Writing and Publishing a Case Report

A case report describes one patient, or a small number, with something unusual or instructive: a rare condition, an unexpected presentation, an adverse event or a useful management decision. It is one of the most accessible first projects for an IMG because it needs a clinical case, a supervising physician and careful writing rather than a dataset. This guide covers the structure, the privacy and consent steps and the realistic value. For the wider submission process, see how to publish a paper.

Is your case worth reporting? #

A case is usually publishable when at least one of these is true:

• It is rare or newly described.
• It shows an unusual presentation of a common disease.
• It reveals an unexpected drug effect or interaction.
• The diagnostic reasoning or management teaches something reusable.
• It challenges an accepted teaching.

"Interesting to us" is not enough. Search PubMed first. If many similar reports exist, ask what yours adds. A supervising physician can usually tell you quickly whether it is worth pursuing.

Use the CARE guideline #

CARE (CAse REport) is the reporting guideline for case reports. It was developed by an international group of experts, is endorsed by many journals, and is listed by the EQUATOR Network, which collects reporting guidelines for different study types (for example PRISMA for systematic reviews and STROBE for observational studies). Many journals ask for a CARE checklist at submission, so download it from the CARE website before you write.

A CARE-style report generally includes:

1. Title that identifies it as a case report and names the key finding.
2. Abstract and keywords.
3. Introduction explaining why the case matters, with a short literature context.
4. Patient information: de-identified demographics, presenting concerns and relevant history.
5. Clinical findings, timeline, diagnostic assessment and interventions, with the reasoning.
6. Follow-up and outcomes, including any adverse events.
7. Discussion with strengths, limitations and relevant literature, and the take-away message.
8. Patient perspective and informed consent, when the journal asks for them.

A timeline (a simple table or figure) is one of the most useful CARE elements. Keep it short and factual.

Privacy and consent #

This is where beginners go wrong. Two separate things apply: the journal's rules, and the privacy law and policy of the place the care was delivered.

Consent. The ICMJE recommendations state that patients have a right to privacy that should not be violated without informed consent. Names, initials and hospital numbers should not appear in text, photographs or pedigrees unless essential and the patient (or a parent or guardian) gives written consent. For consent to be valid, the identifiable patient should be shown the manuscript. Consent should be written and archived, and the published article should say when consent was obtained. Masking the eye region of a photograph is not considered adequate protection.

De-identification. If the case occurred at a US covered entity, the HIPAA Privacy Rule governs what can be disclosed. The HHS "Safe Harbor" method removes 18 categories of identifiers, including names, small geographic areas, dates more specific than the year, and record numbers, and also requires no actual knowledge that what remains could identify the person. Rare diseases, unusual events, small communities and distinctive images can still identify someone even when no listed identifier appears. If you are unsure, get consent, and talk to the institution's privacy officer or research office. Outside the US, other laws apply, and the institution's rules still count.

Practical steps:

1. Ask your supervisor and the institution's research or compliance office what they require before you collect anything.
2. Get written consent from the patient or guardian, using the journal's form if there is one.
3. Work from a de-identified copy. Do not email records or upload them to personal accounts or to AI chat tools.
4. Describe dates as "day 3" or "three months later" rather than calendar dates.
5. Keep consent forms where the institution and the journal's policy require.
6. If the patient has died or cannot be contacted, ask the journal and the institution what they require. Do not assume consent is unnecessary.

Authorship and roles #

A case report often has the treating clinicians as authors. The same rules apply as for any paper. Everyone listed must meet all four ICMJE criteria, and those who do not (for example a department head who only provided access) belong in the acknowledgments. An observer who only watched the case does not automatically qualify. Details are in authorship and author order.

Choosing where to submit #

Venues for case reports fall into a few groups:

• Specialty journals that publish case reports or have a clinical vignette section.
• General case-report journals, which are often open access and may charge fees.
• Conference clinical vignette tracks, often a faster route (see posters and conferences).

Check journal policy before writing: many specialty journals accept few or no case reports. Verify any unfamiliar journal using the checklist in predatory journals. Do not submit the same case to two journals at once.

A conference abstract or poster does not normally prevent a later full paper, according to ICMJE, but tell the journal about it in your cover letter.

What a case report is worth #

Case reports have a role in medical literature, but they sit low in the evidence hierarchy because they describe one patient. On an application, a case report shows that you can finish scholarly writing and work with a mentor. It is generally less weighty than original research, and it counts as a publication only if it is actually published. Our opinion, not official data: one well-executed case report with a poster is better than five rushed submissions to low-quality outlets. See how programs actually view research for what the NRMP data shows.

Common mistakes #

• Starting to write before consent and approvals are sorted.
• Leaving identifiers in tables, images or file names.
• Overstating what one patient proves.
• Skipping the literature search.
• Adding authors who did not contribute.
• Submitting to the first journal that promises fast acceptance for a fee.