who are studying how doctors think and come to diagnostic decisions. The study and some of the results are detailed in a current article in the New Yorker [WHAT’S THE TROUBLE? by JEROME GROOPMAN].