Case Reports

It has been agreed by the FPM Board that case reports will be removed from the Pain Medicine curriculum with effect from August 2017.

If a trainee doctor is therefore beginning their Advanced Pain Training (APT) after 31 July 2017, they will no longer need to complete a case report as part of their assessment portfolio for satisfactory completion of the year.  Any trainee doctor who started their APT before August 2017, will still need to complete the case report.
 

 

Case Report Guidance

 

Case Reports in the training and post-training environment have an important value, but there is perhaps some confusion as to their differences as well as their similarities. In training they are a useful exercise in evaluating the relative merits, and scientific basis for a clinical approach in a systematic way.

In essence, the Case Report is the use of a single case to examine some part of it in detail. This may be in presentation, pathology, diagnosis or management. Published cases usually look at something rare or new, acting as a lesson and a guide. For the trainee it is unlikely that they will be presented with such an opportunity, and common everyday situations are more often written up. The format remains the same. It is important to define the aim clearly, describe the clinical aspects succinctly, with additional detail in the part to be focussed on, and then discuss this aspect, with references to research, analysis and existing guidelines, that have informed current practice, and the care of this individual.

 

Timeframe

The FPM advises that Case Reports should be produced by month 9 into an anticipated 12 month training scheme to allow for review and amendment.

Writing Guidance

Format

  • The word count for each case report should be between 2500 and 3000 words including the abstract.
  • There should be a minimum of 5 references and a maximum of 3 figures. References should not be included in the word count.
  • The document should be double-spaced to allow room for comment.
  • A 12pt, legible font (such as Arial, Calibri or Helvetica) should be used.
  • Headings should be clearly identified in bold and underlined.

Layout

Below is a suggested basic layout for a case report, many journals e.g. BMJ, BMA, Anaesthsia etc also publish guidelines and you may find these useful; please read the marking scheme carefully to ensure you meet all of the criteria. 

  • Title of article

Full name, current Advanced Pain Training institutional address and email address of trainee

  • Abstract

This is usually 15-200 words and should be no more than 350 words. The abstract must emphasise the main learning points. This should reflect any focus indicated in the title. 

  • Case Presentation

The trainees should present all details concerning the case and emphasise the main areas of interest in the case. Trainees are advised that this may be broken into subsections with appropriate subheadings, e.g. Referral information, questionnaire scores, current problems, background history, past medical history, drug history, family history, social history, examination findings, diagnostic formulation and subsequent management.

Focus should be kept on the area of the report that is to be discused, and avoid material, which though important in the overall clinical setting is not pertinent to the topic of discussion. 

Avoid abbreviations. 

Avoid the use of personal pronouns (e.g. 'I decided to start the treatment' is better as 'this treatment was started.')

  • Discussion

The discussion should include the trainee’s views on how relevant evidence may affect management of the case presented as well as populations of patients with or at risk of similar type of pain. Guidelines and papers should be referenced and may be quoted in parts and clearly identified as such. Wholescale copy and paste should be avoided. 

Note: Plagiarism is pretending someone else's work or phrasing is your own. Large scale copying is just poor writing. 

  • Conclusions

This should state clearly the main conclusions of the Case Report and give a clear explanation of their importance and relevance.

A Case Report is designed to highligh some area of a condition or its treatment - use this conclusion to concentrate this. 

  • References

References should not be included in the work count. All references must be numbered consecutively in the order in which they are cited in the text, followed by any in tables and legends. Reference citations should not appear in titles of headings. Each reference must have an individual reference number. Use the 'Vancouver Style'.  Imperial College London have produced this guidance which you may find helpful. 

Examples

Below are some examples of good case reports written by previous Advanced Pain Trainees along with scores and comments produced by the FPM Training and Assessment Committee.

The FPM would like to thank the authors for their permission to publish their work. 

CASE REPORT: Ultrasound guided paravertebral catheter placement and potential future improvements
MARKING SHEET: Ultrasound guided paravertebral catheter placement and potential future improvements

CASE REPORT: The utility of complex regional pain syndrome as a diagnostic label
MARKING SHEET: The utility of complex regional pain syndrome as a diagnostic label

CASE REPORT: A Case of Occipital Neuralgia
MARKING SHEET: A Case of Occipital Neuralgia

CASE REPORT: Intra-Thecal Drug Therapy in Cancer Pain
MARKING SHEET: Intra-Thecal Drug Therapy in Cancer Pain

 

Plagiarism

The Royal College of Anaesthetists, Faculty of Pain Medicine and GMC view the submitting of the work of others as part of a professional activity very seriously. All case reports are subject to analysis by Plagiarism software – as is done by Universities, Academic Journals etc., the results of which are then manually reviewed. When there is evidence that a submitted report is not the original work of the trainee, this will be reported to the GMC.

It is important to recognise that this is a direct responsibility of the trainee to the GMC – the professional regulating body – and the public at large, and not just to the local training authorities.

 

Case Report Submission

  • Case reports should be reviewed locally by LPMESs and RAPMs so that they can be edited and amended to produce a satisfactory report. They are intended to be a formative experience and not purely a solo exercise for the APT.
  • For the purposes of CCT/CESR (CP) the local marking is currently the only requirement. 
  • For the purpose of Fellowship (including Diplomate) the Case report must be submitted to the FPM for cross marking. 
  • Case reports submitted to the FPM for cross marking should already have been reviewed, revised and polished and of a publishable standard*
  • FPM assessment will be anonymous; although the LPMES or RAPM should include their marking scheme, it will not be forwarded to the cross marker before the assessment. Instead, it will assist in the ongoing evaluation of the marking scheme.
  • Feedback will be provided to the RAPMs and LPMESs on individual case reports. At this time, the decision to pass/fail remains a local issue and the FPM scores represent an ongoing evaluative process

*Publishable standard does not mean they have to be submitted to journals. It is likely that most case report topics will be too common to be of publishable interest.

Case Report Prize

The Case Report Prize was introduced in 2016.  Further information can be found here
 
Please note: To be considered for the case report prize, a patient consent form must also be submitted as we will need to publish the winning case report in full. A copy of the patient consent form can be found in the related downloads below.
 
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