UNC Department of Medicine Chair, Dr. Ron Falk recently participated in the case record series at Massachusetts General Hospital. His case record is published this week in the New England Journal of Medicine.

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A tradition of teaching exercises, based on actual cases, still influences medical education at Harvard Medical School after nearly a century. During a clinicopathological conference (CPC), a master clinician is presented a patient case, with testing and lab results, and then comes up with a differential diagnosis, which is discussed and confirmed. The case is then published as a Case Record of the Massachusetts General in The New England Journal of Medicine (NEJM).

Ron Falk, MD
Ron Falk, MD, chair of the UNC department of medicine

Department of Medicine Chair Dr. Ron Falk participated in a recent CPC at MGH, published this week in the NEJM as Case 24-2018: A 71-year-old Man with Acute Renal Failure and Hematuria. The case was based on a patient who was transferred to MGM because of worsening renal function.

Falk’s diagnoses, which were correct, included anti-glomerular basement membrane disease causing a crescentic glomerulonephritis; diverticulitis due to Bacteriodes fragilis and other gram-negative anaerobic bacteria; and podocytopathy, possibly due to mild diabetic nephropathy.

Eric S. Rosenberg, MD
Eric S. Rosenberg, MD, Editor of the New England Journal of Medicine

Case records editor Eric S. Rosenberg, M.D., invited Falk to participate. He was a resident of the UNC School of Medicine’s Internal Medicine program from 1991-1994, as well as chief resident from 1994-1995. Rosenberg is now associate professor of pathology in infectious diseases at Harvard Medical School, and a physician at Massachusetts General Hospital.

The NEJM reports of the clinicopathological conferences are based on a teaching style pioneered by Dr. Walter B. Cannon. His college roommate attended Harvard Law School, and Cannon was 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. To learn more, visit: Mass General.