“That’s a great case. Why don’t we write it up?” It’s a question I’ve heard many times throughout medical school, residency and fellowship. It’s typically intended to be more of a politely worded request than a rhetorical question. We must acknowledge that the process of writing, editing and submitting a case report is onerous, but it can provide immense utility to other physicians, especially with respect to unique diagnostic and management dilemmas that are not covered elsewhere in literature. Indeed, your words can travel far and wide, finding themselves not only in peer-reviewed journals, but also potentially in trade and association publications with even broader appeal, like The Rheumatologist.
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Assuming you work up the courage to write a case report, how do you begin? As a person who enjoys reading case reports and has written a few himself, I have six tips to guide you along the way:
1. Assemble a capable team. Case reports can be written by an individual, but most likely, you will end up working with collaborators to help share the burden of the workload. Enthusiastic medical students are commonly roped in, who are then tasked to write parts of the manuscript or perform literature searches. Of course, medical students should be rewarded for their hard work, and if their efforts are significant enough, should be entitled to be first author. You should also be aware that there are significant disadvantages of outsourcing work to medical students. For one, medical writing is a skill that medical students and residents are often not well versed in. As a fellow, it becomes your obligation to teach them the ropes, and so patience in writing and rewriting is absolutely imperative.
Additionally, due to the multidisciplinary nature of rheumatology, other specialists also tend to tag along. I have personally found the insights of pathologists and radiologists to be invaluable when writing the discussion section of a case report. But that’s only when they actively participate. Adding yet another name to the case report because “they were on the case” or because they provided access to a pathology slide or radiograph only dilutes the contributions of other authors.
More important is identifying a mentor who can look critically at your work and revise it accordingly. Usually, this is the attending physician on the case, but others can function in that role. And while it seems best to get someone who has a knack for editing, if your mentor is too fastidious, it can lead to delays, frustration about the direction of the report and even clashes that make writing a miserable chore.