The death of the long case?

For most of the past century the long case has been an essential tool in the evaluation of clinical skills, being used to make important judgments about the education and practice of doctors throughout the world. Despite its widespread use and rich tradition, the long case has major flaws, making it unwise to use it as the sole basis for making decisions of consequence. In this article I describe the strengths and weaknesses of the long case and report on some of the modifications that have been introduced to improve its performance.