By Jeremy Jones
First, let me be honest, a case report, even in the most prestigious of journals is unlikely by itself to help you land your first-choice fellowship in the Ivy Leagues. With that being said, I have found that the process of writing a case report or abstract can act as a stepping stone to more substantial publications not to mention helping to bolster your CV.
- Find an interesting case.
In all honesty, if you work at a hospital for longer than a week interesting cases will find you, but the point is the same—keep your eyes open for rare diseases and when you find them jot down the pertinent patient information for safe keeping. As an intern, I actually made a special list in Epic called “Cool Cases.” Anytime I took care of a patient that had a particularly rare disease or more commonly a rare manifestation of disease I would add their MRN to my list. Depending on the rotation you will have a variable amount of free time to write so if you can’t muster the strength to write during your Parkland MICU month (this is a joke; don’t do this) at least you will have the patient’s information so that you can reference later when you start writing.
One thing that you will realize very early is that hospital patients are on the whole very sick. They have the most complicated diseases generally at end or near end stage at the time of presentation. While this is an unfortunate reality, it provides us the opportunity to observe first-hand the natural history of many diseases.
- Start writing.
I think one of the hardest parts of writing during residency is getting started. Once you have started, you realize that it is not actually that hard or time consuming. The best way to get through this writer’s block is to realize that writing a case report is really just like writing a detailed H&P. In that vein, try not to spend more than an hour or so writing the initial presentation and facts of the case.
- Research the topic. (This step is actually interchangeable with the previous step)
Do a PubMed search on whatever topic you are writing about and read a few articles about the disease you are writing about. A helpful tip here is to get endnote (free through the UTSW lib) and learn how to use it. There is nothing more annoying than finishing a paper and spending weeks trying to find and edit citations before you can submit. Overall don’t spend more than a day or so reading papers before you start writing.
- Pick a journal/conference to submit.
It is helpful to look through journals online submission guidelines prior to finishing up writing because most of them will have different formats for their specific journal. For example, some will want key teaching points prior to the case/discussion, some want a general discussion of the disease prior to the specific case presentation and nearly everyone has a different style of citation (this is where it EndNote comes in handy).
- Finish writing.
Now that you know what format you need to write and you have done some research, make a few paragraphs (in total you are shooting for 2 or 3 pages max) explaining why your case is unique, what it does to advance medical literature, how smart you are or anything that you want to add.
- Don’t be afraid to collaborate.
This is one of the most important and probably least used tips I can offer. Your case report will be no less impressive if you have 2 authors as opposed to 1. There have been a number of times where I have written a paper and either lost interest or run out time. If you stop at this point all of your hard work was for nothing. A better option is to talk to one of your colleges, tell them about the case and ask them if they would like to help you finish editing and submitting the paper. This is really a win-win situation for both parties and will result in far more publications for everyone.
- Submit and wait.
If you have made it this far the hard work is done. Congratulations. All you need to do now is upload the article into whatever journal you picked and they will walk you through the process from there. You will have to sign a form saying that you have no conflict of interests and that you were involved in the writing of the article, etc. Most journals will give you a decision within 4 weeks or so but other will be much sooner or much, much later (ie 8 wks+).