Here is a complete, actionable template for medical student case presentations, followed by a realistic example you can model immediately.

The 6-Minute Case Presentation Framework

Standard internal medicine format (adjust depth for rotation)

1. The Opening (10 seconds)

"Mr./Ms. [Age]-year-old [Gender] with [Key History] presenting with [Chief Complaint] duration."

2. History of Present Illness (90-120 seconds)

Use the OLD CARTS framework embedded in a narrative:

• Onset: When exactly did it start? Sudden vs. gradual?
• Location: Be specific (RUQ vs. epigastric)
• Duration: Constant vs. intermittent? How long each episode?
• Characteristics: Quality (sharp, burning, pressure), Severity (1-10), Radiation
• Aggravating/Alleviating: What makes it worse/better? (Position, food, meds)
• Associated Symptoms: Systemic (fever, weight loss) + relevant negatives
• Timeline: Chronological narrative from first symptom to now
• Relevant Context: ED visits, prior workup, initial treatments tried

3. Past History (30 seconds)

• PMH: Prior hospitalizations, surgeries, chronic diseases (focus on relevant)
• Meds: Name, dose, frequency (know the mg!)
• Allergies: Reaction type (anaphylaxis vs. rash)

4. Risk Factors (20 seconds)

• Social: Smoking (pack-years), ETOH, drugs, occupation, living situation
• Family: First-degree relatives with relevant disease
• Travel/Exposures: Recent travel, TB exposure, pets, foods

5. Review of Systems (15 seconds)

"On systems review, he denies fevers, night sweats, or weight loss. He reports mild nausea but no vomiting..."

• Only mention positives and pertinent negatives

6. Physical Exam (45 seconds)

Vitals → General Appearance → Focused Exam

• Start with: "Patient is [alert/oriented], [distressed/well-appearing], [specific findings]"
• Highlight abnormalities first, then relevant normals

7. Data (30 seconds)

• Key labs with values (not "WBC was abnormal" but "WBC 18.2 with left shift")
• Imaging: "CT chest showed..." (1-2 key findings only)
• Microbiology if relevant

8. Assessment & Plan (60-90 seconds)

The "One-Liner" Summary → Problem List → Plan for Each

Complete Example: Acute Appendicitis

Opening:
"Ms. Rodriguez is a 24-year-old female with no significant past medical history presenting with 36 hours of progressive right lower quadrant abdominal pain and nausea."

HPI:
"The pain began vaguely around the periumbilical region yesterday afternoon, approximately 4 hours after eating lunch at a food truck. She initially thought it was indigestion, but over the next 12 hours, the pain migrated to the RLQ and became sharp and constant, rating 7/10. Movement and coughing exacerbate the pain; lying still helps slightly. She has had four episodes of non-bloody, non-bilious emesis since this morning and has refused oral intake for the past 8 hours. She denies fever at home but reports chills. No prior similar episodes. No changes in bowel habits, no dysuria, no vaginal discharge or bleeding. She took ibuprofen 400mg without relief. In the ED, she received 1L normal saline and morphine 4mg IV with partial relief."

Past History:
"No prior surgeries or hospitalizations. Medications include oral contraceptives and a multivitamin. NKDA. Last menstrual period was 2 weeks ago, normal cycle, no possibility of pregnancy per patient."

Social/Family:
"Non-smoker, drinks 1-2 glasses of wine weekly, no drugs. Works as a kindergarten teacher. No family history of IBD or GI malignancy."

ROS:
"Positive for anorexia and nausea. Denies chest pain, shortness of breath, urinary symptoms, or rash."

Physical Exam:
"Vitals: Temp 37.8°C, HR 110, BP 128/76, RR 18, SpO2 99% RA. She appears uncomfortable, lying still with knees flexed. Cardiopulmonary exams are unremarkable. Abdomen: Soft, absent bowel sounds in RLQ, positive McBurney's tenderness, positive Rovsing's sign. No guarding or rebound initially, but arousable rebound tenderness present. Psoas sign negative. Pelvic exam deferred."

Data:
"Labs notable for WBC 16.5 with 85% neutrophils and 8% bands. BMP within normal limits. Urinalysis shows 3-5 WBCs, otherwise negative. Serum bHCG negative. CT abdomen/pelvis with contrast demonstrates a dilated, thick-walled appendix with periappendiceal fat stranding and an appendicolith."

Assessment & Plan:
*"In summary, this is a young female with classic presentation of acute appendicitis confirmed by CT.

Problem #1: Acute Appendicitis. Plan: Surgical consult obtained—patient is NPO, IV fluids at 125cc/hr, pre-op labs drawn. Will administer cefoxitin 2g IV pre-operatively. OR scheduled for laparoscopic appendectomy this evening.

Problem #2: Dehydration/Emesis. Plan: Continue IV fluids, serial electrolytes, antiemetics PRN. Ice chips only post-op until bowel function returns.

Problem #3: Pain Control. Plan: Morphine 2-4mg IV q3h PRN, transition to PO analgesics once tolerating diet.

Problem #4: Differential Consideration: While clinical picture is classic, given the proximity to menses, we will maintain broad differential including ruptured ovarian cyst or PID until surgical visualization confirms diagnosis."*

Actionable Delivery Tips

Before You Present:

1. The 3-Minute Rule: Time yourself. If your HPI is >2 minutes, condense.
2. The "Pregnant Pause": After your one-liner assessment, pause. Let the attending digest before diving into the plan.
3. Have the Numbers Ready: Write down exact medication doses, vital trends, and lab values on your card/cheat sheet.

During Presentation:

• Make eye contact until you hit the data section—then it's acceptable to read labs precisely.
• End with the Plan: Never end with data dump. Always finish with "And therefore, my plan is..."
• The "If-Then": Show clinical reasoning: "If the blood cultures return positive, then I will..."

Common Pitfalls to Avoid:

• ❌ Chronological confusion: Don't say "But wait, actually 2 days before that..." Stick to linear time.
• ❌ Data without interpretation: Don't just list lab values; say "suggestive of" or "inconsistent with."
• ❌ Social history omissions: Always include smoking/alcohol/drugs—even if negative.

Your Next Steps

To customize this for your rotation:

1. What year are you (MS1/2 vs. MS3/4) and what rotation is this for? (Surgery presentations differ from Psychiatry)
2. Which section do you struggle with most? (The HPI narrative flow vs. the Assessment & Plan?)
3. Do you have a specific patient you're presenting tomorrow that you want help structuring?

Practice Exercise: Try presenting this case aloud to yourself in 6 minutes using a timer. The muscle memory of the timing matters more than memorizing the content.

What specific type of case presentation do you need to prepare for—oral rounds, written admission H&P, or specialty-specific (like SOAP note for clinic)?

Medical Student Case Presentation: Step-by-Step Guide

As a medical student, delivering a clear, concise oral case presentation is a core skill for rounds, clerkships, and exams. Aim for 3-7 minutes (shorter for walk rounds, longer for formal presentations). Focus on pertinent details—only include what's relevant to the chief complaint and differentials. Use a problem-based structure (common for internal medicine; adapt for surgery/ICU as systems-based).

Follow this standard format (based on guidelines from OSU, UW Medicine, Blueprint Prep, and Student Doctor Network):

Step 1: Gather and Organize Your Data

• Review the chart: H&P, notes, labs/imaging up to now.
• Prioritize: 90% of diagnosis comes from HPI. Use OPQRST for symptoms (Onset, Provocative/Palliative, Quality, Region/Radiation, Severity 0-10, Timing).
• Edit ruthlessly: Exclude full ROS/family/social unless pertinent (e.g., smoking in COPD). No dates—use "3 days prior to admission."
• Write a draft using the template below.
• Know your patient cold: Be ready for questions on differentials, management, or "why this lab?"

Step 2: Structure Your Presentation

Step 3: Practice Delivery

• Memorize: Use bullet notes (not full script)—don't read.
• Rehearse: 3-5x aloud (mirror, record yourself, or with a peer). Time it. Speak confidently, eye contact, no "umms."
• Style: Slow/steady pace, positive phrasing (e.g., "clear lungs" not "no crackles"). Pause between sections.
• Adapt: New admit = full HPI; daily = SOAP (Subjective changes, Objective updates, A/P).

Full Example: Heart Failure Exacerbation (New Admit)

Scenario: 3rd-year IM rotation, 5-min presentation on walk rounds.

One-Liner: "Mr. Jones is a 72-year-old man with history of hypertension, type 2 diabetes, and ischemic cardiomyopathy who presents with 3 days of progressive shortness of breath."

HPI: "He was in his usual state of health until 3 days prior to admission when he noted gradual onset of dyspnea on exertion, now at rest, worse lying flat (4-pillow orthopnea) and improved sitting up. Associated bilateral leg swelling and 5-lb weight gain. No chest pain, cough, fever, or PND episodes recently. Denies recent med changes, high-salt intake, or non-compliance. In ED, diuresed with 1L fluids out."

PMH/PSH: Hypertension, T2DM (A1c 7.8%), CAD s/p CABG 2015, CKD stage 3. No surgeries otherwise.
Meds: Lisinopril 20mg daily, metformin 1000mg BID, furosemide 40mg daily, atorvastatin 40mg.
Allergies: NKDA.
Social: Lives alone, retired, 1/2 ppd smoker x40 years (quit 5 yrs ago), occasional EtOH, no drugs.

ROS: Positive for edema; negative for chest pain, palpitations, orthostasis.

Physical Exam: Vitals: T 98.6, BP 142/88, HR 92, RR 20, O2 94% on 2L NC.
General: Alert, dyspneic, no acute distress. CV: RRR, 2/6 S3 at apex, no murmurs. Lungs: Bibasilar crackles to mid-lung fields. Abd: Soft, no HSM. Ext: 2+ pitting edema to knees. Neuro: Normal.

Labs/Studies:

• BMP: Cr 1.8 (baseline 1.4), K 3.8, BNP 1200 (prior 400).
• CBC: Hgb 11.2.
• Echo (prior): EF 35%. CXR: Cephalization, mild effusion. EKG: NSL axis, no changes.

Assessment/Plan:
"Mr. Jones is a 72M with HFrEF exacerbation likely from dietary non-compliance, now stable on 2L O2.
#1 HF exacerbation: Continue GDMT—furosemide 40mg IV q12h, monitor I/Os strict (>2L goal), daily weights. Add spironolactone 25mg. Echo pending.
#2 DM: Sliding scale, hold metformin (Cr up), endocrinology if needed.
#3 HTN: Continue lisinopril.
DVT ppx: Enoxaparin. Code: Full. Disposition: Telemetry."

Quick Template to Copy/Paste (Customize for Your Case)

Top Tips & Mistakes to Avoid

• Do: Start strong (one-liner primes differential). End with actionable plan (shows thinking).
• Don't: Read notes, ramble (e.g., full PMH dump), editorialize ("I think it's pneumonia"), use negatives ("no wheezing").
• Pro Tips: Tailor to team (ask preferences). For ICU: Systems-based A/P. Practice differentials (3-5, justify #1).
• Resources: Watch "Example of a Great Oral Presentation - Heart Failure" on YouTube; use Blueprint Prep template.

This will get you succeeding on rounds—start practicing with your next patient!

What rotation/specialty is this for (e.g., IM, surgery, psych)? Do you have a specific case details to customize an example? Need tips for visuals or Q&A?