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Published: 30 January 2023

A student guide to writing a case report

Maeve McAllister 1

BDJ Student volume 30 , pages 12–13 ( 2023 ) Cite this article

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As a student, it can be hard to know where to start when reading or writing a clinical case report either for university or out of special interest in a Journal. I have collated five top tips for writing an insightful and relevant case report.

A case report is a structured report of the clinical process of a patient's diagnostic pathway, including symptoms, signs, diagnosis, treatment planning (short and long term), clinical outcomes and follow-up. 1 Some of these case reports can sometimes have simple titles, to the more unusual, for example, 'Oral Tuberculosis', 'The escapee wisdom tooth', 'A difficult diagnosis'. They normally begin with the word 'Sir' and follow an introduction from this.

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Guidelines To Writing a Clinical Case Report. Heart Views 2017; 18 , 104-105.

British Dental Journal. Case reports. Available online at: www.nature.com/bdj/articles?searchType=journalSearch&sort=PubDate&type=case-report&page=2 (accessed August 17, 2022).

Chate R, Chate C. Achenbach's syndrome. Br Dent J 2021; 231: 147.

Abdulgani A, Muhamad, A-H and Watted N. Dental case report for publication; step by step. J Dent Med Sci 2014; 3 : 94-100.

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McAllister, M. A student guide to writing a case report. BDJ Student 30 , 12–13 (2023). https://doi.org/10.1038/s41406-023-0925-y

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Published: 27 November 2013

A guide to writing case reports for the Journal of Medical Case Reports and BioMed Central Research Notes

Richard A Rison 1

Journal of Medical Case Reports volume 7 , Article number: 239 ( 2013 ) Cite this article

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Case reports are a time-honored, important, integral, and accepted part of the medical literature. Both the Journal of Medical Case Reports and the Case Report section of BioMed Central Research Notes are committed to case report publication, and each have different criteria. Journal of Medical Case Reports was the world’s first international, PubMed-listed medical journal devoted to publishing case reports from all clinical disciplines and was launched in 2007. The Case Report section of BioMed Central Research Notes was created and began publishing case reports in 2012. Between the two of them, thousands of peer-reviewed case reports have now been published with a worldwide audience. Authors now also have Cases Database, a continually updated, freely accessible database of thousands of medical case reports from multiple publishers. This informal editorial outlines the process and mechanics of how and when to write a case report, and provides a brief look into the editorial process behind each of these complementary journals along with the author’s anecdotes in the hope of inspiring all authors (both novice and experienced) to write and continue writing case reports of all specialties. Useful hyperlinks are embedded throughout for easy and quick reference to style guidelines for both journals.

Peer Review reports

Introduction: the importance of case reports

Case reports are a time-honored tradition in the medical profession. From Hippocrates (460 B.C. to 370 B.C.), and even arguably further back since the papyrus records of ancient Egyptian medicine (c. 1600 B.C.) to modern day, physicians of all specialties have described interesting cases involving all specialties [ 1 , 2 ]. Published case reports provide essential information for optimal patient care because they can describe important scientific observations that are missed or undetected in clinical trials, and provide individual clinical insights thus expanding our knowledge base [ 3 ].

The publication of case reports has indeed become a standard lexicon of the medical literature. Examples abound. Few practicing physicians would not know for instance the significance and subsequent discovery of a disease whose first description in 1981 began with the title in the medical case report literature as: “A preliminary communication on extensively disseminated Kaposi’s sarcoma in a young homosexual man” [ 4 ]. There is no neurologist that I know who is unfamiliar with the disease whose description began in 1817 by James Parkinson (1755 to 1824) with the title “An essay on the shaking palsy.” [ 5 ].

Yes, both of the above-mentioned famous diseases (the acquired immunodeficiency syndrome and Parkinson’s disease) were first described in the case study format. The act of recording, discussion with colleagues, and publishing our clinical observations with patients remains essential to the art of medicine and patient care. As Osler once said “Always note and record the unusual…Publish it. Place it on permanent record as a short, concise note. Such communications are always of value.” [ 6 ].

But how and when should we do this? Early case reports were little more than personal communications between colleagues about unique and interesting patients seen in their respective medical practices. This anecdotal reporting has evolved into an accepted form of scholarly publication with the ability to rapidly disseminate knowledge to a broad medical audience [ 7 ] using the generally accepted format of a title, abstract, introduction (background), case presentation, discussion, conclusions, and references. Many biomedical journals publish case reports and provide authors with guidelines that provide instruction for acceptance criteria, content, and format and give advice on relevant patient case reports that merit publication [ 3 ].

There are already many well-written published articles on how and when to write a good case report (please see Recommended further reading section at the end). I will not re-invent the wheel, but within this editorial I hope to provide an informal guide on how and when to write a case report for BioMed Central (BMC), in particular the Journal of Medical Case Reports ( JMCR ) and BioMed Central Research Notes ( BMCRN ). The utility of the newly created Cases Database will also be discussed. Relevant and useful website links will be used throughout to allow the reader easy access to further information on BMC requirements. I also hope to impart to the reader a brief overview of case report editorial flow in both JMCR and BMCRN along with the complementary relationship between both journals. I will also give anecdotes of how I personally approach things.

Definitions

What exactly is a case report? From peer-reviewed journals to Wikipedia (and yes, I read Wikipedia like we all do) definitions are readily available and generally agreed upon. A simple online search shows the following definition from “thefreedictionary.com” [ 8 ]: “Case Report A report of a single case of a disease, usually with an unexpected presentation, which typically describes the findings, clinical course, and prognosis of the case, often accompanied by a review of other cases previously reported in the biomedical literature to put the reported case in context.” Wikipedia [ 9 ] has this to say: “In medicine, a case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports may contain a demographic profile of the patient, but usually describe an unusual or novel occurrence. Some case reports also contain a literature review of other reported cases.” Whether one uses the above definitional references or older more classic ones [ 10 ], all are in agreement.

How to start: the patient

Things start at the bedside or in the office with the most important person involved: the patient. Patients and their stories (including from their friends, coworkers, and family) are our portal to writing the case report. Patients (both in-patients and out-patients) are assessed, we confer with colleagues, appropriate investigations then follow, and treatment if possible begins. If I encounter an in-patient on call then I follow him or her throughout his or her hospitalization and, I hope, timely discharge. The patient is then followed and reexamined in the office over the course of time to see how the clinical course evolves. I usually wait 6 months over the course of multiple visits before I actually begin to write a case report so as to allow enough time for the clinical course to play out. Of course if the patient is hospitalized with an acute and rapid illness then this time may be much shorter, but I still follow him or her with daily neurologic examinations.

Collegial discussion and the Internet: our modern day water cooler

When an interesting condition is encountered in either the hospital or the office setting, I discuss the case in person with both my local neurology colleagues and colleagues of other specialties to see if they have encountered before the clinical scenario that I am dealing with at the time. This is usually a quick face-to-face nursing station conversation. If the case is particularly challenging then I will contact my local university colleagues for their opinion (especially if an urgent transfer needs to be arranged). I then “hit the books”, or at least I used to. Nowadays I usually “hit the keyboards” which are plentiful at every hospital nursing station and in my office. Indeed, the Internet seems to have become our modern day replacement for office water cooler conversations. Since it is readily available (and free to me because I am a member of the staff) in the hospital in which I see patients and in my office, I usually start with UpToDate® [ 11 ] and then click the links to individual references. Further reading is then supplemented by both PubMed [ 12 ] (free) and Cases Database (also free) [ 13 ] (see later). If I feel that a particular patient warrants a case report, then I continue to read more and more. There are also medical list servers and medical online communities to which one can post a case with de-identified images online and petition the advice of colleagues worldwide. I use both Neurolist [ 14 ] (a membership-only service, but membership is free) and The American Academy of Neurology (AAN) for my specialty and/or subspecialties [ 15 ] (also a membership-only service, the fee of which comes out of my yearly AAN dues). Another useful list server is sermo® [ 16 ], which has free membership. Teaching grand rounds at one’s local university or hospital, poster presentations, and simple discussion with professors giving lectures at local seminars are also good (and previously “traditional”) places to start. I have always preferred an in-person encounter to discuss a case with a colleague or professor, but given the current day and age (daily workload, travel costs, time away from the office and family, and so on), I have found Internet-based discussion (keeping all patient information anonymous of course) very helpful.

The BMC series, JMCR , and BMCRN : a brief history

The BMC series is a group of open access, peer-reviewed journals that spans most areas of biological and clinical research. There are currently 65 journals in the series, including (alphabetically) BMC Anesthesiology to BMC Women’s Health. Some of these publish case reports within their respective disciplines, and some do not [ 17 ].

JMCR is an online, open access journal under BMC auspices dedicated mainly to the publication of high quality case reports, and aims to contribute to the expansion of current medical knowledge (please see specific publication criteria below). It was created and founded by Michael Kidd and colleagues in 2007 and at the time was believed to be the world’s first international medical journal devoted to publishing case reports from all clinical disciplines. In the 5 years since its launch, JMCR has published over 2000 case reports. In 2011, case reports were downloaded from the journal’s website over 1,500,000 times [ 18 ].

BMCRN is also an online, open access journal under BMC auspices publishing scientifically sound research across all fields of biology and medicine. The journal provides a home for short publications, case series, and incremental updates to previous work with the intention of reducing the loss suffered by the research community when such results remain unpublished. BMCRN began publishing case reports in 2012 and now has a dedicated section for case reports [ 19 ].

Please read on to see the complementary relationship of case reporting between the two journals, how they relate to other journals in the BMC series, and further information on editorial work flow including specific publication criteria.

Cases Database: an invaluable resource

Since the launch of JMCR in 2007 and the more recent introduction of case reports to the BMCRN , which aims to have a broader scope, BMC has acknowledged and continues to acknowledge the value of case reports to the scientific literature. To further strengthen this commitment, BMC in conjunction with Michael Kidd have developed the invaluable new resource of Cases Database, a continually updated, freely accessible database of thousands of medical case reports from multiple other publishers, including Springer, British Medical Journal, and PubMed Central. By aggregating case reports and facilitating comparison, Cases Database provides a simple resource to clinicians, researchers, regulators and patients to explore content and identify emerging trends [ 20 ].

http://www.casesdatabase.com/

I find Cases Database indispensable when I research a particular patient’s condition. It is very helpful in seeing if a particular condition has been reported before and what treatment the authors have performed. It is an invaluable resource which can be used to check and see if previous cases have been reported before and how other authors have managed their patients with similar clinical conditions. When I last checked, Cases Database had in its repository 27,915 peer-reviewed medical case reports from 250 journals (!) [ 13 ]. Cases Database is quickly becoming my first go to when reading about a patient’s condition and symptoms.

When to write a case report

How does one determine when to write an actual case report? What constitutes and what are the criteria for publication? Different journals have different criteria, but here are the criteria for JMCR and BMCRN .

JMCR [ 21 ] publishes original and interesting case reports that contribute significantly to medical knowledge. Manuscripts must meet one of the following criteria: unreported or unusual side effects or adverse interactions involving medications; unexpected or unusual presentations of a disease; new associations or variations in disease processes; presentations, diagnoses and/or management of new and emerging diseases; an unexpected association between diseases or symptoms; an unexpected event in the course of observing or treating a patient; findings that shed new light on the possible pathogenesis of a disease or an adverse effect.

http://www.jmedicalcasereports.com/authors/instructions/casereport

BMCRN [ 22 ] has somewhat different publication criteria: BMCRN considers medical case reports that describe any clinical case. Case reports submitted to BMCRN do not need to be novel, but must be authentic cases and have some educational value along with representing at least an incremental advance in the field. BMCRN will not consider case reports describing preventive or therapeutic interventions because these generally require stronger evidence.

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport

Neither BMCRN nor JMCR will consider case reports where there are ethical concerns.

JMCR and BMCRN have the following definitions that authors should know: a single case report, two case reports, or a case series (greater than two reported cases). Both journals follow this format and accept submissions with these title structures.

I tend to classify case reports in my mind generally as follows: diagnosis-related, management-related, or both [ 10 ]. Either type should have clear and concise take-home messages and teaching points. I personally keep a stack of charts labeled “Curious Cases” on a bookshelf within my small office next to my desk which is always within my field of view at work, adhering to the “out of sight, out of mind” principle. Over the years that space has grown and, admittedly, I have cases dating back over the entire span of my years in practice (now over 13 years) which I simply have not gotten around to yet (!).

BMC editorial workflow for case reports: a brief glimpse

If a BMC Series journal editorial team considers a submitted case report unsuitable for their respective specialty journal (and now a growing list of Springer journals that BMC is now affiliated with), the authors are given the option to transfer their manuscript to BMCRN . If this option is exercised, then the BMC editorial team (usually the Case Report Section Editor for BMCRN in conjunction with the appropriate Associate Editor) determines if the manuscript is suitable for BMCRN or if it is more suitable for JMCR (based on the criteria listed above). The manuscripts will then be forwarded on to the respective Deputy and/or Associate Editors for peer review depending on which of the journals the author(s) agree(s) to. Peer reviewers are solicited (usually at least one at BMCRN and at least two at JMCR ). The peer review comments (which are open and identifiable at JMCR and blinded at BMCRN ) are then usually sent to the authors for appropriate revisions and rebuttals (unless it is felt that the manuscript should be rejected outright, at which time the editorial office sends the authors an explanatory letter). After these revisions and rebuttals have been performed, the revised manuscript and rebuttals are sent back to the respective editors for a final decision and recommendations. These decisions and recommendations are then forwarded on to the Editor-in-Chief for final approval for publication. At JMCR , manuscripts are professionally copyedited before being sent off to the production team for publication, whereas at BMCRN the authors are requested to obtain their own professional copyediting (if needed) before publication (the respective costs being reflected within the different article processing charges for both journals). When the manuscripts are published in both journals, they are in the preliminary form before being converted to the final form after production.

Author satisfaction consistently ranks high for the overall process in both journals.

The actual case report

Now let us discuss the brass tacks of writing the actual case report by going through the individual sections that will comprise the manuscript. I will present them in a sequence that matches the journals’ website requirements and provide easily accessible hyperlinks to both respective journals.

The first page of the manuscript should be a dedicated title page, including the title of the article. The title should be a clear and short description of the case with a list of the full names, institutional addresses and email addresses for all authors. There should always be at least one corresponding author who is clearly identified. Abbreviations within the title should always be avoided.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-title

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#title

I usually end the title with “…: a case report” or “…: two case reports” or “…: a case series”. I also try to avoid any puns or overly cute wording within the title and try to keep things strictly descriptive and clear. The title needs to accurately describe the case – after all, this may be all that someone reads. If a cute or clever title is used that obscures what the case is really about, then it may be even less likely that the manuscript is read.

The Abstract should be “short and sweet”. It should not exceed 350 words. Abbreviations or references within the Abstract should not be used. The Abstract should be structured into three sections: Background, an introduction about why this case is important and needs to be reported. Please include information on whether this is the first report of this kind in the literature; Case presentation, brief details of what the patient(s) presented with, including the patient’s age, sex and ethnic background; Conclusions, a brief conclusion of what the reader should learn from the case report and what the clinical impact will be. Is it an original case report of interest to a particular clinical specialty of medicine or will it have a broader clinical impact across medicine? Are any teaching points identified?

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-abstract

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#abstract

I find this is the most important part because this is often all that people will read and its availability will allow easy retrieval from electronic databases and help researchers decide their level of interest in the case report. The Abstract should be a concise and condensed version of the case report and should include the same main sections of the main text and be as succinct as possible [ 3 ]. This is the last thing that I usually write as it tends to flow easily after I have invested my time in thought and writing of the manuscript.

This section is comprised of three to ten keywords representing the main content of the article. It is important for indexing the manuscript and easy online retrieval.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-keywords

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#formatting-keywords

Introduction (Background)

The Introduction ( JMCR ) or Background ( BMCRN ) section should explain the background of the case, including the disorder, usual presentation and progression, and an explanation of the presentation if it is a new disease. If it is a case discussing an adverse drug interaction the Introduction should give details of the drug’s common use and any previously reported side effects. It should also include a brief literature review. This should give an introduction to the case report from the standpoint of those without specialist knowledge in the area, clearly explaining the background of the topic. It should end with a very brief statement of what is being reported in the article.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-intro

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#background

The Introduction or Background serves as the sales pitch for the rest of the manuscript. It should be concise and salient [ 3 ] and immediately attract the reader’s attention to entice him or her to read on.

Case presentation

This should present all relevant details concerning the case. The Case presentation section should contain a description of the patient’s relevant demographic information (without adding any details that could lead to the identification of the patient); any relevant medical history of the patient; the patient's symptoms and signs; any tests that were carried out and a description of any treatment or intervention. If it is a case series, then details must be included for all patients. This section may be broken into subsections with appropriate subheadings.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-case

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#presentation

This is one of the most integral sections. The case should be described in a concise and chronological order. One should usually begin with the primary complaint, salient history (including significant family, occupational, and other social history along with any significant medications taken or allergies), followed by the physical examination, starting with the vital signs presented at the examination, along with pertinent investigations and results. There should be enough detail (but not too much) for the reader to establish his or her own conclusions about the validity. It should contain only pertinent information and nothing superfluous or confusing [ 3 ].

This is an optional section in JMCR for additional comments that provide additional relevant information not included in the case presentation, and that put the case in context or that explain specific treatment decisions.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-discussion

This section should evaluate the patient case for accuracy, validity, and uniqueness and compare and contrast the case report with the published literature. The authors should briefly summarize the published literature with contemporary references [ 3 ].

Although this section is optional in JMCR (and not even listed separately on the BMCRN guidelines website), I find that most authors write this section, or an expanded conclusions section incorporating the elements listed above.

I personally write a separate discussion section and conclusions section for each case report that I author.

Conclusions

This should state clearly the main conclusions of the case report and give a clear explanation of their importance and relevance. Is it an original case report of interest to a particular clinical specialty of medicine or will it have a broader clinical impact across medicine? Information should be included on how it will significantly advance our knowledge of a particular disease etiology or drug mechanism (if appropriate).

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-conclusion

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#conclusions

This should be short and concise with clear take-home messages and teaching points [ 3 ].

Patient’s perspective

This section is an opportunity for patients to add a description of a case from their own perspective. The patients should be encouraged to state what originally made them seek medical advice, give a description of their symptoms, whether the symptoms were better or worse at different times, how tests and treatments affected them, and how the problem is now. This section can be written as deemed appropriate by the patients, but should not include identifying information that is irrelevant to the case reported. As medicine becomes more person-centered, the voice of the individual patient becomes even more important, both to assist in clinical decision making, and for medical education.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-patients

This optional section is unique to JMCR , and I believe adds an important new dimension to the traditional case report. Most authors still do not yet take advantage of this, but I hope as time goes on and more and more open access case report manuscripts are published that this section will be routinely used, not just in JMCR but also in BMCRN and all other BMC clinical journals. I recall one manuscript in particular where the patient himself was requesting publication as soon as possible because of his terminal disease. He wanted his message out there and be available to all to read before he died.

List of abbreviations

When abbreviations are used in the text they should be defined in the text at first use, and a list of abbreviations can be provided, which should precede the Competing interests and Authors’ contributions sections.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-abbreviations

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#formatting-abbreviations

Both JMCR and BMCRN publish case reports over a wide range of medical and surgical specialties, and it is important for the reader who may not be within that particular specialty to readily access a quick list of commontechnical abbreviations. Also, given the open access nature of both journals, please keep in mind that nonmedical professionals may read the manuscript as well.

This section is compulsory for BMC. It should provide a statement to confirm that the patient has given their informed consent for the case report to be published. The written consent should not routinely be sent in along with the manuscript submission (because of patient privacy issues), but the BMC editorial office may request copies of the consent documentation at any time. The following wording is recommended: “Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.” If the individual described in the case report is a minor, or unable to provide consent, then consent must be sought from his or her parents or legal guardians. In these cases, the statement in the ‘Consent’ section of the manuscript should be amended accordingly. Please keep in mind that manuscripts will not be peer reviewed if a statement of patient consent is not present.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-consent

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#consent

In practice, I always start with written consent from the patient. If the patient is incapacitated or deceased, then I obtain consent from the patient’s next-of-kin. Once this is obtained then I place it in the patient’s chart for safe keeping. I find that most patients and family members are quite agreeable to publication as long as their details are anonymous. BMC has very clear and explicit consent criteria and consent forms in multiple languages. I always keep a consent form within my office (and carry a few in my doctor’s handbag for hospital consults) for ready access. After I have obtained consent, I place it in the patient’s chart and keep it my office.

If the patient has died, then I try to obtain consent from the patient’s next-of-kin. This is usually done via telephone or postal mail. If the deceased patient’s family is amenable (and usually they are), then I send them (I never use email when it comes to patient-identifying information) the pre-filled out consent form in their language with a return envelope and paid for postage via the postal service. If I am unable to obtain consent this way in a case involving a patient who has died, then I write in the Consent section the following: “Written informed consent could not be obtained from the deceased patient’s next-of-kin for publication of this case report and accompanying images despite all reasonable attempts. Every effort has been made to protect the patient’s identity and there is no reason to believe that our patient would have objected to publication.”

If the patient was last known to be living but untraceable (or mentally incapacitated without next-of-kin consent), then I just simply do not publish the case.

For further information, please see JMCR and BMCRN website consent section hyperlinks as listed above.

Authors’ information

This section includes any relevant information about the author(s) that may aid the reader’s interpretation of the article and understanding of the standpoint of the author(s). This may include details about the authors’ qualifications, current positions they hold at institutions or societies, or any other relevant background information. Please refer to authors using their initials. Note this section should not be used to describe any competing interests.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-information

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#formatting-information

In practice, I have frankly also personally used this section to advertise my services and “tout” my certifications and subspecialties (along with any co-authors and affiliated institutions) to my surrounding local community. This has in turn given me a modest increase in business (which has been completely non-monetary to date), usually in the form of email-based queries, many of which come from patients outside of my locality.

Acknowledgements

Authors should acknowledge anyone who contributed towards the article by making substantial contributions to conception, design, acquisition of data, or analysis and interpretation of data, or who was involved in drafting the manuscript or revising it critically for important intellectual content, but who does not meet the criteria for authorship. Also included should be the source(s) of funding for each author, and for the manuscript preparation. Authors must describe the role of the funding body, if any, in the: design, collection, analysis, and interpretation of data; writing of the manuscript; and decision to submit the manuscript for publication. Please also acknowledge anyone who contributed materials essential for the study. If a language editor has made significant revision of the manuscript, I recommend that you acknowledge the editor by name, where possible. Authors may also like to acknowledge (anonymously) the patient on whom the case report is based. If a scientific (medical) writer is used, this person should be included in the Acknowledgements section, including their source(s) of funding. Authors should obtain permission to acknowledge from all those mentioned in the Acknowledgements section.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-acknowledgements

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#formatting-acknowledgements

I have had colleagues who do not want to participate in the actual writing of the manuscript or do any actual “work” who have instead preferred to be mentioned in this section only.

Authors must search for and cite published case reports that are relevant to the case they are presenting. There should be no more than 15 references usually, although BMC does publish manuscripts with more references particularly if there is an extended literature review. Unless it is of historic interest, please keep the references as contemporary as feasible (for example, within the last 5 years or so). Please avoid excessive referencing.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-references

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#formatting-references

Cover letter

This is a separate document that should be written and uploaded with the main manuscript submission. I usually write this after I have written the Abstract. The cover letter should be addressed to the Editor-in-Chief in a formal manner and include all of the authors’ contact information. It should clearly and concisely state the title of the manuscript, and why the authors feel that their case report should be published based on any already available literature on the topic at hand. From an editor’s viewpoint, the cover letter is exceptionally important as that is the first thing that he or she reads and serves as the gateway to the Abstract and then the rest of the manuscript.

BMC author academy: help for all

Both JMCR and BMCRN have a large number of non-native English-speaking authors. Since JMCR and BMCRN are both BMC publications whose editorial offices are based in England, the language of publication is of course English. The BMC author academy is a joint program by BMC and Edanz [ 23 ] aimed at equipping writers for successful publication. Their materials have been developed from training workshops that Edanz gives to researchers worldwide and are not just limited to case reports. BMC recommends Edanz for authors who want to have their manuscript edited by a native speaker of English who is a scientific expert. Edanz provides scientific editing and related services that raise the quality of manuscripts to the standard needed to be understood at peer review.

http://www.biomedcentral.com/authors/authoracademy

I find that most non-native English-speaking authors have their manuscripts reviewed informally by a native English-speaking colleague and/or friend who is usually mentioned within the Acknowledgements section. This is understandable to keep costs down. However, please be aware that poor grammar and frequent spelling mistakes can be an impediment to editorial work flow and peer review. The editorial staff for both JMCR and BMCRN are acutely aware and sensitive to this given the large number of international submissions. At both JMCR and BMCRN , submitted manuscripts with questionable grammar and spelling are returned back to the authors by the editorial staff if it is felt that the grammar and spelling mistakes would impede peer review. If these issues are minor and it is felt that they would not impede peer review, then the manuscripts are sent off to peer reviewers (when appropriate).

Final checklist and the rule of C s

After I have completed a case report, I like to run through my long-winded (but useful) “rule of Cs” which is as follows.

Is it C lear, C oncise, and C oherent? Does it C onvey your message? Have you used C ases Database to look for any previously similar reported cases, and included them, if appropriate, in your references? Have you C onferred with your C olleagues on the C ontent? Will it C ause the reader to be C urious? Did you obtain C onsent? Does it C ontain all of the necessary information? Does it C omply with BM C guidelines? Do you think that it may need C opyediting? Do your C o-authors C oncur with the C ompleted paper? C an you C ut anything unnecessary out? Are your findings likely to be a C oincidence or by C hance alone? If so, then mention this in the Discussion section. Is the writing style C onsistent? Many times I find co-authored manuscripts have different writing styles within the same paper depending on who wrote what section. There should be a C entral, C orresponding author who is in C harge and oversees all of this. Is the C ase report written in a C hronological fashion with respect to the patient’s history and C hain of events? Is there anything that can be C ut out and have it still C ontain the C ompulsory information? Is it C oncise? Have you C onveyed C uriosity for your C ase report within your C over letter to the editorial team? Remember: your C over letter is the sales pitch to the editorial team! Make it C ount! Have you used within the manuscript C opyrighted information from another source? If so, do you need and/or have permission for use? After C ompletion, wait a C ouple of days before final submission to C lear your mind and read the manuscript again to C atch any mistakes that you may have made while you were C aught up in the C ompletion of it. Are the references C ontemporary? C an it be C omprehended by the average (“ C ”) reader? Remember, both JMCR and BMCRN are open access and freely available to anyone with an Internet C onnection and C omputer. C ast as wide a net as possible and C apture your C olleagues’ and other readers’ C uriosity. And first and foremost as a C linician: was the C are of your patient C ompetent and C ompassionate? (that is, are there any ethical concerns that may preclude peer review and publication?).

Summary and parting advice

Case reporting can be fun and a lifelong hobby, both for novice and experienced authors alike. It is now integral and widely accepted within published medical literature and today’s electronic information and data-sharing age. By following the above recommended steps and general overview, I hope to encourage BMC authors to continue to write and submit manuscripts to both JMCR and BMCRN . After your manuscript is complete, please follow the rule of “Cs”, especially “ C lear, C oncise, C oherent, C onsent, C ompassion, and C ompetence”, which will be appreciated by both reviewers and editors. Do not be afraid to obtain help from native English speakers for your manuscript. Also, please adhere to deadlines and follow instructions given by the editorial office, especially regarding any revisions. Editors read many different manuscripts and the longer it takes to get back a manuscript after revisions have been requested the less fresh that manuscript is in mind. Lastly, consider volunteering as an Associate Editor and/or reviewer within your specialty for both journals. I do for both, and the experience has improved both my writing and editing skills and daily interactions with patients.

Author information

Authors and affiliations.

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Richard A Rison

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Correspondence to Richard A Rison .

Additional information

Competing interests.

A competing interest exists when one’s interpretation of data or presentation of information may be influenced by a personal or financial relationship with other people or organizations. Authors must disclose any financial competing interests and should also reveal any non-financial competing interests that may cause embarrassment were they to become public after the publication of the manuscript. Authors are required to complete a declaration of competing interests. All competing interests that are declared will be listed at the end of published article. Where an author gives no competing interests, the listing should read “The author(s) declare that they have no competing interests”.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-competing

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#formatting-competing

I do not usually find any problems with competing interests in the case reports that I publish, but the section should always be completed in our era and in the spirit of complete disclosure.

Authors’ contributions

In order to give appropriate credit to each author of a paper, the individual contributions of authors to the manuscript should be specified in this section.

An ‘author’ is generally considered to be someone who has made substantive intellectual contributions to a published study. To qualify as an author one should: 1) have made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2) have been involved in drafting the manuscript or revising it critically for important intellectual content; and 3) have given final approval of the version to be published. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. Acquisition of funding, collection of data, or general supervision of the research group, alone, does not justify authorship. All contributors who do not meet the criteria for authorship should be listed in an Acknowledgements section. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chair who provided only general support.

http://www.jmedicalcasereports.com/authors/instructions/casereport#formatting-contributions

http://www.biomedcentral.com/bmcresnotes/authors/instructions/casereport#formatting-contributions

I have found over the years a trend towards multi-authored case report manuscripts by many different individuals involved in the care of a patient(s). In my setting, it is usually me, a medical student or resident, a second-opinion tertiary colleague, and/or a pathologist or radiologist (if applicable). But I also recognize that there are situations that warrant more co-authors. The above criteria though for co-authorship should always be followed, and I have seen editorial situations where peer reviewers (including Associate Editors) have questioned what they felt was excessive authorship.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Rison, R.A. A guide to writing case reports for the Journal of Medical Case Reports and BioMed Central Research Notes . J Med Case Reports 7 , 239 (2013). https://doi.org/10.1186/1752-1947-7-239

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Writing a Case Report

This page is intended for medical students, residents or others who do not have much experience with case reports, but are planning on writing one.

What is a case report? A medical case report, also known as a case study, is a detailed description of a clinical encounter with a patient. The most important aspect of a case report, i.e. the reason you would go to the trouble of writing one, is that the case is sufficiently unique, rare or interesting such that other medical professionals will learn something from it.

Case reports are commonly of the following categories :

- Rare diseases

- Unusual presentation of disease

- Unexpected events

- Unusual combination of diseases or conditions

- Difficult or inconclusive diagnosis

- Treatment or management challenges

- Personal impact

- Observations that shed new light on a disease or condition

- Anatomical variations

It is important that you recognize what is unique or interesting about your case, and this must be described clearly in the case report.

Case reports generally take the format of :

1. Background

2. Case presentation

3. Observations and investigation

4. Diagnosis

5. Treatment

7. Discussion

Does a case report require IRB approval?

Case reports typically discuss a single patient. If this is true for your case report, then it most likely does not require IRB approval because it not considered research. If you have more than one patient, your study could qualify as a Case Series, which would require IRB review. If you have questions, you chould check your local IRB's guidelines on reviewing case reports.

Are there other rules for writing a case report?

First, you will be collecting protected health information, thus HIPAA applies to case reports. Spectrum Health has created a very helpful guidance document for case reports, which you can see here: Case Report Guidance - Spectrum Health

While this guidance document was created by Spectrum Health, the rules and regulations outlined could apply to any case report. This includes answering questions like: Do I need written HIPAA authorization to publish a case report? When do I need IRB review of a case report? What qualifies as a patient identifier?

How do I get started?

1. We STRONGLY encourage you to consult the CARE Guidelines, which provide guidance on writing case reports - https://www.care-statement.org/

Specifically, the checklist - https://www.care-statement.org/checklist - which explains exactly the information you should collect and include in your case report.

2. Identify a case. If you are a medical student, you may not yet have the clinical expertise to determine if a specific case is worth writing up. If so, you must seek the help of a clinician. It is common for students to ask attendings or residents if they have any interesting cases that can be used for a case report.

3. Select a journal or two to which you think you will submit the case report. Journals often have specific requirements for publishing case reports, which could include a requirement for informed consent, a letter or statement from the IRB and other things. Journals may also charge publication fees (see Is it free to publish? below)

4. Obtain informed consent from the patient (see " Do I have to obtain informed consent from the patient? " below). Journals may have their own informed consent form that they would like you to use, so please look for this when selecting a journal.

Once you've identified the case, selected an appropriate journal(s), and considered informed consent, you can collect the required information to write the case report.

How do I write a case report?

Once you identify a case and have learned what information to include in the case report, try to find a previously published case report. Finding published case reports in a similar field will provide examples to guide you through the process of writing a case report.

One journal you can consult is BMJ Case Reports . MSU has an institutional fellowship with BMJ Case Reports which allows MSU faculty, staff and students to publish in this journal for free. See this page for a link to the journal and more information on publishing- https://lib.msu.edu/medicalwriting_publishing/

There are numerous other journals where you can find published case reports to help guide you in your writing.

Do I have to obtain informed consent from the patient?

The CARE guidelines recommend obtaining informed consent from patients for all case reports. Our recommendation is to obtain informed consent from the patient. Although not technically required, especially if the case report does not include any identifying information, some journals require informed consent for all case reports before publishing. The CARE guidelines recommend obtaining informed consent AND the patient's perspective on the treatment/outcome (if possible). Please consider this as well.

If required, it is recommended you obtain informed consent before the case report is written.

An example of a case report consent form can be found on the BMJ Case Reports website, which you can access via the MSU library page - https://casereports.bmj.com/ . Go to "Instructions for Authors" and then "Patient Consent" to find the consent form they use. You can create a similar form to obtain consent from your patient. If you have identified a journal already, please consult their requirements and determine if they have a specific consent form they would like you to use.

Seek feedback

Once you have written a draft of the case report, you should seek feedback on your writing, from experts in the field if possible, or from those who have written case reports before.

Selecting a journal

Aside from BMJ Case Reports mentioned above, there are many, many journals out there who publish medical case reports. Ask your mentor if they have a journal they would like to use. If you need to select on your own, here are some strategies:

1. Do a PubMed search. https://pubmed.ncbi.nlm.nih.gov/

a. Do a search for a topic, disease or other feature of your case report

b. When the results appear, on the left side of the page is a limiter for "article type". Case reports are an article type to which you can limit your search results. If you don't see that option on the left, click "additional filters".

c. Review the case reports that come up and see what journals they are published in.

2. Use JANE - https://jane.biosemantics.org/

3. Check with specialty societies. Many specialty societies are affiliated with one or more journal, which can be reviewed for ones that match your needs

4. Search through individual publisher journal lists. Elsevier publishes many different medical research journals, and they have a journal finder, much like JANE ( https://journalfinder.elsevier.com/ ). This is exclusive to Elsevier journals. There are many other publishers of medical journals for review, including Springer, Dove Press, BMJ, BMC, Wiley, Sage, Nature and many others.

Is it free to publish ?

Be aware that it may not be free to publish your case report. Many journals charge publication fees. Of note, many open access journals charge author fees of thousands of dollars. Other journals have smaller page charges (i.e. $60 per page), and still others will publish for free, with an "open access option". It is best practice to check the journal's Info for Authors section or Author Center to determine what the cost is to publish. MSU-CHM does NOT have funds to support publication costs, so this is an important step if you do not want to pay out of pocket for publishing

*A more thorough discussion on finding a journal, publication costs, predatory journals and other publication-related issues can be found here: https://research.chm.msu.edu/students-residents/finding-a-journal

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. 2013. The CARE guidelines: Consensus-based clinical case reporting guideline development. Glob Adv Health Med . 2:38-43. doi: 10.7453/gahmj.2013.008

Riley DS, Barber MS, Kienle GS, AronsonJK, von Schoen-Angerer T, Tugwell P, Kiene H, Helfand M, Altman DG, Sox H, Werthmann PG, Moher D, Rison RA, Shamseer L, Koch CA, Sun GH, Hanaway P, Sudak NL, Kaszkin-Bettag M, Carpenter JE, Gagnier JJ. 2017. CARE guidelines for case reports: explanation and elaboration document . J Clin Epidemiol . 89:218-234. doi: 10.1016/j.jclinepi.2017.04.026

Guidelines to writing a clinical case report. 2017. Heart Views . 18:104-105. doi: 10.4103/1995-705X.217857

Ortega-Loubon C, Culquichicon C, Correa R. The importance of writing and publishing case reports during medical education. 2017. Cureus. 9:e1964. doi: 10.7759/cureus.1964

Writing and publishing a useful and interesting case report. 2019. BMJ Case Reports. https://casereports.bmj.com/pages/wp-content/uploads/sites/69/2019/04/How-to-write-a-Case-Report-DIGITAL.pdf

Camm CF. Writing an excellent case report: EHJ Case Reports , Case of the Year 2019. 2020. European Heart Jounrnal. 41:1230-1231. https://doi.org/10.1093/eurheartj/ehaa176

*content developed by Mark Trottier, PhD

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Education and Communications
Medical Studies

How to Write a Medical Case Study Report

Last Updated: April 18, 2024 Fact Checked

This article was medically reviewed by Mark Ziats, MD, PhD and by wikiHow staff writer, Jennifer Mueller, JD . Dr. Mark Ziats is an Internal Medicine Physician, Scientist, Entrepreneur, and the Medical Director of xBiotech. With over five years of experience, he specializes in biotechnology, genomics, and medical devices. He earned a Doctor of Medicine degree from Baylor College of Medicine, a Ph.D. in Genetics from the University of Cambridge, and a BS in Biochemistry and Chemistry from Clemson University. He also completed the INNoVATE Program in Biotechnology Entrepreneurship at The Johns Hopkins University - Carey Business School. Dr. Ziats is board certified by the American Board of Internal Medicine. There are 15 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 187,290 times.

You've encountered an interesting and unusual case on your rounds, and a colleague or supervising physician says, "Why don't you write up a case study report?" If you've never written one before, that might sound intimidating, but it's a great way to get started in medical writing. Case studies always follow a standard structure and format, so the writing is very formulaic once you get the hang of it. Read on for a step-by-step guide to writing your first case study report.

What is a case study report?

Step 1 A case study report is an academic publication describing an unusual or unique case.

Medical students or residents typically do the bulk of the writing of the report. If you're just starting your medical career, a case study report is a great way to get a publication under your belt. [2] X Research source

Step 2 Your report discusses the case presented by one patient.

If the patient is a minor or is incapable of giving informed consent, get consent from their parents or closest relative. [4] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source
Your hospital likely has specific consent forms to use. Ask your supervising physician if you're not sure where to get one.
Some journals also have their own consent form. Check your target journal's author or submission information to make sure. [5] X Research source

How is a case study report structured?

Step 1 A typical report consists of an abstract, intro, case description, discussion, and conclusion.

Even though the introduction is the first part of a case study report, doctors typically write it last. You'll have a better idea of how to introduce your case study to readers after you've written it.
Your abstract comes at the top, before the introduction, and provides a brief summary of the entire report. Unless your case study is published in an open-access journal, the abstract is the only part of the article many readers will see.

Step 2 Check your target journal for possible variations.

Many journals offer templates and checklists you can use to make sure your case study includes everything necessary and is formatted properly—take advantage of these! Some journals, such as BMJ Case Reports , require all case studies submitted to use their templates.

Drafting Your Medical Case Study Report

Step 1 Pull all of the hospital records for the case.

Patient description
Chronological case history
Physical exam results
Results of any pathological tests, imaging, or other investigations
Treatment plan
Expected outcome of treatment
Actual outcome of treatment

Step 2 Write a draft of the case presentation.

Why the patient sought medical help (you can even use their own words)
Important information that helped you settle on your diagnosis
The results of your clinical examination, including diagnostic tests and their results, along with any helpful images
A description of the treatment plan
The outcome, including how and why treatment ended and how long the patient was under your care [11] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source

Step 3 Research the existing literature on the patient's condition and treatment.

You will need references to back up symptoms of the condition, common treatment, and the expected outcome of that common treatment.
Use your research to paint a picture of the usual case of a patient with a similar condition—it'll help you show how unusual and different your patient's case is.
Generally, aim for around 20 references—no fewer than 15, but no more than 25. [13] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source

Step 4 Write a section discussing the case in light of your research.

Close your discussion section with a summary of the lessons learned from the case and why it's significant to consider when treating similar cases in the future.
Outline any open questions that remain. You might also provide suggestions for future research.

Step 5 Complete your introduction and conclusion after you've written the body.

In your conclusion, you might also give suggestions or recommendations to readers based on what you learned as a result of the case.
Some journals don't want a separate conclusion section. If that's the case for one of your target journals, just move this paragraph to the end of your discussion section.

Polishing Your Report for Submission to Publishers

Step 1 Come up with a title for your case study.

Most titles are fewer than 10 words long and include the name of the disease or condition treated.
You might also include the treatment used and whether the outcome was successful. When deciding what to include, think about the reason you wrote the case study in the first place and why you think it's important for other clinicians to read.

Step 2 Identify the authors of the report on the title page.

Made a significant intellectual contribution to the case study report
Was involved in the medical care of the patient reported
Can explain and defend the data presented in the report
Has approved the final manuscript before submission for publication

Step 3 Write an abstract summarizing the entire article.

Keep in mind that the abstract is not just going to be the first thing people read—it will often be the only thing people read. Make sure that if someone is going to walk away having only read the abstract, they'll still get the same message they would have if they read the whole thing.
There are 2 basic types of abstract: narrative and structured. A narrative abstract is a single paragraph written in narrative prose. A structured abstract includes headings that correspond with the sections of the paper, then a brief summary of each section. Use the format preferred by your target journal.

Step 4 Choose keywords that will help readers find your case study.

Look for keywords that are relevant to your field or sub-field and directly related to the content of your article, such as the name of the condition or specific treatments you used.
Most journals allow 4-8 keywords but check the submission guidelines of your target journal to make sure.

Blur out the patient's face as well as any tattoos, birthmarks, or unrelated scars that are visible in diagnostic images.

Step 6 Include your acknowledgments and conflict of interest statement.

It's common to thank the patient, but that's up to you. Even if you don't, include a statement indicating that you have the patient's written, informed consent to publish the information.
Read the journal's submission guidelines for a definition of what that journal considers a conflict of interest. They're generally the same, but some might be stricter than others. [22] X Research source

Step 7 Compile and format your reference section.

If you're not familiar with the citation style used by your target journal, check online for a guide. There might also be one available at your hospital or medical school library.
Medical librarians can also help with citation style and references if you run into something tricky—don't just wing it! Correct citation style insures that readers can access the materials you cite.

Step 8 Get feedback on your final draft.

It's also a good idea to get a beta reader who isn't a medical professional. Their comments can help you figure out where you need to clarify your points.
Read a lot of case studies published in your target journals—it will help you internalize the tone and style that journal is looking for.

Submitting Your Report to Publishers

Step 1 Choose target journals that publish similar content.

Look into the background and reputation of journals before you decide to submit to them. Only seek publication from reputable journals in which articles go through a peer-review process.
Find out what publishing fees the journals charge. Keep in mind that open-access journals tend to charge higher publishing fees. [26] X Research source
Read each journal's submission and editorial guidelines carefully. They'll tell you exactly how to format your case study, how long each section should be, and what citation style to use. [27] X Research source
For electronic journals that only publish case reports, try BMJ Case Reports , Journal of Medical Case Reports , or Radiology Case Reports .

Step 2 Submit your manuscript according to the journal's requirements.

If your manuscript isn't suitable for the journal you submitted to, the journal might offer to forward it to an associated journal where it would be a better fit.
When your manuscript is provisionally accepted, the journal will send it to other doctors for evaluation under the peer-review process.
Most medical journals don't accept simultaneous submissions, meaning you'll have to submit to your first choice, wait for their decision, then move to the next journal on the list if they don't bite.

Step 3 Revise your manuscript based on peer review comments.

Along with your revised manuscript, include a letter with your response to each of the reviewer's comments. Where you made revisions, add page numbers to indicate where the revisions are that address that reviewer's comments.
Sometimes, doctors involved in the peer review process will indicate that the journal should reject the manuscript. If that's the case, you'll get a letter explaining why your case study report won't be published and you're free to submit it elsewhere.

Step 4 Complete final copy-editing if the editors approve your article.

Some journals require you to have your article professionally copy-edited at your own cost while others do this in-house. The editors will let you know what you're responsible for.

Step 5 Pay the article processing charge if your article is accepted.

With your acceptance letter, you'll get instructions on how to make payment and how much you owe. Take note of the deadline and make sure you pay it as soon as possible to avoid publication delays.
Some journals will publish for free, with an "open-access option" that allows you to pay a fee only if you want open access to your article. [32] X Research source

Through the publishing agreement, you assign your copyright in the article to the journal. This allows the journal to legally publish your work. That assignment can be exclusive or non-exclusive and may only last for a specific term. Read these details carefully!
If you published an open-access article, you don't assign the copyright to the publisher. The publishing agreement merely gives the journal the right to publish the "Version of Record." [33] X Research source

How do I find a suitable case for a report?

Step 1 Keep your eye out for unusual or interesting cases.

A rare disease, or unusual presentation of any disease
An unusual combination of diseases or conditions
A difficult or inconclusive diagnosis
Unexpected developments or responses to treatment
Personal impact
Observations that shed new light on the patient's disease or condition

Step 2 Discuss possible cases with your medical team.

There might be other members of your medical team that want to help with writing. If so, use one of these brainstorming sessions to divvy up writing responsibilities in a way that makes the most sense given your relative skills and experience.
Senior doctors might also be able to name some journals that would potentially publish your case study. [36] X Research source

Expert Q&A

↑ https://www.elsevier.com/connect/authors-update/the-dos-and-donts-of-writing-and-publishing-case-reports
↑ https://www.bmj.com/content/350/bmj.h2693
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686928/
↑ https://health.usf.edu/medicine/internalmedicine/im-impact/~/media/B3A3421F4C144FA090AE965C21791A3C.ashx
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597880/
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476221/
↑ https://www.springer.com/gp/authors-editors/authorandreviewertutorials/writing-a-journal-manuscript/title-abstract-and-keywords/10285522
↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597880/
↑ https://thelancet.com/pb/assets/raw/Lancet/authors/tl-info-for-authors.pdf
↑ https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-017-1351-y
↑ https://guides.himmelfarb.gwu.edu/casereports
↑ https://casereports.bmj.com/pages/authors/
↑ https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-7-239
↑ https://research.chm.msu.edu/students-residents/writing-a-case-report
↑ https://authorservices.taylorandfrancis.com/publishing-your-research/moving-through-production/copyright-for-journal-authors/#

About This Article

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

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Writing a medical case...

Writing a medical case report

Related content
Peer review
Aimun A B Jamjoom , foundation year 1 doctor 1 ,
Ali Nikkar-Esfahani , final year medical student 2 ,
J E F Fitzgerald , specialty trainee, general surgery 3
1 Lincoln County Hospital, Lincoln LN2 5QY
2 University of Nottingham Medical School, Queens Medical Centre, Nottingham NG7 2UH
3 Medical Education Unit, University of Nottingham Medical School

Case reports have fallen out of favour, but they still have a role to play

Given the unpredictable and challenging nature of medicine, many medical students will have come across a patient who has not been a textbook case. The patient may have presented in an unusual way, had a strange new pathology, or reacted to a medical intervention in a manner that has not been seen before. The publication of these novelties and curiosities as case reports has for many centuries been a fundamental way of sharing knowledge and conveying medical experience, and throughout history there have been famous case studies that have helped shape the way we view health and disease (box 1).

There are those who argue, however, that case reports are increasingly irrelevant in current medical practice and education. 1 Their obscurity and rarity appeal only to the specialised few, and they add little to everyday medical practice. Their anecdotal nature lacks the scientific rigour of large, well conducted studies, and they have therefore fallen down the hierarchical ladder of medical evidence (box 2). Sadly, many medical journals now refuse to publish case reports.

Box 1: Famous case reports

Multiple myeloma.

William MacIntyre and Henry Bence-Jones contributed greatly to our understanding of multiple myeloma by recording the effect of this disease on Thomas Alexander McBean. They found that Mr McBean’s urine was “abound in animal matter.” It is owing to this observation that the protein found in urine of patients with multiple myeloma is called Bence-Jones protein. 2

Mental health disorders

Sigmund Freud, best known for his psychoanalysis and theories of the unconscious mind, also had a special interest in recording the case histories of his patients. Many of his case reports helped further our understanding of a number of mental health disorders, such as obsessive compulsive disorder (rat man), dissociative disorder (Anna O), phobias (Little Hans) and post-traumatic disorder (wolf man). 3

Broca’s area, the speech production centre in the brain, was named after Paul Pierre Broca, a French physician and anatomist. He made his discovery while studying the brains of dysphasic patients. The first patient that he examined was nicknamed Tan because of his inability to say any word apart from “Tan,” which he repeated over and over. On postmortem examination Broca discovered that Tan had a fluid filled cavity in the left hemisphere caused by syphilis and concluded that this area is responsible for speech production in humans. 4

Box 2: Evidence needed 5

Category I—Evidence from at least one properly randomised controlled trial

Category II-1—Evidence from well designed controlled trials without randomisation

Category II-2—Evidence from well designed cohort or case-control analytic studies, preferably from more than one centre or research group

Category II-3—Evidence from multiple case series with or without intervention or dramatic results in uncontrolled experiments

Category III—Opinions of respected authorities, based on clinical experience, descriptive studies, and case reports, or reports of expert committees.

Despite their limitations, case reports still have a role to play in furthering medical knowledge and education. Their ability to flag up novelty means that they are still used to identify emerging pathologies. Case reports also hold valuable educational worth as brief clinical caveats. Many people find abstract medical knowledge easier to remember when linked to a patient. Different areas of medical education such as physiology, pathology, pharmacology, and anatomy are brought together in case reports and help students and doctors to develop a more holistic approach to patients.

Should I try and write a case report?

Case reports help students gain a deeper understanding of a medical topic, but they also act as an excellent introduction to academic writing. Doing a literature review, structuring a manuscript, and learning how to submit and revise your article are skills worth developing early on. In addition to this, a published case report is a contribution (though small) to medical science and a way to get your name in print; it is also something that can be put on your curriculum vitae and help you stand out in future job applications.

How do I go about finding a suitable case to report?

As a medical student it is difficult to know when a case is unique or interesting enough to warrant reporting, and it is therefore important to make the most of help from your seniors. If you’re in a clinic or on the ward and you hear a consultant mention that a case is rare, or that they’ve never seen one like it before, it’s worth inquiring whether you could write it up as a case report. If you don’t have the good fortune of coming across any suitable cases it is also worth asking if any of the senior doctors have cases that you could help them research and write up.

Preparation

When you have found a suitable case it is vital to do a number of tasks before you can start putting pen to paper.

Literature review

A literature review on a medical database such as PubMed, Ovid, or Medline can be used to check if there have been any similar cases; this helps you gauge how rare your case is.

Liaising with doctors in charge

It is very important to discuss writing a case report with the senior clinician in charge of the patient’s care. Not only must you gain their permission, but they will also help to provide guidance and advice. In addition, it is also worth discussing the case with clinicians of other specialties (such as pathology, radiology, and microbiology) who have played a role in the patient’s care.

Gaining consent

Check the journal guidelines carefully. It is extremely important to gain written consent from the patient if you wish to include pictures or clinical details from which they may be identified. During the consent process you must explain why you wish to share their case with others, the risks and benefits of doing so, and you must answer any questions they may have. Get senior help for this.

Data collection

When you have done your literature review, liaised with the senior doctor, and gained consent from the patient you can start bringing your patient’s case together. This involves finding his or her medical notes, laboratory results, imaging, and any other relevant material.

How do I structure a medical case report?

The basic structure of a medical case report is as follows:

Abstract — This section is read by people trying to decide whether they wish to go on and read your full case report. It is therefore vital to keep it concise (no more than 150 words) and snappy, and to encompass all the important aspects of your case, particularly highlighting what this adds to medical knowledge.

Case report—In this section you are presenting your patient to the reader. This should include a concise history and any relevant examination and investigation findings. It is important to include any relevant negatives based upon the potential diagnoses, but do not clutter this section with unnecessary detail.

Discussion—When you have presented your case to the reader you are expected to put it into context in the discussion section. Here you give information about the condition or intervention in question, such as the basic epidemiology, pathophysiology, clinical presentation, investigations, and treatment. As you paint this picture it is extremely important for you to show how your case has differed from the norm and how this is contributing to medical understanding.

Where can I get my case reports published?

Given the reluctance of many journals to publish case reports these days, where are you to turn when you wish to share your newly written up experience of an interesting case?

Fortunately, the vastness of cyberspace has allowed for the development of a new breed of medical journal. A number of new online journals such as BMJ Case Reports ( www.casereports.bmj.com ), Cases Journal ( www.casesjournal.com ), the Journal of Medical Case Reports ( www.jmedicalcasereports.com ), Radiology Case Reports ( www.radiology.casereports.net/index.php/rcr ), and the Journal of Dermatological Case Reports ( www.jdcr.eu ) allow the publication and dissemination of notable case reports. These allow doctors from all over the world to share their experiences of new and interesting cases. Although still in their infancy, these journals have the potential to act as large case banks that allow doctors to search for cases similar to ones that may be puzzling them, to help guide their management.

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Harvard T.H. Chan School of Public Health Case-Based Teaching & Learning Initiative

Teaching cases & active learning resources for public health education, writing a case.

An overview of the case planning and writing process, by experienced case-writer and CBTL workshop leader Kirsten Lundberg.

2019. The Case Centre . Visit website A non-profit clearing house for materials on the case method, the Case Centre holds a large and diverse collection of cases, articles, book chapters and teaching materials, including the collections of leading business schools across the globe.

Abell, D. , 1997. What makes a good case? . ECCHO–The Newsletter of the European Case Clearing House , 17 (1) , pp. 4-7. Read online "Case writing is both art and science. There are few, if any, specific prescriptions or recipes, but there are key ingredients that appear to distinguish excellent cases from the run-of-the-mill. This technical note lists ten ingredients to look for if you are teaching somebody else''s case - and to look out for if you are writing it yourself."

Roberts, M.J. , 2001. Developing a teaching case (abridged) , Harvard Business School Publishing. Publisher's Version A straightforward and comprehensive overview of how to write a teaching case, including sections on what makes a good case; sources for and types of cases; and steps in writing a case.

Writing a case (8)
Writing a teaching note (4)
Active learning (12)
Active listening (1)
Asking effective questions (5)
Assessing learning (1)
Engaging students (5)
Leading discussion (10)
Managing the classroom (4)
Planning a course (1)
Problem-based learning (1)
Teaching & learning with the case method (14)
Teaching inclusively (3)

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About the Medical Writing Program

Delivery method.

Live Online
Number of courses: 4 required courses (10 units) and 6 units of electives
Total units: 16

Medical Terminology: An Anatomy and Physiology Approach FPM-40632

Units: 1.50

Using an anatomy and physiology systems approach, this course reviews common terms associated with medical practice, research, and different healthcare settings. The goal: to better prepare individual...

Upcoming Start Dates:

Grammar lab wcwp-40234.

Units: 3.00

Grammar Lab (WCWP-40234)10 Weeks | OnlineThis ten-week online Grammar Lab course is skillfully designed to meet the needs of all students. It is beneficial for those with little grammar experience and...

Clinical Trials and Regulatory Writing Primer FPM-40672

Units: 1.00

This course introduces the components of effective clinical trial design, and the basic phases, and purposes of pharmacological and clinical development. Gain foundational knowledge of the overall cl...

CT: Practical Clinical Statistics for the Non-Statistician FPM-40233

Units: 2.00

This course presents the statistics essentials for the non-statistician involved in clinical trials. Topics include study designs, hypothesis testing, sample size calculations, assumptions, controls, ...

Introduction to Medical Writing and Editing FPM-40696

Introduction to Medical Writing and Editing is intended for people who are considering a career in medical communication and is designed to introduce students to the profession of medical writing and ...

Applied Medical Writing and Editing FPM-40652

This course builds on the knowledge gained in the Introduction to Medical Writing and Editing course and introduces the student to some of the more complex topics in writing and editing scientific and...

Ethics for Medical Writers FPM-40609

This course covers the current tools and resources that should be used by medical writers who desire to practice their craft in an ethical manner. Students will be made aware of professional ethical c...

Designing Figures, Tables, & Graphs FPM-40608

This course focuses on how to construct effective, accurate and attractive figures, tables and graphs. Course content includes basic statistics, principles of the visual display of quantitative inform...

Communicating Real World Evidence; Medical Writer Professional Development FPM-40658

This course examines real world evidence (RWE), and the role of the professional medical writer in this rapidly expanding area of evidence generation. Learn the basics of RWE, and how and why these s...

Citations and Reference Methods for Medical Writing FPM-40660

This course covers the current tools and resources that should be used by medical writers to properly cite courses. Medical writers must be able to cite their work and correct the citations of others....

CT: Documents in Drug Development: Writing Protocols, Reports, Summaries, Submissions, and Disclosures FPM-40685

No clinical trial can begin until a protocol has been written, and no clinical trial is complete until the final report is assembled, signed, and submitted to the FDA. Good documentation for clinical ...

Health Economics and Outcomes Research (HEOR) FPM-40659

This course covers the foundations Health Economics Outcomes Research (HEOR) and demonstrates why this growing field provides important information for making healthcare coverage and access decisions....

Capstone: Journal Article and Publication Development FPM-40630

Units: 4.00

This course will benefit students who are seeking to write and publish an article in a peer-reviewed journal. Using knowledge acquired throughout the medical writing program, students in this capston...

Capstone: Medical Education Materials FPM-40627

Medical writers play a vital role in creating continuing medical education (CME) materials that help physicians and other health care providers remain current in the knowledge and skills needed to pro...

Capstone: Regulatory Writing FPM-40628

Regulatory Writing is as much about knowing the regulations and guidance that govern regulatory submissions as it is about the building the intelligence, knowledge, relationships, and know-how in beco...

Conditions for Admission

Successful applicants must have relevant educational background, and native-level fluency in English with the demonstrated ability to write clear, logical, and grammatically correct sentences as evidenced by the application, official transcripts and writing samples. Accepted applicants will have degrees in biomedical or life sciences, such as biology, chemistry, pharmacy, nursing, nutrition, or public health. It is anticipated that many will have advanced degrees, including PhDs. Candidates with PhDs are particularly competitive for medical writing positions in the commercial sector and academic settings.

Certificate Guidelines

All students must either take the following prerequisites or have taken appropriate equivalents within the past five years, earning a grade of B- or better:

Medical Terminology FPM-40172, 1 unit online
Practical Clinical Statistics for the Non-Statistician FPM-40233, 2 units online
Grammar Lab WCWP-40234, 3 units online
Clinical Trials and Regulatory Writing Primer, FPM-40672, 1 unit online

Prerequisites can be waived for individuals whose work experience demonstrates foundational knowledge of these subjects. Applicants seeking this waiver should email their CV to Jessica Bradford, Program Manager, at [email protected] for determination in advance of their application.

Next Steps Experience

Connect your classroom education with real-world experiences through a Next Step Experience course. These specially designed classes allow students to gain hands-on experience by working closely with instructors and/or peers on real-world projects. In the Capstone course, students will apply all previously learned concepts to work through one or more projects in one of the four pre-identified Medical Writing areas. The purpose of the Capstone is to:

Gain hands on experience of researching information, and analyzing, interpreting, and communicating data as would be expected of a Medical Writer. The final project(s) will be submitted for critical review by the advising faculty leader
Have a clear sense of the critical behaviors and practical work practices that make the student a better Medical Writer.
Identify areas of continued improvement moving forward to hone knowledge and skill in the evolving Medical Writing profession.

To be eligible to take this course, you must have completed all of the other courses in the Medical Writing program with a B-/80% or higher. You must select from one of the four areas of specialization to fulfill this final required component of the certificate.

Capstone: Journal Article and Publication Development (FPM-40630)

Capstone: Medical Education Materials (FPM-40627)

Capstone: Regulatory Writing (FPM-40628)

Capstone: Scientific Grants (FPM-40629)

Advisory Board

Michelle Beauclair

Medical writer and copywriter

MB Medical Writer

Tim Collinson, BSc (hons), ISMPP CMPP

Director, Global Publications

Santen Inc.

Noelle Demas

Medical Writer

Panorama MedWriters Group, Inc.

Thomas Gegeny, MS, ELS, MWC, CMPP

Director, Scientific Strategy & Partnerships

Prime Global Medical Communications Ltd.

Timothy Mackey, MAS, PhD

Assistant Professor

UC San Diego School of Medicine

November 19, 2020

Making a Change: From Scientist to Medical Writer

Tanvir Khan switched from researcher to medical writer in less than a year by taking UCSD Extension’s Medical Writing certificate program. Now he’s fielding job offers and pursuing a refreshing new career path without missing a beat.

October 12, 2020

The Top 6 Healthcare Careers You Can Do From Home

Healthcare may not seem like an obvious work-from-home career option, but there are a number of professional areas perfect for working remotely. Check out our top 6 recommendations for this rapid growing industry.

June 19, 2019

How I Did It: Going from Medical Doctor to Medical Writer

What happens when you have multiple degrees and a talent for sharing complex information in a clear and thoughtful way? You write.

November 18, 2015

Turning science into sentences: The art of medical writing

Turning science into sentences – meaningful, factual and compelling sentences – is the art and the craft of medical writing. It is also a skill that is increasingly in demand. According to the U.S. Bureau of Labor Statistics, jobs for technical writers in the health care field are projected to grow nearly 27% from 2012 to 2022.

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How to Write a Case Study

This guide explains how to write a descriptive case study. A descriptive case study describes how an organization handled a specific issue. Case studies can vary in length and the amount of details provided. They can be fictional or based on true events.

Why should you write one? Case studies can help others (e.g., students, other organizations, employees) learn about

new concepts,
best practices, and
situations they might face.

Writing a case study also allows you to critically examine your organizational practices.

The following pages provide examples of different types of case study formats. As you read them, think about what stands out to you. Which format best matches your needs? You can make similar stylistic choices when you write your own case study.

ACF Case Studies of Community Economic Development This page contains links to nine case studies that describe how different organizations performed economic development activities in their communities.

National Asthma Control Program Wee Wheezers This case study describes a public health program.

CDC Epidemiologic Case Studies This page contains links to five classroom-style case studies on foodborne diseases.

ATSDR Environmental Health and Medicine This page contains links to approximately 20 classroom-style case studies focused on exposures to environmental hazards.

What are your goals ? What should your intended readers understand or learn after reading your case? Pick 1–5 realistic goals. The more goals you include, the more complex your case study might need to be.

Who is your audience? You need to write with them in mind.

What kind of background knowledge do they have? Very little, moderate, or a lot of knowledge. Be sure to explain special terms and jargon so that readers with little to moderate knowledge can understand and enjoy your case study.

What format do you need to use? Will your case study be published in a journal, online, or printed as part of a handout? Think about how word minimums or maximums will shape what you can talk about and how you talk about it. For example, you may be allowed fewer words for a case study written for a print textbook than for a webpage.

What narrative perspective will you use? A first-person perspective uses words such as “I” and” “we” to tell a story. A third-person perspective uses pronouns and names such as “they” or “CDC”. Be consistent throughout your case study.

Depending on your writing style, you might prefer to write everything that comes to your mind first, then organize and edit it later. Some of you might prefer to use headings or be more structured and methodical in your approach. Any writing style is fine, just be sure to write! Later, after you have included all the necessary information, you can go back and find more appropriate words, ensure your writing is clear, and edit your punctuation and grammar.

Use clear writing principles, sometimes called plain language. More information can be found in the CDC’s Guide to Clear Writing [PDF – 5 MB] or on the Federal Plain Language website .
Use active voice instead of passive voice. If you are unfamiliar with active voice, review resources such as NCEH/ATSDR’s Training on Active Voice , The National Archive’s Active Voice Tips , and USCIS’ Video on Active Voice .
Word choice is important. If you use jargon or special terminology, define it for readers.
CDC has developed many resources to help writers choose better words. These include the NCEH/ATSDR Environmental Health Thesaurus , CDC’s National Center for Health Marketing Plain Language Thesaurus for Health Communicators [PDF – 565 KB] , CDC’s Everyday Words for Public Health Communication [PDF – 282 KB] , and the NCEH/ATSDR’s Clear Writing Hub .

After writing a draft, the case study writer or team should have 2–3 people, unfamiliar with the draft, read it over. These people should highlight any words or sentences they find confusing. They can also write down one or two questions that they still have after reading the draft. The case study writer or team can use those notes make edits.

Review your goals for the case study. Have you met each goal? Make any necessary edits.
Check your sentence length. If your sentence has more than 20 words, it might be too long. Limit each sentence to one main idea.
Use common words and phrases. Review a list of commonly misused words and phrases.
Be sure you have been consistent with your verb tenses throughout.

Finally, the writer/team should have someone with a good eye for detail review the case study for grammar and formatting issues. You can review the CDC Style Guide [PDF – 1.36 MB] for clarification on the use of punctuation, spelling, tables, etc.

Green BN, Johnson CD. How to write a case report for publication. Journal of Chiropractic Medicine. 2006;5(2):72-82. https://doi.org/10.1016/S0899-3467(07)60137-2

Scholz RW, Tietje O. Types of case studies. In: Embedded Case Study Methods . Thousand Oaks (CA): SAGE Publications, Inc.; 2002. P. 9-14. doi:10.4135/9781412984027

Warner C. How to Write a Case Study [online]. 2009. Available from URL: https://www.asec.purdue.edu/lct/HBCU/documents/HOWTOWRITEACASESTUDY.pdf [PDF – 14.5 KB]

Title: Organization: Author(s):

Goals: After reading this case study, readers should

Introduction Who is your organization? What is your expertise? Provide your audience with some background information, such as your expertise. This provides context to help them understand your decisions. (How much should you write? A few sentences to 1 paragraph)

What problem did you address? Who identified the problem? Provide some background on who noticed the problem and how it was reported. Were multiple organizations or people involved in identifying and addressing the problem? This will help the reader understand how and why decisions were made. (1 paragraph)

Case Details Provide more information about the community. What factors affected your decisions? Describe the community. The context, or setting, is very important to readers. What are some of the unique characteristics that affected your decisions? (1 paragraph)

How did you address the problem? Start at the beginning. Summarize what happened, in chronological order. If you know which section of the publication your case study is likely to be put in, you can specify how your actions addressed one or more of the main points of the publication/lesson.

What challenge(s) did you encounter? Address them now if you have not already.

What was the outcome? What were your notable achievements? Explain how your actions or the outcomes satisfy your learning goals for the reader. Be clear about the main point. For example, if you wanted readers to understand how your organization dealt with a major organizational change, include a few sentences that reiterate how you encountered and dealt with the organizational change. (A few sentences to 1 paragraph)

Conclusion Summarize lessons learned. Reiterate your main point(s) for the reader by explaining how your actions, or the outcomes, meet your goals for the reader.

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v.11(2); Apr-Jun 2019

Guideline on writing a case report

Basim saleh alsaywid.

1 Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard, Jeddah, Saudi Arabia

2 Department of Research Unit, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

Nada Mansour Abdulhaq

3 Department of Pediatric, Rabigh Branch, King Abdulaziz University, Jeddah, Saudi Arabia

4 Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia

Research is an important competency that should be mastered by medical professionals. It provides an opportunity for physicians to develop numerous skills including communication, collaboration, time management, and teamwork. Case report, as a research design, describes important scientific observations that are encountered in a clinical setting to expand our knowledge base. Preparing a case report is far easier than conducting any other elaborative research design. Case report, with its main components, should be focused and delivers a clear message. In this article, the key components of a case report were described with the aim of providing guidance to novice authors to improve the quality of their reporting.

INTRODUCTION

“The best teaching of medicine is that taught by the patient himself” is a famous statement by William Osler which describes the opportunities we have as physicians to learn from our encounters with patients.[ 1 ] This learning experience, based on the observation of clinical cases, can be transferred to others, locally, nationally, and internationally, through communication and reporting. A case report is the first effort for many doctors, and other health professionals to convey a message to the entire medical profession by the means of specialized journal and remain essential to the art of medicine.[ 2 ] The purpose of the case report is to expand our knowledge on clinical manifestation, diagnostic approach, or therapeutic alternative of a disease, ultimately, to improve the quality of care provided to our patients. A case report that is worth reading should, therefore, contain both practical and educational messages.[ 3 , 4 ]

The clinical case report has been an integral part of medical literature throughout history. The oldest example of a preserved clinical case in medical literature is a text from an ancient Egyptian papyrus dating from the 16 th to the 17 th dynasty, 1600 BC, addressing the management of dislocated jawbone.[ 5 ] From Hippocratic case histories, “Epidemics” 400 BC, through Galenic case reports, in the second century AD, case reports were usually used to tell other doctors or colleagues about interesting cases they have encountered. Muslim scholars have reported case histories as well, particularly, Abu Bakr Mohamed Ibn Zakariya Al-Razi (865–929 AD), where he left a large collection of case reports in his 25-volume medical encyclopedia “Kitab Al-Hawi.”[ 5 ]

Those case histories were not a publication but rather a documentation or a message between the medical professionals, and it is usually kept in their records. Case reports have now been developed and accepted as a scholarly publication to disseminate knowledge to a wide medical audience.

GENERAL PRINCIPLES OF CASES REPORT

The case report is a research design where an unexpected or novel occurrence is described in a detailed report of findings, clinical course, and prognosis of an individual patient, which might be, but not mandatory, accompanied by a review of the literature of other reported cases. Although case reports are considered the lowest in the hierarchy of evidence-based practice in the medical literature [ Figure 1 ], it provides essential information for unfamiliar events and shared individual experiences, for better understanding and optimizing patient care. This approach might generate an idea or hypothesis, but it will not be confirmed unless we conduct further confirmatory quantitative experimental or observational study designs such as clinical trials or cohort studies. Despite that, case report provides the medical community with information which cannot be picked up by any other designs. Just to name a few, in 1819, James Parkinson published a case report entitled “An essay on the shaking palsy”[ 6 ] and lead to the discovery of Parkinson's disease. And in 1981, a case report was published in the literature as “Preliminary communication on extensively disseminated Kaposi sarcoma in a young homosexual man”[ 7 ] few years later, HIV from this case report was discovered. Furthermore, in 2012, Ali Zaki reported an article in New England Journal of Medicine titled “Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia” which ultimately, lead to the discovery of Middle East Respiratory Syndrome Coronavirus.[ 8 ] All those previous examples show how important is case report in the advancement of medical practice. The case report might be in the tail of the hierarchy of evidence-based medicine but if properly selected and appropriately reported it might stand a better chance of publication in high impact journals than even a clinical trial.

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Hierarchy of evidence base medicine

Some scientist classifies case reports as a qualitative study design, others might consider it a quantitative approach or even a mixed method design.[ 9 ] This polarization of the case report is unfair. However, if we have to categorize it; when we consider all research approaches in medicine, it can be classified into exploratory or confirmatory; then, case reports definitely will be considered an exploratory research approach. Case report can be classified as a single case report, two case reports or case series, which aggregate more than two cases in a report. Case reports are usually retrospective by nature, however, it can be prospectively designed, for example, applying a new diagnostic or management approach or guideline of a particular health condition to discover new cases.[ 10 ]

Cases deemed appropriate for a publication are listed in Table 1 .[ 3 ] Despite these restrictive criteria, any case report could have a reasonable chance of publication even if it was not novel, as long as it was authentic, lead to an incremental advance in medicine or carries an educational value.

Criteria for published case report

STAGES IN PREPARING A CASE REPORT

The source of case reports is clinical setting, every single patient is a potential case report therefore, always keep an eye on unusual cases in your practice either in the ward or in the clinic. Once a potential case is identified, and the patient is in hospital, follow him through hospitalization until discharge. Give the case an appropriate time frame in the course of the disease to observe the development over time. Wait for 6 months during multiple visits, before you start writing a case report to allow adequate time to complete the clinical course.

Once you have a potential case, how would you know if this is an appropriate for reporting or not? Especially if you are a novice physician, once you encounter a possible case and you are suspecting if this patient fulfills one of those criteria which are described in Table 1 . The first step is a high index of suspicion; keep your eyes open for every case, once you suspect a case then ask your colleagues either directly or in a group related to the same discipline, locally, to confirm that this could be a case report. The next step would be asking an expert from the national or international medical community about this case scenario, get their opinion and feedback, including the appropriateness of reporting this case. Once the feedback is positive, perform extensive literature search, through PubMed, Embase, Google Scholar, and databases for case reports to ensure that you retrieve all available information on this topic. Do not forget to look at popular case reports which are not indexed in PubMed and read through previously published case reports that will enhance your understanding of the subject and gives you a general scaffold to prepare your own report.

Once the decision was made to report this case, obtain an informed consent from the patient; otherwise, it will not be accepted for publication. Moreover, take a permission from consultant in-charge of the case before writing your report.

Once you have reviewed the literature and improved your knowledge on the topic, use the patient's note to record the key points in history, examination findings, relevant data results and interpretation, treatment (including operational findings), and outcomes. Delete all patients’ personal information, identifiers or contact detailed from the prepared report, including the radiological or histopathological images before you copy them into your article. Save the prepared report on a password protected hospital computer.

The last step would be checking the journal which is most appropriate for your case report. Those journals provide you with the required criteria and appropriate format to prepare your report, to enhance their acceptability for publication. Many journals are interested in published case reports, but not all. In 2007, the first case report journal was created “Journal of Medical Case Reports” since then, the interest raised and many other journals dedicated for case reports were created including a specific database for all case reports are aggregated and continuously updated from several publishers.[ 3 ]

FORMAT FOR WRITING A CASE REPORTS

The word count for case report may vary from one journal to another, but generally should not exceed 1500 words, therefore, your final version of the report should be clear, concise, and focused, including only relevant information with enough details.[ 3 ] If a shorter version is required by the journal, then you can always edit or trim off the discussion section of your article. The general format adopted for most case reports is detailed in the following subsection and summarized as a checklist in Table 2 .

Checklist for writing a case report

This is the most commonly read part of your article; therefore, it should be relevant, concise, informative, descriptive, and appealing enough to attract readers to your report. It is placed in the first page of the manuscript, but some journal might request you to specify a separate file from the manuscript, labeled as a “title page” file. In preparing the title, avoid unnecessary words, wordplay, double meaning, cute wording, and never uses abbreviations in the title. It is always advisable to add “case report” in your title. Beneath the title, list all authors and their affiliations on the same page including their E-mails account. Most of the case reports are not prepared by a single author, but it should not exceed more than six authors; otherwise, the journal might not accept your case report for publication. Finally, under the subsection of corresponding author, assign one author to communicate with the journal and include all details of communication, such as institutional address, E-mail, and phone numbers.

Who should be the corresponding author? Any person who will submit the article to the journal to get the feedback from the editor of the journal and should be one of the article's authors.

It is the most important part of your article as it will be freely accessible for others to read when retrieved from any medical databases during the relevant search. However, it is the last part written in your article. It should include a brief summary that gives a general idea of the content of the case report. It should not include any references or abbreviations and should not exceed 350 words, preferably <250 words. Check your journal instructions for a detailed guideline on word counts. The abstract is usually arranged into three subsections: background, case presentation, and conclusion. The background should clarify the importance of reporting such a unique case. Afterward, a brief description of the clinical scenario of the patient listing only the important details. Finally, the conclusion should be brief with lesson learned and impact on the interested group.

This is quite important for indexing your article, and it should be from three to ten words, and you should be very careful in your selection, as it would help in retrieving your paper during the search.

Introduction

In this section, the definition and brief description of the pathology, including common presentations and disease progression is discussed, explaining the background of the selected topic. Followed by a brief description of what is about to be reported and the importance of reporting such case. The content should be clear, focused, concise, and attract the reader's attention and interest.

Case presentation

Provide a clear picture of the patient's condition and presentation, and it is best presented in chronological order with sufficient detail and explanation. Describe the relevant demographic information of the patient censoring any details that could lead to the patient being identified. Start with the current medical condition and primary complaint with detailed history including relevant family history, occupational and social history, medication, and allergy. Findings of physical examination should be briefly reported with all relevant investigation, laboratory results and images, and its analysis. Describe the differential diagnosis and the rational of the management approach, including follow-up results and final diagnosis. Avoid any extensive interpretation or defense for the approach you took. This section can be broken up into small subsections if needed, and it should be supplemented with necessary images and tables to facilitate reader's understanding of the case.

Probably, this is an optional section, but it is preferable if reported, as it would explain more of your rational and approach with added additional relevant information about the uniqueness of this case. Compare your findings with what is known in the literature and why you think this case is different. Only discuss what is relevant to your case and do not provide any unproven and unsupported speculation. Acknowledge and explain any ambiguity or unexpected features occurred even if it is contradicting your concept. Explain how this case would contribute to the literature and suggest justifiable recommendations.

The section should include a concise and brief statement, explaining the importance and relevance of your case and it should relate to the purpose of the paper.

Patient's perspective

This new section is an optional, but it adds a new dimension to your paper, as it gives the chance to patients with their own perspective to write and describe their experiences throughout the disease process. Make sure that any patient's identifiers are removed, and his identity is managed appropriately with confidentiality, removing all irrelevant information to the case report.

Before submission, make sure that the patient gave his informed consent for publication, and statement indicating that should be clearly narrated in the report. You do not need to send the consent form on submission, but it should be available if requested. In case of the child, the parent or legal guardian should be consented instead, and if the child is a teenager then both patient and his parent should be consented. Many journals will not proceed with the peer review process unless a statement like “written informed consent was obtained from the patient for publication” is clearly stated. This statement could be in a separate section, as indicated here, or within the content of the report. If the patient is incapacitated or deceased, obtain the consent from the next-of-kin, and this should be stated clearly in the report. If the patient is deceased and next-of-kin is unreachable, you should exhaust all reasonable attempts to obtain the consent. If you fail, then you should state that in your report. If the patient is still alive but unreachable and you did not obtain the consent, do not bother publishing the case.[ 3 ]

Competing of interest

In this mandatory part, all authors should disclose any financial competing interest. If none, then, a statement like “the authors declare that they have no competing interests” should be clearly stated.

Author contribution

In this section, you need to credit all individuals who made a substantial contribution to the production of this study. Criteria of qualification to be an author should be strictly followed and explicitly stated for each author, separately. The first criterion is being a part of the conceptual development, data acquisition or analysis, then involvement in drafting part of the manuscript, and finally approving the final version of the manuscript. If those criteria are not fulfilled, then those individuals should be acknowledged in the next section. Be cautious from excessive authorship as this might lead to rejecting your article.

You need to mention around 15 references if possible, and few of them should be within the past 5 years, but do not exceed more than 25 references.

Cover letter

This is an optional supplementary document, addressed to the editor-in-chief, in a formal letter. Explain why this report is important and why it should be published in this journal.

JOURNAL EVALUATION FOR A CASE REPORT

Writing a case report varies from one physician to another, depending on the expertise of the author who prepared the report. This variation is influenced by many factors ranging from the author's knowledge base to his writing skills. The Peer review process will detect this variation to assure the quality of reporting through critical appraisal. It will assess the report, provide a valuable, supposedly constructive, feedback and helps the editor in a decision regarding the publication. This assessment should be as objective as possible to reach an unbiased decision. Therefore, several schemes were formulated to evaluate the quality of the case report. One of which is the Piersons 5-component scheme which relays on five major components, each component is scored from 0 to two, with a possible total score of 10 and lowest score of zero. The five major components are uniqueness, documentation, interpretation, objectivity, and educational value.[ 11 ] If the calculated score is more than 8, then this report is worth publishing. A score from 6 to 8, indicate possible publication with caution about validity. Any score <6, indicate the insufficient quality of the case report. Further details about this evaluation scheme are explained in Table 3 .

Matrix of case report evaluation

The calculated total score: Score of 9-10: Excellent report and most likely will add new information to the medical literature, Score of 6-8: Can be published but reader should be caution of validity and clinical value, Score of 5 or Less: Report is considered inadequate and inappropriate for publication

Case report remains an important source of information and common method in knowledge dissemination among physicians due to its simplicity in design. It will continue providing new research ideas through hypotheses generation. Finally, as I commenced my article with William Osler, I will end by quoting his other famous statement…. “Always note and record the unusual…. Publish it, place it on permanent record as a short, concise note. Such communication is always of value.”

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

Acknowledgment

You need to mention and acknowledge the source of the research fund if any. Moreover, acknowledging all people who helped you, supervised you, or assisted you in finalizing this report, if they are not fulfilling the criteria to be an author.

Delving into PubMed Records: Some Terms in Medical Writing Have Drastically Changed after the Arrival of ChatGPT

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It is estimated that ChatGPT is already widely used in academic paper writing. This study aims to investigate whether the usage of specific terminologies has increased, focusing on words and phrases frequently reported as overused by ChatGPT. The list of 118 potentially AI-influenced terms was curated based on posts and comments from anonymous ChatGPT users, and 75 common academic phrases were used as controls. PubMed records from 2000 to 2024 (until April) were analyzed to track the frequency of these terms. Usage trends were normalized using a modified Z-score transformation. A linear mixed-effects model was used to compare the usage of potentially AI-influenced terms to common academic phrases over time. A total of 26,403,493 PubMed records were investigated. Among the potentially AI-influenced terms, 75 displayed a meaningful increase (modified Z-score ≥ 3.5) in usage in 2024. The linear mixed-effects model showed a significant effect of potentially AI-influenced terms on usage frequency compared to common academic phrases (p < 0.001). The usage of potentially AI-influenced terms showed a noticeable increase starting in 2020. This study revealed that certain words and phrases, such as “delve,” “underscore,” “meticulous,” and “commendable,” have been used more frequently in medical and biological fields since the introduction of ChatGPT. The usage rate of these words/phrases has been increasing for several years before the release of ChatGPT, suggesting that ChatGPT might have accelerated the popularity of scientific expressions that were already gaining traction. The identified terms in this study can provide valuable insights for both LLM users, educators, and supervisors in these fields.

Author Summary Artificial intelligence systems have rapidly integrated into academic writing, particularly in the medical and biological fields. This study investigates changes in the frequency of specific terminologies reported as overused by ChatGPT. By analyzing PubMed records from 2000 to 2024, we tracked 118 potentially AI-influenced terms and compared them with 75 common academic phrases. The study’s findings reveal that terms such as ‘delve,’ ‘underscore,’ ‘meticulous,’ and ‘commendable’ saw a marked increase in usage in 2024. However, this trend actually began around 2020. This suggests that while some of these terms were already gaining popularity before the release of ChatGPT, the large language model may have accelerated their adoption in scientific literature. Furthermore, the analysis highlights that the impact of ChatGPT extends beyond new terminologies to altering the frequency and style of commonly used academic phrases. Understanding these trends can help researchers and educators see how AI tools are shaping academic writing.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

KM is supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (grant number 22K15778).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Funding: KM is supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (grant number 22K15778).

Section on Possibly AI-influenced terms expanded with one additional entry; Abstract updated; Discussion section partially revised; Figures updated; Supplemental files updated.

Data Availability

The data used for the analysis was available as supplementary information (S3 Data).

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Top 10 CROs Offering Medical Writing Services

Medical writing is an indispensable piece of the pharmaceutical, biotechnology, and medical device research industries, with the field experiencing significant growth in recent years. In 2022 alone, the market for medical writing was valued at US $3.15 billion , and by 2032, it is expected to double and be worth US $7.95 billion . Medical writers are professionals proficient in scientific research and communication for a variety of target audiences, such as healthcare professionals, regulatory authorities, and patients . Medical writing teams at pharmaceutical companies and contract research organizations ( CROs ) are experts at developing a diverse array of medical materials, ranging from research papers and regulatory submissions, to clinical trial reports and medical education content .

With the globalization of the pharmaceutical industry and the consequential need for localized medical documents to comply with various regional regulations, many CROs are expanding their clinical trial capabilities to include medical writing . This article will delve into the medical writing services offered by ten of the top CROs worldwide, in no particular order.

Read on to learn how the following companies can support the success of your next clinical trial!

1. Premier Research

Founded: 1989

Headquarters: Durham, North Carolina

Company Size: 2,500 employees

The first on our list of top CROs offering medical writing services is Premier Research, a mid-sized company that is well-recognized globally . Their team is composed of regulatory medical writing experts who have an impressive average of 20 years of experience in the industry. Premier’s medical writing capabilities span the entire spectrum of needs for clinical trials and regulatory document preparation, including the development of study protocols, clinical study reports (CSRs), and patient narratives, amongst other regulatory submission documents. In addition to these core services, this CRO also offers support for marketing applications, complete with associated documents such as Clinical Overviews, Summaries of Clinical Efficacy and Safety, and more. The medical writing team at Premier is a top choice for sponsors because its team is highly knowledgeable about the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) guidelines, as well as adhering to the principles of CORE Reference and TransCelerate’s common document templates .

Premier Research offers medical writing services that span several therapeutic areas, including the following:

Rare Disease
Cell & Gene Therapy
Dermatology

2. Ergomed CRO

Founded: 1997

Headquarters: Surrey, United Kingdom

Company Size: 1,800 employees

Ergomed is a mid-sized CRO with over 25 years of experience and is a leading provider of extensive medical writing services to ensure the success of any clinical research program . Their medical writing team not only supports pharmaceutical and biotechnology sponsors around the globe, but is also highly experienced, with each member boasting more than 15 years of experience. Ergomed has a proven track record of creating documents compliant with EMA and FDA guidelines, with a strong commitment to staying up-to-date with the latest recommendations and practices. Because of the company’s global reach, its medical writing team can offer a 24-hour service, significantly shortening timelines and making it a reliable partner for urgent projects. Ergomed’s medical writing services span the full development cycle, from clinical to non-interventional and real-world evidence areas, consisting of developing and updating documents such as the following: CSRs, protocols, investigator’s brochures, investigational medicinal product dossiers (IMPD), informed consent forms (ICFs), and many more. Their standalone medical writing services also include consulting, designing studies, and conducting literature reviews .

Examples of some therapeutic areas covered by Ergomed CRO’s medical writing team include the following:

Oncology
Neurology / CNS
Allergy / Respiratory
Metabolic Disease

3. TFS HealthScience

Founded: 1996

Headquarters: Lund, Sweden

Company Size: 800 employees

TFS HealthScience CRO is another of our top CROs that offers a wide range of medical writing services , promoting clarity, compliance, and quality in every piece of work they deliver . The TFS Medical Writing team consists of skilled professionals who are not only proficient in multiple languages but also compliant with all ICH guidelines and regulatory requirements around the world. In particular, TFS stands out for the continuity and experience they offer in their medical writing services . A significant proportion of their medical writers have over 10 years of experience, and many have been with TFS for several years, supporting the company’s mission to cultivate successful, long-standing working relationships with clients. Recognizing that clinical trials are incredibly time-sensitive, TFS CRO’s clients can typically expect the first drafts of protocol and CSRs within four to five weeks, with further revisions delivered within five to ten working days after receiving comments . Visit the TFS Medical Writing Services page to learn more about the specific types of documents we can help you with for your next clinical trial!

TFS HealthScience CRO offers medical writing services across the following therapeutic areas:

Hematology and Oncology
Dermatology, Immunology & Inflammatory Diseases
Ophthalmology
Internal Medicine
Neuroscience
Rare Diseases and Orphan Drugs
Pediatrics

Founded: 1990

Headquarters: Dublin, Ireland

Company Size: 41,100 employees

ICON is one of the top CROs worldwide known to provide specialized medical writing services to support successful clinical trials . In addition to these services spanning from developing individual documents to extensive medical writing programs, this leading CRO also offers certified translations of all writing deliverables for global projects. Furthermore, the close collaboration between their medical writing team and key operational departments ensures the team delivers highly coordinated results to clients. To maintain organization, each project is assigned a single point of contact throughout the entire writing process to keep sponsors updated on project progress against established timelines. Overall, ICON boasts a global medical writing team with more than 48 writers located in the U.S., the European Union (EU), China, and India, each of whom comes with an average of more than 10 years of writing experience. These qualities, combined with the company’s high retention rate of over 95%, emphasize how ICON consistently provides highly reliable and accurate medical writing services.

ICON CRO ’s medical writing team is equipped with the expertise to cover many therapeutic areas, including the following:

Cardiovascular
Central Nervous System
Endocrine & Metabolic Disorders
Infectious Diseases
Internal Medicine & Immunology

Founded: 2002

Headquarters: Kirkland, Quebec (Canada)

Company Size: Fewer than 100 employees

Based in Canada, ethica CRO is next on our list of top CROs offering comprehensive medical writing services for clinical trials globally . The company’s overall approach is designed to streamline the review process for all key stakeholders, as well as to minimize the need for drafting burdensome and resource-intensive protocol amendments down the pipeline. In addition to creating clear, regulatory-standardized ICFs, ethica specializes in the development of clinical study protocols. The process begins with detailed planning to identify key elements of a sponsor’s research, including proper population dynamics, study design, and statistical strategy to ensure the final protocol adheres to the highest scientific and ethical standards. Their team of experienced medical writers can deliver clinical trial documents, such as case report forms (CRFs) and CSRs, as well as regulatory documents, such as clinical trial applications (CTAs) and investigational new drug (IND) submissions. As a company, ethica aims to place the research participants at the heart of their medical writing services , ensuring their team is well-informed on North American and European regulatory agency requirements, as well as internationally recognized best practices .

ethica CRO offers an experienced medical writing team for the following therapeutic areas:

Dermatology
Respiratory Diseases
Medical Devices

6. PPD Global

Founded: 1985

Headquarters: Wilmington, North Carolina

Company Size: Over 35,000 employees

For over 25 years, PPD’s medical writing team has been providing expert support to clinical trial sponsors across various industries, translating complex scientific information into high-quality, regulatory compliant documents . Their deliverables have a wide range of variety, from protocols and CSRs to patient narratives and IND applications. The medical writing team at PPD comprises over 130 writers with an average of 10 years of industry experience, based in over 14 countries, who have collectively completed more than 1000 documents in the last three years. The company also offers customized medical writing solutions, including quality review services, and as well as functional service partnerships, through which they provide efficient and quality services that reduce fixed costs. Overall, PPD understands that every client’s needs are unique, adapting their services accordingly to meet these requirements adeptly every time .

Examples of some therapeutic areas covered by PPD CRO’s medical writing team include the following:

Nephrology and Renal Diseases
Gastroenterology
Hepatology
Vaccine Development
Urology

7. Theradex Oncology

Founded: 1982

Headquarters: Princeton, New Jersey

Company Size: Over 200 employees

Theradex is a specialized oncology CRO that offers extensive medical writing services for this particular therapeutic area while maintaining strict adherence to ICH Good Clinical Practices and the U.S. Code of Federal Regulations . Their experienced medical writing team seamlessly collaborates with medical monitors, scientific experts, and sponsors on a variety of projects within the realm of cancer research. Their wide array of medical writing deliverables includes clinical study protocols and amendments, briefing documents for the Food and Drug Administration (FDA), CSRs, abstracts, journal articles, and much more.

For over 40 years, Theradex has been a notable player in advancing oncology clinical trials, providing central data management and monitoring services for early-phase cancer studies. Since its founding, this niche CRO has expanded globally, now with a strong presence in Europe and through partners in Asia, to deliver personalized service and efficiency with their medical writing team. Overall, Theradex is committed to evolving with advancements in cancer treatment, and its medical writing services reflect the company’s mission to drive the availability of novel treatment options for cancer patients worldwide .

8. Syneos Health

Founded: 1999

Headquarters: Morrisville, North Carolina

Company Size: Over 28,000 employees

Syneos Health CRO is another leading provider of medical writing services with decades of expertise that covers 19 therapeutic areas, as well as a wide range of document types . The medical writers at Syneos are not only well-equipped with strong project management and negotiation skills, but they also excel at meeting timelines and reconciling sponsor feedback efficiently. Some of the notable achievements of this CRO’s medical writing team include the completion of 5500 writing projects in the past 3 years, and the publication of 1900 regulatory documents annually. The company also provides flexible solutions for partnering with in-house writers of their clients, offering cost-efficient services that reduce the burden of routine medical writing tasks within a project. It’s important to note that Syneos Health’s medical writing services can be delivered as part of full-service programs or as standalone solutions in a functional service partnership model. Overall, this CRO consistently delivers success in clinical trial projects, ensuring high-quality output with every piece their medical writing team develops .

Syneos Health’s medical writing team is equipped with the expertise to cover many therapeutic areas, including the following:

Immunology & Inflammation
Cell and Gene Therapy
Medical Device and Diagnostics
Infectious Diseases & Vaccines

9. Pro Pharma

Founded: 2001

Headquarters: Raleigh, North Carolina

Company Size: Over 2,500 employees

Next on our list of top CROs offering expert medical writing services is Pro Pharma Research Organization, a CRO that caters to the pharmaceutical and medical device industries, both for human and veterinary research . Their medical writing team is highly experienced with several types of documents, including developing CSRs, regulatory submissions, patient information leaflets, summaries of product characteristics, scientific articles, clinical protocols, and more. As a reputable CRO , Pro Pharma upholds the highest industry standards in all its operations, and its medical writing team is committed to delivering content that is not only scientifically accurate but also compliant with all relevant regulatory requirements. Other unique features offered by the company are its use of proprietary technological platforms, validated questionnaires, and comprehensive frameworks for real-world evidence (RWE). Pro Pharma ensures its medical writing services entail high-quality deliverables for sponsors to enable success for any medical product in every stage of the therapeutic pipeline, from initial development to clinical trials.

Pro Pharma offers medical writing services across the following industries and more:

Medical
Regulatory
Digital
Veterinary

10. Allucent

Founded: 1994

Headquarters: Cary, North Carolina

Company Size: Over 1,500 employees

Last, but certainly not least, we have Allucent, a US-based CRO that is known to offer a wide array of medical writing services to support pharmaceutical and biotechnology clinical trial sponsors . Their skilled and multidisciplinary team of medical writers is committed to maintaining the utmost quality standards throughout the entire process of clinical documentation. The range of documents produced by Allucent broadly includes CSRs, investigator brochures, IMPDs, as well as IND files, manuscripts, and ICFs. The medical writing team at this CRO collectively possesses strong expertise for several regulatory agencies around the world, including the U.S. FDA, Health Canada, and bodies in the EU, United Kingdom, and Asia Pacific. With more than 30 years of experience in over 60 countries, Allucent’s medical writing services have established a reliable reputation for sponsors globally. Overall, the company’s medical writing capabilities consistently prioritize high-quality and personalized customer service, effective communication, and lean project management .

Allucent CRO offers an experienced medical writing team for the following therapeutic areas and more:

Oncology and Hematology
Infectious Disease and Vaccine

Conclusion

In conclusion, the growth and expansion of industries such as pharmaceutical, biotechnology, and medical device research have led to an increased demand for medical writing services . These top 10 CROs play a pivotal role in meeting this demand, offering a range of services essential for conducting successful clinical trials worldwide.

About TFS HealthScience CRO

TFS HealthScience is a global CRO that supports biotechnology and pharmaceutical companies throughout their entire clinical development journey. Our skilled medical writing team is composed of professionals well-familiarized with all ICH guidelines and regulatory requirements worldwide. Visit our website to learn more about the medical writing services TFS can offer for your next clinical trial, or connect with a TFS representative today!

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Open access
Published: 28 May 2024

Reform of the first year of medical studies and diversification of student profiles in France: an unmet need?

Raoul K. Khanna 1 , 2 ,
Emmanuelle Blanchard 2 ,
Jeremy Pasco 3 ,
Patrice Diot 2 &
Denis Angoulvant ORCID: orcid.org/0000-0003-0788-8092 2

BMC Medical Education volume 24 , Article number: 581 ( 2024 ) Cite this article

Metrics details

To determine whether the reform of the first year of medical studies implemented in September 2020 in France met its objective of diversifying the profiles of students admitted to second year at the faculty of medicine at the University of Tours.

Single-centered, retrospective study, covering students who passed the first year of medical studies between 2018 and 2022. Student profiles originating from three different entry gateways (PACES, PASS and L.AS) to the second year of medical studies were compared.

One thousand four hundred and seventy-nine students over five promotions were included (806 in PACES, 329 in PASS, 198 in L.AS). The ratio of students who had obtained a baccalaureate with high or highest honors was significantly higher in PACES (85%) and PASS (96%) compared to L.AS (66%; p < 0.001). These differences were related to increased student intake via a standard pass in L.AS (21% compared to 3.2% in PACES and 0.9% in PASS) ( p < 0.001). In terms of geographical origin, the proportion of students residing in regions outside the University City area increased significantly in L.AS (11%) compared to PACES (1.7%) and PASS (3.3%) ( p < 0.001). The mean number of parents from the white-collar and knowledge professional category was significantly higher in PACES (0.91) and PASS (1.06) compared to L.AS (0.80; p < 0.001).

Students with a scientific background and who obtained highest honors in their high school diploma, remain the standard in PACES and PASS. Diversification of student profiles was achieved only within the L.AS gateway, which represented 42% of total second year admissions during the post-reform year. Student profile diversification was therefore a partially achieved objective and follow up studies of future promotions is needed to assess the medium and long-term impact of the reform. Particular attention should be paid to the future of these students who have different profiles between L.AS and PASS to determine whether these changes will have any impact in the quality of healthcare for the French population.

Peer Review reports

Introduction

The medical education system in France has undergone a significant overhaul over the past decade across all three cycles of study, from revising the competitive entry exam to reorganizing phased professionalization. The changes in the first cycle, implemented in 2020, aimed to broaden access, with the goal of enhancing student diversity across various socioeconomic backgrounds. In the second cycle, the focus shifted from purely imparting knowledge to facilitating skill acquisition, a change introduced in 2020. The third cycle introduced the challenge of promoting professionalization through three consecutive sequences.

Before the recent changes, from 2010 to 2020, entry into medical studies in France was secured through a competitive selection exam held during the First Common Core Year for Health Studies (PACES). This exam was prepared for during one academic year and served as an essential prerequisite for various healthcare disciplines, including medicine, midwifery, dentistry, pharmacy, and physiotherapy. Students had two opportunities to take this exam: their initial attempt and a single re-sit, if necessary. Success was determined by their PACES ranking; high-ranking students progressed to the second year of their chosen course, while others who did not succeed had the option of one re-sit.

The PACES pathway has been criticized for its elitist approach. Candidates failing to achieve the required cutoff (up to 40%) found that their year of study yielded no educational credits transferable to subsequent courses [ 1 , 2 ]. In 2020, the PACES was replaced by a double entry pathway, i.e., the Health Access Specific Pathway (PASS) and a Bachelor’s degree with Health Access minor (L.AS) (Table 1 ).

The first aim of the medical studies admissions reform was to widen the admissions pathways to increase student diversity and opportunities, based on the hypothesis that a more inclusive student typology might improve the variety of future medical doctors (MDs), potentially counteracting unequal healthcare access in France [ 3 ]. Additionally, the reform required students to choose a mandatory minor discipline, offering an alternative to traditional medical studies. The reform also aimed to reduce the number of students facing academic failure by implementing a forward-moving system, thereby eliminating the need to repeat a year.

The current study aimed to evaluate the impact of the reform on student typology, based on the data of students who passed the first year of medical studies at the University of Tours, France, before and after the reform of the first year of medical studies.

This retrospective study included second-year medical students at the University of Tours, France, who successfully completed the first common core year (PACES and then PASS or L.AS). The study spanned from September 2018 to September 2023 and covered the academic years 2018–2019, 2019–2020, 2020–2021, 2021–2022, and 2022–2023. The reform, implemented in 2020 for first-year students, consequently affected the 2021–2022 and 2022–2023 academic years for second-year students. Students whose application files were incomplete at N-1, those repeating their second year of medicine at N-1, and students admitted through a bridge program were not included.

The Faculty of Medicine at the University of Tours is the only medical faculty in the Centre-Val de Loire region (39,150 km² area; 2,574,863 inhabitants). In 2022, there were 350 doctors for every 100,000 inhabitants, representing one of the lowest medical densities in France [ 4 ]. The Centre-Val de Loire region comprises six areas, each with its own main administrative office: Tours, Blois, Orléans, Chartres, Châteauroux, and Bourges (see Supplemental material 1).

Permission to access data from the APOGEE (French universities database) was granted by the University of Tours. Only strictly necessary data were accessed, and it was extracted anonymously and used in compliance with both French and European legislation. This study was approved by the Institutional Ethics Committee of the University Hospital of Tours (n°2,023,060). According to French Law, informed written non-opposition was obtained from all subjects, ensuring compliance with ethical and regulatory standards.

Data collection

For each student in the study, the following information was extracted from APOGEE database: date of birth, gender, N-1 year of PACES/PASS/L.AS, baccalaureate (results, specialization, and year), parents’ region of residence and socio-economic background (according to the National Bureau of Statistics, INSEE).

Statistical analyses

To facilitate comparison between year levels, quantitative data was expressed in absolute values and qualitative in relative values (percentage in relation to the year). Data analysis was performed using “R”, software version 4.02. The class of 2021–2022 (i.e., the reform year) and the sum of the previous three years’ results were compared using the following methods: quantitative variables were analyzed with the Student’s t-test, and qualitative variables were analyzed using the Fisher test. Within the 2021–2022 year level, qualitative variables comparing the three entry streams (PACES, PASS, L.AS) were analyzed using the Chi-squared homogeneity test. The comparisons between the three entry streams for the entire study period were performed using One-Way Analysis of Variance (ANOVA) for quantitative variables and Chi-squared homogeneity tests for qualitative variables. A p -value < 0.05 was considered statistically significant.

The flow diagram is presented in Fig. 1 .

Flow diagram

Comparison of the five year levels

The student population studied over the three periods is presented in Table 2 . No difference was found in relation to average age nor gender ratio.

Baccalaureate

During the reform year, fewer students obtained high honors or highest honors (147, 73.9%). In contrast, a greater number of students obtained honors and standard passes (89, 26.3%) compared to the average of the three previous years (Student’s t-test, p < 0.001, 95% CI [9.5; 20]) (Supplemental material 2).

One year after the reform, the figures returned to the same distribution as pre-reform years, with an increase in the number of the high honors and highest honors (292, 87.4%) and decrease among the honors and standard passes (42, 12.6%) (Supplemental material 2).

Geographic origins

Geographic origins of students based on their entry pathway are presented in Fig. 2 .

Breakdown of enrolled students based on parental domicile. The proportions of students originating from the six territories within the Centre-Val de Loire region for each entry stream are presented

During the reform year, there were proportionally fewer applicants from the Tours area (University City), with 51% compared to 64% during the average of the previous three years ( p < 0.001, 95% CI [6.4; 20]). However, applications from neighboring areas and regions outside of the Centre-Val de Loire region increased (Supplemental material 3). This trend continued the following year with only 46.3% of the students coming from the Tours area (University City).

Parental socioeconomic category

In the whole cohort, two thirds of the students (64.0%) had one parent belonging to white-collars and knowledge professional category. One fourth of the students (28.1%) had both white-collar parents and knowledge professional category ( Fig. 3 ) . This distribution remained stable among the five years.

Parental socioeconomic category 1 and 2 according to the three entry pathways (A. PACES, B. PASS, C. L.AS)

Results of the reform year (2021–2022)

The three entry streams presented differences in student baccalaureate levels. PACES and PASS streams resulted in a greater proportion of high honors and highest honors (respectively 64.6% and 95.6%) compared to L.AS (44.6%; Chi-squared homogeneity test, p < 0.001). The L.AS group included a higher proportion of students with a standard pass baccalaureate (44.6% compared to 8.3% in PACES and 1.5% in PASS).

Half of the students came from the University area in PACES (50.3%) and PASS (50.7%) whereas one third only for L.AS (33.9%) (Fig. 4 ). This difference was statistically different when comparing PACES and PASS together versus L.AS ( p = 0.023). The L.AS stream drew more student domiciled from territories outside of the Centre-Val de Loire region (17.9% compared to 2.8% in PACES and 4.4% in PASS).

Graph of enrolled students in relation to their parental domicile for the reform year. The proportions of students originating from the six territories within the Centre-Val de Loire region for each entry stream (PACES/PASS/L.AS) are presented

The proportion of students with at least one parent in the white-collar or knowledge professional category was higher in PASS (1 parent: 72.8% compared to 57.2% in PACES and 48.2% in L.AS ( p = 0.002); 2 parents: 34.6% compared to 26.2% in PACES and 17.9% in L.AS ( p = 0.051)).

Results of the post-reform year (2022–2023)

2022–2023 was the first year following the reform year, without students from the PACES stream. Most students enrolled in PASS, had just passed their baccalaureate (187, 96.2%). In contrast those from L.AS had completed a one year diploma before L.AS (102, 71.8%).

Among the L.AS group, a greater number of students had standard pass or honors (25.5%) baccalaureate results compared to the PASS students (3.1%) where highest honors was more prevalent (70.5% compared to 48.2% in L.AS).

The geographic origins between the two streams remained relatively homogenous, except in L.AS, where there was an increase in students from territories outside region Centre-Val de Loire (7.0% against 1.6% in PASS).

Parental socioeconomic background

The proportion of students with at least one or two white-collar parents and knowledge professional category was higher in PASS (1 parent: 56.5% compared to 47.9% in L.AS ; 2 parents: 36.3% in PASS compared to 19.0% in L.AS ).

The transition from the PACES selection mechanism to the PASS system marked a pivotal change. However, a significant increase in student diversity was predominantly observed in the L.AS pathway. This increase was relatively modest during the reform year, considering L.AS represented 17% of student enrollments into second year of medical studies. A year subsequent to the implementation of this reform, diversity among medical students improved as students originating from the L.AS pathway represented 42% of the total number of students.

The reform entry prerequisites stipulated for PASS, that the curriculum have a majority of health science subjects and an elective (non-health sciences) which would be chosen by the student, and inversely so for the L.AS. The aim of increasing student diversity through modifying the PACES selection process was not achieved. The PACES student profile (i.e., high honors or highest honors in their scientific baccalaureate results), was merely transferred to the PASS students. However, entry via the L.AS stream resulted in a new category of students with standard pass or honors for their scientific baccalaureate results. The following year, this diversity via the L.AS entry stream fell, and the L.AS became as competitive as the PASS.

In examining second-year medical students, it was noted that fewer had parents residing in the University City. The percentage declined from an average of 63% over the prior three years to 47%. This suggests an increased proportion of students originating from locations more distant from the university. Among the French medical faculties, the L.AS pathway curriculum varies depending on the resources available at each university. This curriculum heterogeneity could partly explain why students residing beyond the Centre-Val de Loire region, chose to apply outside their region. However, the openings provided by the L.AS stream to students coming from surrounding areas, diminished during the post-reform year.

It is crucial to acknowledge the potential for self-censorship among applicants. The PASS pathway, designed to replace PACES, may be perceived as especially competitive, whereas L.AS is viewed as an alternate entry route to medical studies. This perception of PASS’s heightened competitiveness might promote self-censorship tendencies among potential applicants. External factors, such as social background or the proximity of a student’s family home to the university, may also influence the selection process. A notable overrepresentation of students from the white-collar and knowledge professional sectors within PASS, compared to the general population ratio and in contrast to L.AS, lends credence to the hypothesis of student self-censorship during enrollment. Comprehensive research, inclusive of all first-year applicants and not just those who succeeded as in our current study, is necessary to ascertain the influence of these factors on medical student selection.

Parents enrolling their children into first year medicine, understandably, would wish to optimize their child’s chances for success. One could hypothesize that certain candidates believed that the less competitive L.AS stream, would increase their likelihood acceptance into medical studies. The proportional increase of higher scoring students in L.AS in the post-reform year supports this hypothesis. In addition, our observations would indicate that high school students strategically modify their performance and choices in relation to the selection system. This adaptive approach to course selection could in the end, render moot real diversification. In summary, the L.AS stream entry to second year medicine enabled access to a wider range of student profiles, albeit temporarily.

Concurrent with the pedagogic reform at the Medical Faculty of the University of Tours, there was a notable rise in the intake for medical studies. The intake increased by 22.2% (60 additional students) in 2021–2022, in contrast to a 3.7% rise (10 additional students) over the previous two years. In response to parental concerns about the first-year medical reform, the French Council of State mandated the Faculty of Medicine in Tours, along with 14 other such faculties in France, to admit a larger number of students into the second year of medicine [ 5 ]. The French Council of State recognized that seats in the second year of medical studies were largely allocated to students from the previous system, PACES, even if the intention was to ensure fairness for the new first-year students in the recently introduced courses, PASS and L.AS. Even though PACES students represented 30% of the first-year cohort, they were given nearly 48% of the positions in the second year. Additionally, the Council of State pointed out that fifteen universities had not sufficiently expanded their second year enrollment capacity. This posed a risk that the reform could disadvantage PASS and L.AS students.

There is growing scientific evidence that a diverse health care workforce will contribute to improve national health care for the population [ 6 , 7 , 8 ]. Medical schools must cultivate a broader applicant base that mirrors the demographic composition of the general population, ensuring a representative mix among medical students [ 9 ]. According to our findings, achieving a diverse health care workforce is still a distant objective, and its realization hinges on the inclusiveness of the national medical student population.

The observations of this study should take into account certain limitations, such as the non-inclusion of “transfer” students – who enter second year medicine via an alternative selection pathway who remain outside the average student profile. Nevertheless, the number of transfer students remains modest, averaging approximately ten students per academic year. Another limitation of this study lies in its monocentric nature. However, this approach is still more favorable than a multicentric comparison which could involve data from varied and inconsistent admission systems.

The reform replaced the elite selection system PACES with two pathways PASS and L.AS. Increased student diversity was observed in the L.AS stream which represented 42% of the total number of students during the post-reform year. Certain universities suggested only maintaining the L.AS stream as the sole entry point to health education, in order to avoid PASS being a disguised PACES. It remains to be seen how these reform changes in student selection might influence the future doctors, their professional pathways, both geographical distribution and mode of practice, and ultimately the quality of care offered. These points should be followed up in the coming years.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors wish to thank all the students of the University of Tours and university staff members who made the reform of the first year of medical studies possible. The faculty team is proud of all its students. We are grateful to Julien Bender for extracting data from the Apogée database and to the Jane Lee, for the translation of the article. We thank Flexisanté for the financial support of educational content for the first year of medical studies.

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Department of ophthalmology, University Hospital of Tours, INSERM 1253 iBraiN, Tours, France

Raoul K. Khanna

Department of medical pedagogy, Faculty of medicine, University Hospital of Tours, 2 boulevard Tonnellé, Tours, 37000, France

Raoul K. Khanna, Emmanuelle Blanchard, Patrice Diot & Denis Angoulvant

Unité de Recherche Clinique & Innovation, Centre Hospitalier Public du Cotentin, Cherbourg, France

Jeremy Pasco

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Contributions

RKK wrote the main manuscript text and conducted the analyses with JP. All figures and tables were prepared by RKK and JP. All authors were involved in drafting the article, revising it critically and approving its final version for submission. RKK had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of data analysis.

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Correspondence to Denis Angoulvant .

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Ethics approval and consent to participate.

This project has obtained the necessary permissions from the University of Tours for the extraction of anonymized data from the Apogee database. The data acquisition process was complied with in accordance with French and European laws in force within the University. Only strictly necessary data was extracted and used.

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Supplementary Information

12909_2024_5570_moesm1_esm.png.

Supplementary Material 1. Areas constituting the Centre-Val de Loire region and their location in France. The logo represents the University of Tours.

12909_2024_5570_MOESM2_ESM.docx

Supplementary Material 2. Results in relation to the baccalaureate (time frame and level) (Due to *2022 baccalaureate reform, stream identification was unavailable).

12909_2024_5570_MOESM3_ESM.docx

Supplementary Material 3. Breakdown of enrolled students based on parental domicile. The proportions of students originating from the six territories within the Centre-Val de Loire region for each year are presented.

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Khanna, R.K., Blanchard, E., Pasco, J. et al. Reform of the first year of medical studies and diversification of student profiles in France: an unmet need?. BMC Med Educ 24 , 581 (2024). https://doi.org/10.1186/s12909-024-05570-4

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DOI : https://doi.org/10.1186/s12909-024-05570-4

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In their own words: Medical students reflect on their journeys

Through 55-word stories, students share aspects of their medical school experiences — from meaningful patient encounters to moments of joy and heartbreak..

Medical students talking in class and sharing ideas

The growth was sudden and swift, but also so slow I didn’t even notice. Medical school will change you in ways that you don’t even notice until reflecting at the end of the four years. All I can say is, it has been the most amazing, thrilling journey, that I never hope to do again. —Megan Corn, University of North Dakota School of Medicine & Health Sciences

The most important thing you can learn during medical school isn’t how to answer questions; it’s how to ask questions. We’ve reached the point where AI can pass the USMLE, but while AI might have the answers, it’s useless unless it has the necessary information. Getting that information from the patient is up to you. —Jonathan Walsh, Perelman School of Medicine at the University of Pennsylvania

Medical school — a musical snow globe, magical and completely enveloping. Unfortunately, life still happens on the outside; occasionally the music stops. It’s not just patients that die. The trick is figuring out how to give yourself a shake, wind yourself back up, get that snow falling and music playing again. The show must go on. —Marinos Pylarinos, Rutgers New Jersey Medical School

“You will grow so much.” The once unfamiliar halls become mapped roads trodden more than a thousand times; the silent strangers ambling past now beam at a comrade in arms and exchange warm greetings; the wavering uncertainty blossoms into a calm security; the road barrels forward, teeming with new adventures. What new growths lie ahead? —Kim Tran, LSU Health New Orleans School of Medicine

Overpriced lattes and overworked laptops. Low-stakes gossip between practice questions. Exchanging tales of indefensible pimping failures to remedy our humiliation with laughter. Salty margarita rims after exams we swore we failed. Medical school was the hardest thing I’ve ever done, but I’d do it a million times again if I could do it with them. —Jillian O’Shaughnessy, Renaissance School of Medicine at Stony Brook University

My third laparoscopic cholecystectomy with the grumpy attending. A stapler malfunction, lots of cursing, tensions rising, he fishes for the staple. Clearing my throat, “Do you mind if I try?” Tepidly, I grab for the staple resting on the loop of bowel — success! A smile forms under his mask, “Well, I’ll be damned, good job.” —Kevin Gertner, The University of Tennessee Health Science Center College of Medicine

Of all the awards, achievements, and accolades, all the tests passed, challenges overcome, and concepts mastered, the most important event I experienced in medical school was a sick patient telling me, “Thank you for being kind.” Even at the most difficult of times, I would do it all again if that was the final reward. —De’mond Glynn, University of Kansas School of Medicine

We are sorry. You did not match to any position: 10 words that make you feel like you failed the ultimate mission. Colleagues, mentors, and faculty build you up. These are the people that fill your cup. Although the journey is different than planned, I cannot wait to impact my patients; I will still stand. —Michael Nichols, University of Kentucky College of Medicine [Nichols will complete a preliminary general surgery year before pursuing anesthesiology]

On patients as people:

You and me, each behind a mask, but it doesn’t take more than our eyes locking to know that we are in this moment together. You pour out months of struggle in just a few minutes, we acknowledge the hardship and heartbreak. Together we pick a piece of the puzzle and start building something new. —Natalie Alteri, The University of Arizona College of Medicine Phoenix

Patient on swallow precautions, because of a recent trip to the MICU, for aspiration pneumonia. I go to examine her, lifting her sheets gingerly, to not disturb her sleep. And there, right by her mouth, is a Lindt chocolate bunny, with the head bit right off. When you’re 85, some things are worth aspirating for. —Carly Ferre, Spencer Fox Eccles School of Medicine at the University of Utah

It was 7:30 p.m., and the other patients were in bed. Across from me sat a late-20s veteran with PTSD and anterograde amnesia. We locked eyes. “I trust you.” The words left his lips and sliced the silence, followed by a throbbing drumbeat—my heart; it knew the way and told me where to go. —Billy Nguyen, The University of Oklahoma College of Medicine

“He’s not just a patient; he’s a person. It’s only respectful to introduce yourself even if he won’t remember any of it.” —Attending anesthesiologist on why he introduced me, a shadowing med student, after the patient had received an amnesiac. Sometimes, we focus so much on the medicine that we lose sight of the person. —Sunny Liu, Duke University School of Medicine

The helicopter’s blades slowed as it landed, transporting a man in agonizing pain from cancer. He shared of months of unacknowledged and neglected pain. Amidst treatment planning, I couldn’t help but prioritize time by his side. Ordering medications, I also ordered a listening ear and a warm embrace, ensuring he felt heard and cared for. —Kevin Reyes, University of California San Francisco School of Medicine

My patient with opioid use disorder pats the seat next to me, inviting me to sit. She asks me, “Have you ever used substances before?” I look at her questioningly and say, “No I haven’t. Why?” My patient says, “It’s just that you talk and listen to me as if you know what it’s like.” —Mandy Perez, Perelman School of Medicine at the University of Pennsylvania

On delivering bad news:

On the darkest day of my own life, an intern and I diagnosed a woman with cancer. I lied and said I had a migraine. I got to run and curl up in a ball. I’ll never know if the intern’s life was falling apart. Maybe all three of our souls were crushed that day. —Valery Kravchuk, University of Kentucky College of Medicine

It was a rainy day. And through the skylights in the pediatric ICU I felt salty rain hitting my cheeks. A little girl was dying. Her family hugging her edematous body, that had once run, jumped, and played. There were no other options, the medical team said. As if we were talking about the rain. —Carly Ferre, Spencer Fox Eccles School of Medicine at the University of Utah

His eyes locked hers, tears flowing down their cheeks. The world moved slowly, neither dared speak. Love so palpable, understanding so profound. Embracing him, she knew deep down. Stop aggressive measures and be at peace. He would be gone within a week. Emotions unspeakable, never to perish. What makes us alive, these moments we cherish. —Christopher Economus, Northeast Ohio Medical University

The resident quietly cries in the elevator after explaining a diagnosis of small cell lung cancer to a young patient. His father, I learned, suffered the same fate. That night, I cry for hours; for the patient, resident, both of their families. Medical school does not prepare us for grief, either over patients or ourselves. —Grace Noonan, University of Kansas School of Medicine

On what it means to become a doctor:

The first time someone thanked me for being a doctor broke my heart. I told a wife that her husband’s lung cancer was metastatic in the ED, because other doctors couldn’t fit them into their schedule for two months. She told me, “Thank you for being my doctor when no one else wanted to be.” —Alexander Chiang, California Northstate University College of Medicine

In fourth-year, I often heard, “This won’t apply to you.” While true of ventilator settings, I still held the hand of the scared mom, her baby intubated. For weeks, I did one thing: cared. The mom gave me a keychain, covered in daisies. A daily reminder, as I enter intern year, that caring always applies. —Jenna Jensen, Spencer Fox Eccles School of Medicine at the University of Utah

In the dim glow of the night shift, as monitors beeped and patients slept, a quiet epiphany unfolded. Amidst the complexities of diagnoses and treatments, the human connection shone brightest. Each conversation and each shared moment of vulnerability reaffirmed my path. Internal Medicine became not just a specialty, but a calling to nurture my soul. —Suhail Singh Sidhu, Creighton University School of Medicine

My patients have taught me to see them beyond their disease. To pull up a chair, listen, and understand their goals. To do everything reasonable to design our plans in respect of their wishes. Sometimes the best treatment is no treatment. Success can be more than the absence of disease… but the presence of peace. —Cameron Quon, Western Michigan University Homer Stryker M.D. School of Medicine

Medical Education

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"Now feeling 100%," he wrote on X , formerly Twitter, May 28, "even though I don't need to be to beat Jake Paul ."

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"He is appreciative to the medical staff that were there to help him," the rep continued, adding that the boxer is now "doing great."

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Case Study Template
Effective Medical Writing
Medical Case Study Template
🐈 Medical case study sample. 19 medical case study examples. 2022-11-15
Writing Medical Case Studies Gi
Writing Medical Case Studies Gi

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Guidelines To Writing A Clinical Case Report
A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports usually describe an unusual or novel occurrence and as such, remain one of the cornerstones of medical progress and provide many new ideas in medicine. Some reports contain an extensive review of the relevant ...
Developing a Beginner's Guide to Writing a Clinical Case Report: A
In this study, medical students indicated that lack of formal training and lack of mentorship were significant barriers to writing and presenting cases. There are several journal-specific guides and instructions on how to write clinical case reports but despite this, junior doctors still find it difficult to write up a case report.
Writing a case report in 10 steps
Writing up. Write up the case emphasising the interesting points of the presentation, investigations leading to diagnosis, and management of the disease/pathology. Get input on the case from all members of the team, highlighting their involvement. Also include the prognosis of the patient, if known, as the reader will want to know the outcome.
Guidelines to the writing of case studies
It is best to simply tell the story and let the outcome speak for itself. With these points in mind, let's begin the process of writing the case study: Title page: Title: The title page will contain the full title of the article. Remember that many people may find our article by searching on the internet.
How to write a medical case report
Writing a case report is an excellent way of documenting these findings for the wider medical community—sharing new knowledge that will lead to better and safer patient care. For many medical students and junior doctors, a case report may be their first attempt at medical writing. A published case report will look impressive on your ...
How to Write Case Reports and Case Series
can introduce very effective treatment paradigms. Preparing the manuscript for a case report may be the first exposure to scientific writing for a budding clinician/researcher. This manuscript describes the steps of writing a case report and essential considerations when publishing these articles. Individual components of a case report and the "dos and don'ts" while preparing these ...
A student guide to writing a case report
Sometimes case reports include a short literature review, if you think it is worthwhile, include it. 2. Describe your patient and follow the diagnostic pathway. For example - Patient X is a 10 ...
A young researcher's guide to writing a clinical case report
A clinical case report or case study is a means of disseminating new knowledge gained from clinical practice. Clinical case reports are the first-line evidence in medical literature as they present original observations. This article provides detailed guidance on how to identify, write, and publish a case report.
A guide to writing case reports for the Journal of Medical Case Reports
Case reports are a time-honored tradition in the medical profession. From Hippocrates (460 B.C. to 370 B.C.), and even arguably further back since the papyrus records of ancient Egyptian medicine (c. 1600 B.C.) to modern day, physicians of all specialties have described interesting cases involving all specialties [1, 2].Published case reports provide essential information for optimal patient ...
Writing A Case Report
A medical case report, also known as a case study, is a detailed description of a clinical encounter with a patient. The most important aspect of a case report, i.e. the reason you would go to the trouble of writing one, is that the case is sufficiently unique, rare or interesting such that other medical professionals will learn something from it.
PDF How to write a clinical case report
It is best to write the actual report in one stretch if possible, including as much detail as you think is relevant. You can always edit the discussion and trim down the article at a later stage. Below is the general format adopted for most case reports. Introduction. Summarise your case report in a sentence. Mention how rare this condition is ...
Writing a Medical Case Study: From Inspiration to Publication
5. Complete your introduction and conclusion after you've written the body. Since these sections summarize key points of your case study, it's best to write them last. The introduction gives a brief overview of the basic condition of your patient and the problem you'll address in your case study.
Writing a medical case report
Case reports have fallen out of favour, but they still have a role to play Given the unpredictable and challenging nature of medicine, many medical students will have come across a patient who has not been a textbook case. The patient may have presented in an unusual way, had a strange new pathology, or reacted to a medical intervention in a manner that has not been seen before. The ...
A Case Study in Medical Writing
The outline was written in 2003. It was part of a cache of documents unsealed by a court on Friday, July 31, 2009 in a personal injury lawsuit. Documents unsealed by a judge in a personal injury ...
PDF 10. Guideline and Template for Writing a Case Report/Case Series
Part Two: Writing your second draft Step 11: Start by writing the entire text and listing the references. Your manuscript should generally not exceed 1200 words. Leave the title, abstract, key words and formatting for last (Steps 12-15) Background1 Tuberculosis is a common illness for vulnerable populations in resource-limited settings with latest
Writing a case
Developed by 2020-2021 Harvard Chan Equity, Diversity, and Inclusion Fellow Sana Farooqui (MPH 2021), this guide provides suggestions for case writers and course instructors on writing and selecting cases featuring diverse protagonists and DEI topics, as well as leading inclusive case discussions in the classroom. Kane, N.M. & Madden, S.L., 2014.
Homepage
A journal publishing case reports in all medical disciplines, including general medicine, drug interaction and adverse reactions. The largest online collection of medical case reports. Validation period: 5/27/2024, 2:02:46 PM - 5/27/2024, 8:02:46 PM. Subscribe Login.
Medical Writing
Certificate Guidelines. All students must either take the following prerequisites or have taken appropriate equivalents within the past five years, earning a grade of B- or better: Medical Terminology FPM-40172, 1 unit online. Practical Clinical Statistics for the Non-Statistician FPM-40233, 2 units online. Grammar Lab WCWP-40234, 3 units online.
How to Write a Case Study
Proofreading and editing your draft. After writing a draft, the case study writer or team should have 2-3 people, unfamiliar with the draft, read it over. These people should highlight any words or sentences they find confusing. They can also write down one or two questions that they still have after reading the draft.
Comparison of an AI-Generated Case Report With a Human-Written ...
Introduction: The utility of ChatGPT has recently caused consternation in the medical world. While it has been utilized to write manuscripts, only a few studies have evaluated the quality of manuscripts generated by AI (artificial intelligence). Objective: We evaluate the ability of ChatGPT to write a case report when provided with a framework. We also provide practical considerations for ...
Case study
A case study is an in-depth, detailed examination of a particular case (or cases) within a real-world context. For example, case studies in medicine may focus on an individual patient or ailment; case studies in business might cover a particular firm's strategy or a broader market; similarly, case studies in politics can range from a narrow happening over time like the operations of a specific ...
Guideline on writing a case report
The clinical case report has been an integral part of medical literature throughout history. The oldest example of a preserved clinical case in medical literature is a text from an ancient Egyptian papyrus dating from the 16 th to the 17 th dynasty, 1600 BC, addressing the management of dislocated jawbone. From Hippocratic case histories ...
Delving into PubMed Records: Some Terms in Medical Writing Have
It is estimated that ChatGPT is already widely used in academic paper writing. This study aims to investigate whether the usage of specific terminologies has increased, focusing on words and phrases frequently reported as overused by ChatGPT. The list of 118 potentially AI-influenced terms was curated based on posts and comments from anonymous ChatGPT users, and 75 common academic phrases were ...
Top 10 CROs Offering Medical Writing Services
The first on our list of top CROs offering medical writing services is Premier Research, a mid-sized company that is well-recognized globally.Their team is composed of regulatory medical writing experts who have an impressive average of 20 years of experience in the industry. Premier's medical writing capabilities span the entire spectrum of needs for clinical trials and regulatory document ...
Full article: Finding our way in the In Vitro Diagnostic Medical
Learning from the scientific community. Upon publication of the Medical Device Coordination Group Document MDCG 2022-10, on the interface between clinical trials and the IVDR [Citation 2] in May 2022, a number of those concerns were confirmed, with a clear statement that clinical trial assays used for patient selection, allocation and/or monitoring were indeed considered to be within scope of ...
Reform of the first year of medical studies and diversification of
The first aim of the medical studies admissions reform was to widen the admissions pathways to increase student diversity and opportunities, based on the hypothesis that a more inclusive student typology might improve the variety of future medical doctors (MDs), potentially counteracting unequal healthcare access in France [].Additionally, the reform required students to choose a mandatory ...
In their own words: Medical students reflect on their journeys
In their own words: Medical students reflect on their journeys. Through 55-word stories, students share aspects of their medical school experiences — from meaningful patient encounters to moments of joy and heartbreak. May 23, 2024. 55-word stories have a long tradition in medicine: Many medical schools invite their students to use the medium ...
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Clinical Project ManagerLocation - Hyderabad #LI HybridAbout the Role:This role is responsible to Lead and manage a multidisciplinary cross functional Clinical Trial Team (CTT) (medical writing, statistics, data management, monitoring partner, drug supply, regulatory, safety etc.) or support the Sr. CPM (where applicable) in the effective planning, regular re-evaluation and implementation of ...
Mike Tyson Shares Update on Health After Suffering Medical Emergency
Boxing legend Mike Tyson is on the mend after suffering a medical emergency during a May 26 flight from Miami to Los Angeles, writing, "Now feeling 100%."

A student guide to writing a case report

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A guide to writing case reports for the Journal of Medical Case Reports and BioMed Central Research Notes

Introduction: the importance of case reports

Definitions

How to start: the patient

Collegial discussion and the Internet: our modern day water cooler

The BMC series, JMCR , and BMCRN : a brief history

Cases Database: an invaluable resource

When to write a case report

BMC editorial workflow for case reports: a brief glimpse

The actual case report

Introduction (Background)

Case presentation

Conclusions

Patient’s perspective

List of abbreviations

Authors’ information

Acknowledgements

Cover letter

BMC author academy: help for all

Final checklist and the rule of C s

Summary and parting advice

Recommended further reading

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Drafting Your Medical Case Study Report

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Submitting Your Report to Publishers

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