A Case-Based Guide to Clinical Endocrinology

In December 2005 I changed my mind [1]. Up until that time I had put my name on one case history in 400 publications [2]. I changed my mind and realized that reading case histories could be a good learning exercise. I had previously considered useful case histories to be essentially live case demonstrations. Indeed, I had persuaded years of endocrine clinical fellows that writing case histories was not something to be encouraged. But the cheese moved. Livecase historypresentationsbecametoo complexforeasy digestibility. Themany investigations and vast literature review required more contemplation than a live presentation had required in the past. And writing these exercises as a formal case history allowed the complex literature to be better understood. Furthermore, as our evidencebase hasgrown,theidiosyncraticapproachso commoninlivecase dem- strations of the past has become totally unacceptable. The written or prepared case has become the ideal forum for demonstrating how to manage a medical case to the greatest bene?t of the patient. Indeed, written case histories are clearly the very best means of showing medical care guidelines in real practiceandofrevealingtheiradvantagesanddisadvantages[3]. Thatdoesnotmean we should no longer give live case demonstrations. Demonstrating a supportive and knowledgeable patient can be a magni?cent teaching tool. For many years I have presentedendocrinologycasesto our?rst-yearmedicalstudents,andformanyyears these physicians later told me how much they enjoyed them and that they remember them well. So clearly, both formats of delivery remain effective.