One of the most influential innovations in medical education, in the sixteenth century, was bedside teaching. Originating in Italy, clinical teaching in hospitals, in particular, has attracted a great deal of attention in historical research. By contrast, another innovative casuistic approach to teaching that was introduced in Padua at about the same time, hardly has received any attention among historians, the so-called collegia. In a collegium, two, three, or even more professors discussed the case of a specific patient in front of their students. The participating professors each offered a detailed, reasoned judgment on the nature and the external and internal causes of the disease, the prognosis, and the suitable therapy. In doing so, they taught their students a sophisticated methodical approach that would allow them to successfully diagnose and treat their own future patients. Numerous handwritten and printed student notes on such collegia attest to the students’ great appreciation of this form of casuistic teaching. At the same time, as the paper shows, these collegia were academic rituals, in which the hierarchical order of the different professorships was staged in front of the assembled students. For, just like in ordinary joint consultations at the bedside, the lowest-ranking participant had to start, present the case, and give his opinion. In the toxic environment of Padua University, this was often the professor of anatomy, Gabrielle Falloppia and later Girolamo Fabrizi d’Acquapendente, both international celebrities. They were put in their place by their colleagues, who might be less popular but enjoyed a higher formal status (and salary) and who would speak after them, free to contradict them, correct them, or add to their judgment, without giving them the opportunity to respond.