Writing andpublishing a usefuland interesting
Case Report
How many junior doctors have published originallaboratory-based research from their student days,
an audit or clinical study from their ﬁrst two years
on the ward or have national and internationalpresentations under their belt at the time ofapplication for core training? Whether publicationis perceived essential to postgraduate learning,
there is no doubt that inclusion of publication
experience in a training portfolio is essential forjunior doctors applying for jobs. Even with time set
aside for research and audit in clinical work andopportunities in academic posts, most doctors
applying for jobs seek out opportunities to publish
and present nationally or internationally.

So, go ahead and start typing.
We look forward to seeing
your work.
BMJ Case Reports, launched in November 2008, was developed purely for the publication of casereports – there are more than 7,000 currently available from authors in more than 70 countries. It is an
online only journal, has all the tradition of the BMJ, is peer reviewed, referenced and boasts an archive
available – at the click of a mouse – of cases listed by specialty from anaesthesia to urology. All
material, including pictures, is free to subscribers (Fellows) to use for further clinical teaching. We havean editorial board and a huge range of reviewers who peer review not just the science and the
medicine of the article, but see the process of writing and rewriting the manuscript through with theauthors to the ﬁnal production of what is, for many, their ﬁrst publication.

We base our decision to publish on two principles:First, healthcare workers including medical students and junior doctors must ﬁnd the cases a valuable learning resource,
both relevant and engaging.
Second, there is more to learn from common cases that present in an unusual way, present a diagnostic, ethical ormanagement challenge or where there are pitfalls to learn from, than from rare or exotic cases that most of us are unlikely
ever to have to manage. Instead we suggest that you:
Use the Word templates at casereports.bmj.com andstart writing up a clinical case that you think demonstrates
valuable clinical or ethical lessons for an audience ofmedical students or junior doctors. Take any clinicalpictures you need to illustrate your case (download ourconsent form to use in addition to the consent forms you
use locally) and then write your article in our template
under the following headings:• Summary• Background• Case presentation• Investigations• Diﬀerential diagnosis• Treatment• Outcome and follow-up• Discussion• Learning points/take home messages

This gives you the ﬁrst draft of the report which you should
show to a senior colleague at work or in university. Without
any delay send this oﬀ to us and we will help you shape itinto a publishable manuscript using the comments of ourreviewers. The case reports most likely to be accepted are
well-written, with a clear discussion of management
decisions and lessons to be learned. We welcome a briefsummary and discussion of relevant guidelines, pitfalls andthe prevailing evidence, and, schematics that illustrate themechanism of an injury or pathology. It is not unusual forcases to pass between reviewers and authors several times
before a ﬁnal polished article is accepted. An annualsubscription (Fellowship) gives myou the freedom tosubmit as many cases as you like as well as access to andreuse of all the published material. We have institutional
Fellowships so speak to your tutors and postgraduate
managers about an institutional subscription. We are about
to begin a global health blog as so many of our contributors
and reviewers are truly global and comprise a spectrum ofmedical backgrounds. This leaves us ideally placed to
publish cases from student electives and, for students anddoctors seeking placements abroad, to network and ﬁnd asuitable clinical placement.

What to include in the submission
template for full cases
General guidance

Title of case

The most diﬃcult problem we face in review of manuscripts ispoor language or grammar. It is a huge shame to reject articles
because they are badly written when the message they containis important.

You do not need to include “a case report” in the title – you
may be cryptic if you wish.

The language reﬂects the authors, their institution and thejournal, and inevitably, presentation and style hugely inﬂuences
the perception of the management of any case.

This will be freely available online. Up to 150 words
summarising the case presentation and outcome. We need agood ﬂavour of the case – emphasise the learning points.

Read the case presentation back to yourself. Is there a natural
ﬂow from presentation to discharge and follow-up? Are alldecisions explained?

BackgroundDon’t be afraid to write about complications. They are universal
and learning from each other’s experience is key in medicine.
Do discuss these with clarity so that all ﬁndings andmanagement decisions are obvious. The audience are notreading to approve or disapprove but need to be in a position
to make sense of the story. The discussion of pitfalls is thesingle biggest contribution to learning in case reports:• Why is the case of interest to our readers?

• Unusual presentations of common cases• Inconclusive results

Summary

Why you think this case is important – why did you write it up?
• Is this a prevalent health problem?
• Is there a clear message?

Case presentation
Presenting features, medical/social/family history. This is thepatient’s story – but please be sensitive to patient
conﬁdentiality.
• How did they present?

• Grey areas in indications for treatment• What is the relevant history?
Why is this relevant?

• Management challenges• Explain your ﬁndings and how they inﬂuenced your decisions• Near misses

Do not use abbreviations for diseases or investigations.

Investigations
Example of a well presented Case Report
Resection of a large carotid paraganglioma in
Carney-Stratakis syndrome: a multidisciplinary featRebecca Spenser Nicholas, Ayyaz Quddus, Charlotte
Topham, Daryll Baker
Published: 16 April 2015

If relevant. All investigations that create a background(baseline) picture are relevant.
All investigations that are crucial to management decisions
should be discussed in full.
Chose appropriate images and videos to illustrate your point(maintaining patient conﬁdentiality

Contact your librarianor head of department
to seen if yourinstitution already has
a FellowshipDiﬀerential diagnosis

References

If relevant. Please don’t list these. What we want to see is how
the ﬁnal diagnosis is teased out. What are the consequences tomanagement or treatment for the diﬀerential diagnoses? For
example: A man in his 60s who has smoked for 40 years andpresents with epigastric pain radiating posteriorly may have aleaking abdominal aortic aneurysm, acute pancreatitis or aperforated duodenal ulcer. Particular historical details andinvestigations separate these diagnoses, and treatment of eachis vastly diﬀerent; indeed, treating one cause for the other isdetrimental. Discuss these and the pitfalls that may ensue.

Include only relevant references including guidelines in
Vancouver style.

Figure/video captions
We do not have a limit on illustrations but choose only whatillustrates your case most eﬀectively. We encourage colour
images and video ﬁles.

Patient’s perspective

TreatmentThis is an optional section to give the patient the opportunity tocomment on their experience – only very relevant personaland family details should be included.

If relevant. Include pharmacological and nonpharmacological,eg, surgery, physiotherapy, supportive care.

Essential information

Outcome and follow-up
Always include follow up data where you can; it gives readers aclear understanding of outcome. The follow-up period should
be deﬁned. Please state if the patient has died even if notdirectly related to your case.

In addition to the guidance in this template please read theinstructions to authors online. You must have signed informed
consent from patients (or relatives/guardians) before
submitting to BMJ Case Reports. Please anonymise the patient’s
details as much as possible, eg, speciﬁc ages, occupations.
Consent forms are available in several languages
group.bmj.com/products/journals/patient-consentforms.

Discussion
Include a very brief review of similar published cases. This is theopportunity to describe mechanisms of injury, guidelines andtheir relevance, diagnostic pathways (use diagrams if you like)and the points of interest of the case. A brief summary ofrelevant clinical guidelines is appropriate.

You or your institution must be a Fellow of BMJ Case Reports inorder to submit. Fellows can submit as many cases as they like,access all the published material, and re-use any publishedmaterial for personal use and teaching without furtherpermission.

• Did you have to make an exception?

For more information on rates and how to purchase yourfellowship visit• Did you have to adapt the guidelines?

casereports.bmj.com/site/about/becomeafellow.xhtml

Learning points/take home messages
3 to 5 bullet points. This is a required ﬁeld. These are the most
crucial part of the case – what do you want readers toremember when seeing their own patients?

For more information, please visit
casereports.bmj.com