ABSTRACT
Correct use of the office microscope is the most important ingredient in making an accurate diagnosis at the time of the office visit. It can immediately confirm the diagnosis or lead the physician to order appropriate confirmatory laboratory testings. Unfortunately, in the United States, many physicians either no longer have a microscope in their office, because of Clinical Laboratory Improvement Amendment (CLIA) regulation, or seldom use the one that is present. In the United States, physicians are often poorly trained in medical school and residency in the use of the microscope and are poorly compensated for these services. Fortunately, there remains an emphasis on the use of microscopy in the European Union, with medical school, residency, and postgraduate medicine training available. A practicing physician should perform microscopic examinations of vaginal fluids of women with vulvovaginal symptoms and colposcopic examinations of women with abnormal cytology reports. Although the interpretation of the colposcopic examination is much more difficult than the microscopic evaluation of a wet mount smear, residents in the United States master this demanding technical skill because they have one-on-one training with a faculty colposcopist and they will be adequately compensated for this procedure when they go into practice1.
