A useful geriatric-medicine casebook records how function, goals and available support change the plan. It should do more than collect diagnoses. For DGM and CGM preparation, the central question is often what the person could do before the illness, what they can do now and what remains uncertain about recovery.
Keep preparation for knowledge assessment separate from evidence of clinical performance. A well-written case note does not establish that an examination or supervised assessment has occurred.
Confirm the qualification component
The Royal College of Physicians' CGM and DGM information, checked on 13 September 2026, provides the current route, component and preparation information. Use the page relevant to the assessment you are taking rather than treating CGM and DGM as interchangeable labels.
This article focuses on building a casebook. iatroX's existing explanation of the qualification route remains the appropriate companion for the broader distinction; the current College documentation should resolve eligibility or transition questions.
The casebook proposed here is an original study asset, not a required portfolio format or an official clinical-assessment record.
An original case with an incomplete baseline
A fictional older adult is recovering from an acute illness. The summary says they were 'independent before admission' and that a relative can help at home. The learner proposes a discharge plan without asking what either statement means.
Unpack independence. Did the person manage mobility, personal care, medicines, meals and access outside the home without assistance? Were adaptations or informal arrangements already supporting that description? A single adjective cannot answer those questions.
Now clarify that the relative who offered help is unavailable during much of the week. That new information does not prove that discharge is impossible. It changes the assumptions supporting the proposed plan and identifies something that needs resolution.
In another version, the person describes a goal that differs from the team's initial expectation. Record the preference directly rather than assume that the relative's account is an adequate substitute for it.
Organise the case around change
Use three columns: baseline, current situation and intended or possible next state. Under each, describe relevant function and support rather than merely listing conditions.
A change may concern mobility, cognition, confidence, symptoms, practical support or the environment. Specify what is known, how it was established and what remains uncertain. Do not treat an unobserved ability as normal just because the casebook needs a complete row.
NICE NG56 on multimorbidity provides a relevant framework for considering individual goals and treatment burden. The casebook exercise uses that principle to organise learning, not to prescribe a discharge arrangement from a short vignette.
The rehabilitation and discharge worksheet
Include baseline function, current abilities, the person's goals, reversible barriers, support arrangements, unresolved risks, proposed learning or assessment needs and responsibility for follow-up. Record a source for important claims, such as the person's account or a documented professional assessment.
An original entry might say: 'The previous summary described independence but did not specify the activities involved; the proposed plan therefore rests on an unverified baseline.' Another might identify a difference between offered help and support that has actually been arranged.
The worksheet should make the missing information visible without inventing service availability. A plan that relies on a service not established in the scenario remains conditional, however reasonable that service would be in principle.
Let new information alter the plan
After completing the first version, add a new functional observation, a clarified preference or a change in support. Ask which part of the plan changes and which remains appropriate.
Avoid rewriting the entire case every time. The exercise is more revealing when the learner can identify a specific dependency. 'The plan changes because the required support is not available' is clearer than 'The case is now more complex'.
Then ask what would resolve the uncertainty. The answer might be further assessment, discussion with the person or confirmation of an arrangement. It should not automatically be another medical investigation unrelated to the decision.
Use knowledge questions to expose the learning need
A missed question can reveal that you do not understand a concept, have overlooked function or have treated social information as irrelevant. Those require different remedial activities.
For a knowledge gap, return to appropriate teaching and guidance. For a planning gap, use another casebook entry that requires linking function to a practical consequence. For a clinical skill, arrange appropriate supervised learning rather than claim that the written exercise demonstrates it.
Keep commercial questions within the authorised platform. Record the issue in your own words instead of copying a paid stem or explanation into a separate tool.
Where iatroX belongs
This article is published by iatroX and includes its own learning tools. Its September 2026 specification describes geriatric-medicine knowledge practice, adaptive sequencing, spaced repetition and a question-linked Socratic Tutor.
A useful tutoring discussion examines why 'independent' was accepted without clarification or why a proposed support arrangement was treated as confirmed. The planner can schedule further study around that gap, but it does not arrange clinical observations or generate authentic workplace evidence.
Use the College for assessment requirements, appropriate clinical teaching for examination and rehabilitation work, and question practice for knowledge application. Supplementary tutoring is relevant where you can list the issues but cannot explain how they change the decision.
Keep the casebook honest
Label fictional exercises and de-identified clinical learning separately. Do not turn a simulated case into a claim that you assessed a real person, received supervisor feedback or demonstrated a competence.
A good entry ends with the learning achieved and the next question to resolve. It need not claim that the patient's outcome improved, particularly where no follow-up information exists. That distinction makes the casebook more useful for discussion and less vulnerable to unsupported retrospective certainty.
Frequently asked questions
Is CGM preparation identical to DGM clinical preparation?
No. Check the College's current component requirements and distinguish knowledge practice from clinical performance.
Is 'independent at baseline' enough information for a casebook?
Usually it needs clarification. Record the relevant activities, support and source of the description.
Can a fictional casebook entry be used as workplace assessment evidence?
It should remain clearly labelled as a learning exercise. It must not be represented as a real observed clinical encounter.