case report

Five years ago, I was struggling to initiate my academic career and I started off with publishing an image. To this day, I remember my excitement and satisfaction when receiving the acceptance email. Writing a case report is the first step in establishing an academic medical profile. In this blog, I will guide you on how to publish a case report or image.

Recognize the opportunity and do your homework:

During rounds, you come across many interesting cases. If you recognize one of those cases, read a review article about the topic, which will give a very good idea of what you are dealing with. Search the web if there are any similar case reports and read one or two of them. At this point, most likely you would realize that the phenomenon that you thought was very rare is well documented and published in several other case reports. If you are lucky enough that there are no similar cases, then you have struck gold. If not, which happens in most of the cases, then find a different angle to your case. Try to think about your case from a different perspective. How can I make my case special? Find a unique angle and highlight it. After you have a solid grip of the topic, run it by your attending, fellow, or senior.

Gather the data:

Make sure you have gathered all the information you need from the patient and obtain written consent before the patient gets discharged. Support your case report with pictures if possible, hence take pictures if it’s applicable (skin changes, etc..). Visit the radiology department to get high-quality images/videos of the patient’s CT or MRI. Talk to the radiologist, he/she will guide you in selecting the best images. Also, make sure that you have a copy of the gross and microscopic pathology images.

Finding the right journal:

Case reports/images can be published in a very wide spectrum of journals. Evaluate your data in order to recognize a good fit for your manuscript. If you have exceptional images and by that, I mean excellent quality, unique finding, different imaging modalities you should aim high. Write it as an Image and try submitting your manuscript to NEJM, Lancet, JAMA, JACC, Circulation, and ESC families. Keeping in mind that the acceptance rate is around 10%. So even if you have an exquisite image, most likely it will get rejected. At a certain point, you might feel that this manuscript is worthless. The good news is, most journals will provide you with constructive feedback or point out the weakness in your image. Use this feedback to improve your manuscript and try again. If your manuscript was rejected in several high impact journals, then you should consider downgrading to journals with a lower impact factor. If it does not get accepted, then switch your image into a case report and explore different case report journals. The problem with case report journals is that they do not have an impact factor and most of them will charge you ranging from 300 to 1500 USD. So, make sure that you check the article processing charges (APC) beforehand.

Writing the case report:

If you are not familiar with any referencing software, learning how to use one is a crucial initial step for your academic career. Invest time to familiarize yourself with one (trust me on this one). There are many options, some of them are free, others offer discounts for students and doctors in training. Check with your institution, occasionally they offer it for free. The next step is writing, which is my favorite part. If it’s an image, then probably you will need to describe your case in around 250 words with a 2-liner conclusion and 0-4 references. If it’s a case report, then it’s highly variable between journals but it could reach 1000-2000 words. The discussion is the trickiest part. Hence, make sure you read several case reports and review articles on the topic before you start the discussion. Highlight what you like and what you think is relevant in different articles and then lay it out in your own words. After you are done, proofread it and use grammar check software. Use any help that you could have, talk to the resident who published several case reports before, look for a mentor with a prestigious academic profile, and definitely the team that was taking care of the patient. But keep in mind that some journals require only two authors on an image, so make sure you check before having a big author block.

Finalize the manuscript:

Once you have a version you are happy with, send it to your senior and accept the criticism with no hard feelings. We have all been there, after putting hours and days of effort into a manuscript, your mentor rips it apart and reconstructs the whole thing. This is how we all learn! After the modifications submit your manuscript and hope for the best and do not give up!!

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