Case Log

In order to acquire specialist knowledge, the resident must be involved with the direct work-up of a balanced distribution of common equine internal medicine clinical cases. This is verified by maintaining a case log of all cases seen in consultation with an ECEIM Diplomate or a diplomate from another speciality. It is the intention of the residency-training programme that the resident has enough time to work-up each case as thoroughly as possible. The learning objective of the case log is for the resident to demonstrate progressive acquisition of knowledge, specialist competencies, written communication skills, problem solving and time management through the provision of a portfolio of cases for which she/he has reflected upon in consultation with her/his supervising Diplomate.

The case log must consist of a minimum of 600 cases when submitted in totality as part of the credentials packet, all of which have been seen in direct consultation with an ECEIM Diplomate and/or a diplomate from another speciality.  In the process of completing the case log, the resident must also demonstrate that they are competent in performing the diagnostic and therapeutic techniques required to be a specialist. [For a later date when available: A  list of ECEIM approved specialist techniques can be found on the ECEIM website.]

It is the responsibility of the supervising Diplomate to determine the level of case responsibility for the resident at each stage of the residency, and this should be reflected upon by the resident/supervisor in the progress report. Whilst it is expected that the resident take primary responsibility for the majority of the cases in his or her case log, cases in which the resident has been involved in the preliminary investigation resulting in referral to other services/colleagues; or cases in which the resident has performed a specific procedure on a case being managed by another service (e.g., examining the cardiovascular system in a horse prior to general anaesthesia for an elective surgical procedure) will also be accepted, so long as the resident and supervisor are able to explain how the case has contributed to the learning objectives of the case log. 

The ECEIM Board recognises that it will be necessary for some institutions to extend the duration of the residency-training programme beyond the three years and/or to incorporate more than the required minimum of 93 weeks of clinical training to achieve the required number of cases. There is no need to list more than the 600 cases required. The resident is expected to preferentially include cases of special interest or difficulty in her/his case log.

When logging a case, the following information is required:

• The case identifier (name or case number)
• Date of initial examination
• Assigned discipline (e.g. cardiovascular)
• A short case descriptor/key words (<10 words) outlining the diagnosis or diagnostic procedures carried out; ECEIM approved specialist techniques (e.g. BAL, echocardiography etc.) and any other specialist treatment that the resident would like to highlight [e.g. TVEC (transvenous electrical cardioversion) etc.].

The resident is expected to divide cases seen between the various disciplines as listed in Table 3. The quality and distribution of cases will be assessed regularly by the Educational and Credentials committee. It is expected that the resident will exceed the minimum required number in some of these disciplines to achieve the required 600 cases. The cases within each category should be varied and the same condition should not make up more than 20% of cases within a category.

The resident is responsible for completing their case log. It is imperative that the supervisor checks the case log carefully. Case documentation should be readily available to verify the logged case. The Executive and the Education and Credentials Committees reserve the right to check that cases are in fact genuine by requiring access to copies of the original hospital case records. Of all submissions, 10% will be audited each year. 
When submitting the resident’s progress report, the resident must include a reflection on their case log to date and a plan to address any gaps in specific ECEIM approved specialist competencies. The case log reflection should be approximately 500 words in length and should be written in consultation with the supervising Diplomate.

FAQs for case log

1. If I am dealing with a disease outbreak, can I log each case separately in my case log and will they all count towards my case log requirements?
   We would advise against this unless individual cases presented different challenges or includes different competencies.
2. If the case that I want to log can potentially fit into more than one category, which category should I choose and can I log the case in both categories?
   You should discuss this with your supervisor and make a collective decision about which category the case best fits into. It might be that you have logged sufficient cases in one category, and in such a situation, you might want to log this case in an alternative category if it is appropriate to do so.  It is more important that you reflect on your case log and determine whether you are getting a broad range of experience
3. I find it difficult to decide what cases to log as sports medicine cases.
   Any investigation can be logged as a sports medicine case, even if you are unable to make a diagnosis, however you must have done an internal medicine assessment as part of your investigation.
4. If I am seeing a case together with another resident, can we both log the same case?
   This will be up to the discretion of the Diplomate or associate Diplomate with whom you see the case, however it would be expected that the resident logging in the case has been responsible for completing some of the diagnostics on the case.