In Reply to Steinhilber et al
We also appreciate the point about teaching learners to look beyond “zebras” and focus on the educational value of the case. This gets to the historical roots of the case report. Hippocrates was not looking for novelty; he carefully described the cases that he encountered, considered what could be learned from them, and compiled his teaching points, or aphorisms. That same ancient process, when done well, can still lead to useful and often publishable case reports.
The successful case report educational program described by Dr. Steinhilber and colleagues is not an isolated phenomenon. Other similar programs are emerging,1,2 and editorial voices are beginning to call for expanded use of case reports in medical education.3,4 The next step, in our era of competencies and milestones, will be to define the specific educational objectives that can be met with case report curricula. The ability to select, prepare, and publish a case report may fulfill several of the Accreditation Council for Graduate Medical Education (ACGME) competencies, including medical knowledge, patient care, practice-based learning, and communication.4 In fact, we think this activity may provide a more robust and objective assessment in some areas than the methods proposed by ACGME. We recommend that the UAB case report program and others like it should be studied and put into broader practice.