Most college biochemistry courses are taught in a format in which the professor lectures and the student memorizes. Although this is the best method for conveying large amounts of material, it puts the student in the position of passive learner. The lecture-based format has not been abandoned, but has been supplemented with case study projects assigned to the students upon completion of the intermediary metabolism unit. The case study assignment is modeled on similar exercises carried out in medical school biochemistry courses in the US and around the world. A description of the assignment follows: a group of 4-5 students is given a case study which gives the medical history of a patient with an inherited metabolic disease. The group is asked to provide biochemical explanations for the patient's symptoms and to suggest an effective course of treatment. The evaluation consists of a short paper that the students write as a group. The assignment provides the opportunity for small group interaction within a larger class and emphasizes cooperative-collaborative learning. Students learn by researching the topic on their own and debating it in small group discussions, and in so doing, gain a sense of confidence in themselves and the material they have learned over the course of the semester. Solving a "real-life" problem helps develop analytical and higher-order thinking skills and allows the students to see how biochemical concepts they have learned apply to a clinical situation.