📝 Clinical Case Reviews: What & How Many?

   

Clinical case reviews are the bread and butter of your portfolio - here’s everything you need to know. 

      

Of all the entries in your FourteenFish portfolio, Clinical Case Reviews (CCRs) are one of the most important... and probably the most time-consuming. You’ll need 36 per training year, which equates to about 3 per month.

But with ARCP often taking place in early July, the real pace is closer to 1 per week from the start of the academic year.

This article walks you through:

• How to write a CCR - what to include and where to put it
• How to map your case to capabilities and Clinical Experience Groups (CEGs)
• Tips and tricks to make CCRs quicker, easier, and less painful to write

      

🐠 Where to log a CCR

From the Portfolio tab, click on Clinical Case Reviews - it’s the first option under "Learning Logs". Click New Clinical Case Review to begin.

          

✍️ How to Write a CCR (Step-by-Step)

You’ll now see a screen with multiple sections to complete:

1. Title

A short, descriptive summary. E.g. “Safeguarding concerns in a child”, “Tired all the time” etc. 

2. Date & Setting

Add the date of the clinical encounter and choose the setting (e.g. GP surgery, hospital, home visit).

3. Brief Description

This is the factual part of the case. 

💡 Tip: Keep this bit relatively concise. You’ll reflect later.

• What happened?
• How did the patient present?
• What were your examination findings, differentials, and management plan?

Example: This is an entirely fictional case used to demonstrate how to complete a CCR.

       

🎯 Mapping to Clinical Experience Groups (CEGs)

Next, you’ll be asked to select Clinical Experience Groups — there are 9 total. Choose the ones relevant to your case.

Example:

• Elderly man with frailty and newly diagnosed lung cancer → tick Older Adults (including frailty) and Long-Term Conditions (including cancer).

🔁 You can link one CCR to one, or multiple CEGs.

In the example case above, I linked this to: Population Health and health promotion (including people with non-acute and/or non-chronic health problems)

          

🧠 Capabilities — and How to Map Them Properly

This section asks you to select up to 3 capabilities your CCR demonstrates.

There are 13 capabilities in total — covering everything from diagnostic skills to team working, communication, and ethical practice. Essentially, skills you need to be a ‘capable’ GP. 

🎯 Aim for 2–3 per CCR.

💡💡 Top tip:
When selecting a capability, click “Show word descriptors” beneath it. This reveals descriptions of what it looks like to perform at different levels:

• Underperformance
• Needs further development
• Competent
• Excellent

📌 Use the “competent” or “excellent” descriptors to guide your justification section. Mirror their language and include key points — it not only helps your supervisor sign off capabilities more easily at the ESR, but also gives you a clear framework to work from, making the whole process quicker and a little less painful.

      

🪞 Reflection & Learning Needs

This is arguably the most important part of the Clinical Case Review. Your supervisor isn’t looking for perfect medicine — they’re looking for insight, self-awareness, and progression.

Break it down into two parts and answer the question ‘What will I maintain, improve or stop?’
Here’s how to think about each part:

✨ Maintain

What went well - and what will you keep doing?

Examples:

• You built good rapport and the patient felt heard.
• You explained a complex diagnosis clearly without using jargon.
• You recognised red flags and arranged prompt referral.
• You managed time well and kept the consultation focused.

💡 Tip: Think about communication, professionalism, teamwork, and clinical judgement — not just the outcome.

🔧 Improve

Where could things have gone better — and how will you improve?

Examples:

• You weren’t confident in the latest asthma guidance.
• You forgot to safety-net clearly or document it.
• You ran out of time and didn’t explore psychosocial issues.
• You missed a chance to ask about red flags.

💡 Tip: This isn’t about criticising yourself — it’s about showing insight and awareness.

🛑 Stop

What will you avoid doing in future?

Examples:

• Stop jumping into advice before the patient finishes speaking.
• Avoid over-investigating when no red flags are present.
• Stop using jargon — the patient looked confused.

📌 Use this framework to keep your reflections focused — and easier for your supervisor to assess.

           

🎯 Learning Needs

Mention any clinical or non-clinical gaps you identified, and how you plan to address them.

Examples:

• Learning need: Better recognition of assessment and management of pneumonia in older patients
  Plan: Read NICE guidance and discuss cases at VTS
• Learning need: More confidence with ECG interpretation
  Plan: Book a tutorial with your supervisor next week
• Learning need: Improve use of ICE early in the consultation
  Plan: Practise during next 5 consultations and reflect again

💡 Tip: Link your learning need to a PDP item if it’s a priority — and come back later to reflect on progress.

         

📎 Attachments (Optional)

At the bottom you’ll see an “Attach Files” button. This is optional - you can use it if you referred to a specific guideline, flowchart, or useful resource. But you don’t have to.. 

        

✅ Save & Submit

Click the pink Save button. If all boxes are complete, you’ll then be able to send it to your supervisor for review.

In most placements, CCRs should be reviewed by your Educational Supervisor, not your Clinical Supervisor — but double check locally.

        

🔗 Other Linking Options (Optional)

Once saved, you’ll see icons at the top of the screen. These let you:

• Link the CCR to a PDP entry
• Link it to your mandatory training (e.g. if it’s a safeguarding case)

        

🟢 What Happens Next?

Back on your Portfolio homepage, if you’ve done everything right, you’ll see some of those white circles on the CEG and Capability charts start to turn green.

This means your CCR has been mapped successfully.

          

🧠 Tips from Experience

• Little and often — aim for 1 per week from the start of the year. It’s very easy to fall behind and suddenly find yourself with a mountain of paperwork to complete..
• Use the descriptors to make capability mapping easier
• Keep the factual part relatively concise - focus most of your energy on reflection
• Link CCRs to PDPs or training if relevant
• Write down learning needs with a plan
• Quality > Quantity - write meaningful reflections, not essays

            

🔑 Why This Matters

You’ll need to complete 36 Clinical Case Reviews per year — that’s around 3 per month, or roughly 1 per week if you factor in early ARCP deadlines.

It might feel like a box-ticking exercise at first, but CCRs can genuinely help you track your progress, reflect on your decision-making, and build confidence in common (and not-so-common) cases.

Once you get into the habit and find a workflow that works for you, they become much easier. 

         

📎 Next Up:

Check out our guide to Curriculum Coverage: Capabilities & CEGs and how to map them properly.