The Grand Round is a long-standing tradition within academic medicine, representing a formal educational meeting for healthcare professionals. These sessions remain a fixture in teaching hospitals and medical institutions worldwide. This practice is a structured method for sharing clinical knowledge and promoting continued learning among an institution’s medical staff.
Defining the Grand Round
A Grand Round is a scheduled gathering, typically occurring weekly, within a teaching hospital or academic medical center. These sessions are often specialized by department, such as Surgery or Internal Medicine. It is a formal conference designed to provide education on clinical cases, medical research, or advances in treatment.
The practice traces its origins to the late 19th century, particularly at institutions like Johns Hopkins, where physicians moved bedside teaching sessions to an auditorium to accommodate larger audiences. The name reflects the original practice where a senior physician, accompanied by staff and students, would “make the rounds” to visit and discuss patients. While the traditional model involved the patient being physically present, modern Grand Rounds are now predominantly lecture-based, often using technology like presentations.
The Central Purpose of Grand Rounds
The primary function of Grand Rounds is to serve as a platform for Continuing Medical Education (CME), ensuring that practitioners remain current with the rapidly evolving field of medicine. These sessions help seasoned physicians and trainees alike stay informed about the latest diagnostic criteria, treatment protocols, and research findings. The regular scheduling of these events ensures a consistent influx of new information necessary to maintain high standards of patient care.
Grand Rounds also fulfill a role in quality improvement and peer review within the hospital setting. Complex, rare, or challenging patient cases are often presented for collective analysis, allowing the staff to review the management strategies applied. This provides an opportunity for a multidisciplinary team to discuss alternatives, assess outcomes, and learn from experience in a non-punitive environment.
The sessions bridge the gap between academic research and direct patient care, highlighting translational research—findings that move from the lab bench to the bedside. Grand Rounds are a forum for experts to disseminate knowledge about new pharmaceuticals, surgical techniques, or changes in medical guidelines that impact clinical decision-making.
Structure, Attendance, and Typical Format
Attendance at Grand Rounds includes a broad spectrum of the hospital’s medical community, typically comprising medical students, residents, fellows, and attending physicians. Nurses, pharmacists, and other allied health professionals often attend as well, making it an interdisciplinary educational event. For those in training, such as residents and fellows, participation is frequently a mandatory component of their graduate medical education program.
The structure of the session is formal and usually runs for about an hour, often taking place in a large hospital auditorium or lecture hall. A typical session involves a formal presentation delivered by an invited external expert or a senior member of the department’s faculty or training staff. The presenter focuses either on a single, compelling clinical case study or a didactic lecture on a cutting-edge topic within the specific medical specialty.
For case-based presentations, the presenter details the patient’s history, diagnostic process, differential diagnoses considered, treatment choices, and ultimate outcome. The presentation is followed by a discussion period, which is a significant component of the format. This question-and-answer segment allows the audience to probe the presenter’s reasoning, debate the evidence, and engage in a collective intellectual exercise.