Medicine frameworks and spatial reasoning

I feel like no matter how far along I get in medicine I struggle to remember all the steps of workup for each condition. There's always something I forget to do. This is basically a memorization thing. But I also struggle from extremely poor spatial reasoning to the point that it's almost a disability although I've improved over time. I'm wondering if there's a correlation between keeping all the things to think about in your head with spatial reasoning. I'm very good at memorization when it's linear - eg steps in the Krebs cycle or something or the pathophysiology of different conditions and have overall a pretty good memory. This serves me well for outpatient medicine. I feel like I struggle with inpatient sometimes where it's like what are all the possible causes of x condition and all the initial dz and management steps. I find this most difficult when the steps are changed due to another condition the patient has, for example remembering that their liver or kidney function or anticoagulation will affect things. It's almost feels like an inability to spatially keep all the info in my head at the same time. Wondering if anyone else struggles with this. Edit: I think maybe frameworks was the wrong word. It's more like a) remembering all the steps for each branch of said frameworks and then b) like if patient a has problems x,y,z I have difficulty keeping all the problems in my mind at the same time if there's an interplay.