A Brief History of the Clinicopathological Case Series

The Clinicopathological Conferences have a long tradition at 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 Mass General 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 "CPCs") have been published regularly in the New England Journal of Medicine as Case Records of Mass General. At each conference, a guest physician is asked to deduce the diagnosis of an anonymous, actual Mass General patient based solely on the medical history and preliminary test results. The confirmed diagnosis is then presented, with evidence, by a member of the Mass General 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.