A Brief
History of the Clinicopathological Case Series
The Clinicopathological Conferences
have a long tradition at the Massachusetts General Hospital
in Boston, Massachusetts.  In
the late 1800's Dr. Walter B.Cannon, pioneered the use
of case studies in medical education. Dr. Cannon had
had a roommate in college who attended Harvard Law School,
and he had been impressed by the case method of teaching
practiced there. Several physicians followed Dr. Cannon's
innovation, and in 1900, Dr. Richard Cabot of the Massachusetts
General Hospital Pathology Service, formalized the teaching
exercise to be part of the third year training for Harvard
Medical School students. Since 1924, the clinicopathological
conferences (or "CPC's") have been published
regularly in the New England Journal of Medicine as Case
Records of the Massachusetts General Hospital. At
each conference, a guest physician is asked to deduce
the diagnosis of an anonymous, actual MGH patient based
solely on the medical history and preliminary test results.
The confirmed diagnosis is then presented, with evidence,
by a member of the MGH Pathology Service. The guest physicians
are frequently correct in their analysis, but on occasion,
they have been known to be wrong. This is all part of
the teaching exercise. As Dr. Castleman stated in 1960, "The
clinicopathological conferences remain an exercise in
deductive reasoning and clinicopathological correlation.
It is less important to pinpoint the correct diagnosis
than to present a logical and instructive analysis of
the pertinent conditions involved. On the rare occasions
when the correct diagnosis is esoteric or almost unattainable,
if the discusser emphasizes the practical clinical problems,
it doesn't matter if the answer is wrong." *Today,
the CPC's remain a vital part of the Harvard Medical
School training, and they are read by physicians and
medical students all over the world.
* Castleman, Benjamin, M.D. and H.
Robert Dudley, M.D., editors, Clinicopathological Conferences
of the Massachusetts General Hospital, Selected Medical
Cases, Little, Brown and Co., Boston, 1960, p. viii. |
