With the sad news of the death of neurologist Gerald Stern, it is a fitting time to recall his treatise in praise of Grand Rounds.¹ This traditional style of learning has long been cherished by neurologists as the optimal way to teach both the clinical method and deductive reasoning.² Medical education has significantly evolved, with the recognition of varying learning styles, availability of simulations and remote e-learning. Case presentations and the clinicopathological conference are among the most popular sessions in feedback from the Association of British Neurologists’ annual meeting, but the tradition of regional hospital-based Grand Rounds is no longer widespread. Attendance struggles with increasingly squeezed job plans, and the educational environment itself has been open to criticism.

Grand Rounds evolved as a concept around the turn of the 20th century from the bedside teaching pioneered by Sir William Osler, but with exemplars such as Jean-Martin Charcot’s ‘Leçons du Mardi’ at the Salpêtrière Hospital, and Sir William Gowers’ now eponymous gathering at the National Hospital for Neurology and Neurosurgery, Queen Square. The term ‘rounds’ is linked to Osler’s tour of patients at Johns Hopkins Hospital, Baltimore, though the satellite wards were octagonal in shape rather than the circular ones proposed by British anatomist and surgeon John Marshall in 1878 (reviewed in Taylor³).

The classic Grand Rounds structure comprises the case description, originally with the patient present. Discussion is intended to be educational, with audience participation encouraged. It has evolved as both an educational event for trainees …