In the SOAP note, which component is used to record the patient's own description of symptoms?

• A. Subjective
• B. Objective
• C. Assessment
• D. Plan

Answer: (A)

The patient's own description of symptoms belongs in the subjective portion of the SOAP note. This section captures information the patient reports directly—the chief complaint, details about the present illness (onset, duration, quality, intensity, location, timing), factors that worsen or relieve symptoms, and any relevant medical history or medications as described by the patient. It reflects the patient’s experience and perspective rather than something that can be observed or measured by the clinician.

In contrast, the objective portion contains observable and measurable data gathered by the clinician—vital signs, physical examination findings, and results from tests or imaging. The assessment is the clinician’s diagnosis or differential based on the collected data, and the plan outlines the treatment and follow-up steps.