Review of Systems (ROS)

The review of systems is a list of closed ended questions intended to uncover any recent symptoms that haven’t already come up. In the clinic, patients often complete the ROS on paper or online before the visit, and the provider simply reviews it. For a new patient in the hospital, physicians typically ask at least one or two of the most important questions about each organ system, but they would rarely ask all the questions on the checklist below.

A complete review of systems is important when a patient’s presenting problem is unusual or their diagnosis is very unclear. Uncovering another symptom, which the patient might not recognize as important or related, can be very helpful in narrowing the differential diagnosis

As a beginning medical student, practicing the complete ROS can help you remember which other symptoms to ask about related to your patient’s chief concern. Once you identify the organ system or systems that may be causing your patient’s problem, you’d ask all of the questions in those sections of the ROS. The presence or absence of each of these symptoms is included in the HPI.

For other systems, practice asking at least a few questions from each organ system. We encourage you NOT to use the checklist to tick off every question as you interview your patient, though you can use it to double check that you’ve asked all the pertinent questions. You’ll need to remember both the lay language that you might use with patients and the medical terms you might use in communicating with other clinicians.

Example: Review of systems

REVIEW OF SYSTEMS – FCM CHECKLIST

Download FCM ROS Checklist as a PDF

Use the middle column prior to your interview to make note of how you might ask about the particular system or symptom. In the “Notes” column, note the presence or absence of the symptom and any additional details.