Clinical case presentations

Case presentations are one of my favorite things about Internal Medicine, apart from patient care. They're essentially a patient's entire hospital course compressed into one hour. A resident, intern, or medical student presents a particularly interesting or educational patient to the entire group. The chief resident moderates the discussion, pausing at certain points to allow the group to further investigate the case. The idea is for the group to collectively "work up" a patient as we would in real life.

I enjoy thinking through the case in my mind, figuring out what questions I would ask or what other labs I would order, then comparing that to what the group comes up with. As a medical student, I find this exercise invaluable in using the interns and residents as models for how I should approach a patient. Plus, I feel so actively engaged in the case presentation that the clinical lessons seem to stick almost as well as seeing a real patient.

Case presentations are generally similar at PSL compared to DHMC; their differences are mostly due to individual personalities of the faculty moderators. At PSL, the faculty moderators tended to give the chief resident and the group discussion more free reign, adding to the discussion only when an experienced opinion was needed.

At Denver Health, though, the faculty moderator is an old-school personality locally famous for his chest x-ray readings and his bow-ties. He takes more control over the discussion, explaining his diagnostic approach step-by-step. Every piece of information you gather should inform your next question to the patient, he says. He also reinforces a systematic approach to thinking about all possible causes of a given set of signs and symptoms. I feel smarter just listening to him.

I hope other clerkships have case presentations, or something like them.