How Should I Present Cases on Rounds?

Thomas E. Robey, MD, PhD


January 19, 2010


Every time I work with a new resident or attending, it seems like the requirements for my clinical case presentations change. Do you have any tips to help me predict how I should present?

Response from Thomas E. Robey, MD, PhD
Resident, Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut

I've been mulling over my response to this great question for several weeks, only because there are so many potential answers but also a number of pitfalls. So when my new senior resident on an off-service floor month gathered our team before rounds this morning, the answer jumped out at me: Just ask! In about 5 minutes, I knew how to structure my presentations for the rest of the month.

It's natural to be apprehensive about rounds, and the guessing game about oral presentations doesn't end when you graduate from medical school. As long as you are junior to another doctor (in effect for your foreseeable future), you will need to adjust your presentation to accommodate your supervisor. And isn't that true when you talk to anyone? You'd use different language, mannerisms, and sentence structures for outreach at a grade school vs when you defend your PhD dissertation, right? In the same way, you can expect to use different styles on surgery or medicine clerkships.

That said, I had a tough time with rounds in my third year of medical school. This was usually to my detriment, as evaluation comments would come back to the tune of, "Thomas understands the clinical information but struggles to present it in a concise manner on rounds." Of course, one attending complimented me on my monologues as she chastised a senior resident trying to interrupt me. She said, "I find Thomas' presentations refreshing. They remind me of reading Faulkner." I'm not sure whether that was actually a compliment.

But I digress. The only contact you may have with your attending is on rounds, so it's important to make sure you're giving the presentation that he or she wants to hear. When you start a clerkship, ask your resident what he or she expects and what the attending prefers. Be specific! Here are some concrete questions to ask your senior resident:

  • What do you expect from my clinical presentation?

  • Do I present my plan by problem or by system?

  • Am I shooting for 10 minutes, 3 minutes, or 3 sentences?

  • Should I expect interruptions?

  • What does Dr. Attending like and hate in a presentation?

  • Does the team generally read from notes?

  • How are my presentations going?

  • Could you meet me 15 minutes before rounds to go over my presentation?

I found that last one the most useful. Usually interns are too busy to help out before rounds, and the senior resident is better situated to offer feedback. Are you still unsure of the general skeleton of your presentation? At some point in medical school, you should have received coaching for this. If you need more, the UCSD School of Medicine has an excellent online guide for comprehensive oral case presentations. As a medical student, you are allowed to err on the side of too much information, and as your experience grows, your presentation will shrink. Soon enough, you'll be an expert yourself!