You need at least 36 per year. They are the backbone of your portfolio evidence. And most trainees write them badly — not because they cannot reflect, but because no one teaches them the difference between describing what happened and analysing what they learned.
Structure
Description (3-4 sentences maximum). Who was the patient (anonymised)? What was the presentation? What did you do? Keep this brief — the panel does not need a detailed clinical narrative.
Reflection (bulk of the entry). What were you thinking? What was uncertain? What went well and what did not? Why did it happen that way? What is the relevant guideline or evidence base? What would you do differently?
Capability linking (2-3 capabilities per entry). Which RCGP capabilities does this entry demonstrate? Use descriptor language from the curriculum — not generic claims. "This case demonstrates capability 2 (Data Gathering) as I used a structured approach to differential diagnosis, systematically excluding red flags before formulating my assessment."
Common Mistakes
Lengthy descriptions — half the entry is what happened, leaving no space for reflection. No genuine reflection — "I learned that X is important" without explaining why or how it changes your practice. Linking to too many capabilities — 5+ links per entry suggests you are linking without thought. Identical structure across all entries — panels notice and it suggests formulaic output. No identified learning needs — every case review should generate at least one DEN (Doctors' Educational Need) that feeds into your PDP.
Topics Worth Writing About
Cases where you were uncertain — the uncertainty itself is the learning. Cases where you changed your approach based on the encounter. Cases with ethical or communication complexity. Cases where you identified a knowledge gap and addressed it. Cases that surprised you — the outcome was different from your expectation.
Closing the Loop
Every case review should generate a DEN → PDP entry → CPD activity → reflection on outcome. This learning cycle is what panels want to see — not 36 disconnected entries.
Where iatroX Fits
After a challenging case, use Ask iatroX to explore the clinical question in depth — checking guidelines, verifying management pathways, understanding the evidence base. The Q&A session itself becomes evidence of self-directed learning, and the knowledge gained feeds your reflection.