EMA Report on Personalised Medicines
May 23, 2017
Dr Giulio Cavalli
FDIME Grant Award Ceremony at ECIM Congress, Milan 1 September 2017
September 11, 2017

The ESIM Summer School Ede,
The Netherlands 25 June - 1 July 2017

http://www.esim2017.org

FDIME awarded educational bursaries to:
Zane Svikle (Latvia) and Nikola Panic (Serbia).

Zane Svikle and Nikola Panic
Report from Zane Svikle 3rd year Resident in Internal Medicine at Pauls Stradins Clinical University Hospital, Riga, Latvia

I was sure I will learn many new things in European School of Internal Medicine, but in reality, I got so much more than expected. I expanded my mind and refreshed my passion for Internal Medicine.

It was amazing to watch and listen all the great presentations from lecturers and to be a part of audience. Everybody was welcome to make comments or ask questions – it is very important to feel safe to do that. It was great quality of teaching, learning and supervision, because everyone was open and interactive. I saw many different experiences, opinions and ways how to do something and it all came together perfectly to make this summer school so special and worthy.

I was sure that European School of Internal Medicine will have a great impact on me, and it really was a unique and outstanding way to enhance knowledge and widen outlook in order to become a more professional and qualified doctor. After this study visit I felt so inspired to reach new personal goals in Internal Medicine and study even harder to become better doctor.

In my opinion, best aspects of this educational visit were improvement of analytical thinking and presenting skills. Every topic, every lecture and workshop was aimed to do so. Every lecturer showed us the best and their unique way how to speak with audience in a way that is understandable to it. Every topic was exciting and something to learn from. Clinical presentations made us think harder and analyze to solve complex cases.

From my own personal perspective, all aspects of the course were helpful and widely covered. As we discovered in the process, there are many differences in European Curriculum, but the most noticeable difference appeared to be with ultrasonography. In some countries internists use it in everyday practice when they investigate patient, but somewhere only radiologists investigate patient with the help of sonography. In my country internists can use it if they want and understand it, but it is not part of our current Curriculum. For me it was very interesting to take part in sonography workshops and learn something completely new. I will definitely use this new experience in my practice in future and I hope to improve my skills regularly.

I have improved my knowledge as a result of attending European School of Internal Medicine in many ways. We widely discussed European Curriculum in Internal Medicine not only in lecture and workshop but also afterwards. It is good to compare to make improvement. There are a lot of differences in all European countries not only in programs but also in the way of evaluation and supervision. In Latvia, there is new Curriculum in Internal Medicine in process. It was very interesting to hear and discuss about Dr Watson. For me it was something completely new and I wonder how these new technologies will help doctors in their everyday work. And there really is a question – can we rely on it? Is evidence based medicine always the best answer? Should not we think more about personalized medicine? These are difficult questions to answer, but modern technologies definitely can help us in many ways. My favorite lecture was on delirium experience. There has not been enough talking about delirium and what to do and how to react in these situations. After this lecture and gaming I feel wiser and better prepared to deal with the patient who is in delirium, although we always have to remember the power of prevention. There was a very good reminder to never trust data and read publications very carefully to see if there are no errors and evaluate if you can trust the information. Bias and error can result at all stages of trial and it is important to be aware and careful all the time. There was a very good topic about patient safety. We discussed some clinical case, what and why we could do, what would be the best for patient safety. Mostly, there is not one a right way to act, but different options. Most important part of it is ability to discuss, see pros and cons and then make a decision. Sonography workshop was very useful to me, because I have very little or in some cases no experience at all in it, but I feel it is very important and helpful to know at least basic things in everyday practice and especially in cases of emergency. I found less important for me the topic about antibacterial resistance, not due to the presentation, but due to my previous knowledge gained at homeland.

Overall scientific program seemed balanced, in spite of a long daily schedule, sometimes a small additional break between lectures would be welcome. Many of the participants, including me, wished to have more variety for the meals, with less sandwiches, but more warm dishes, at least for lunch. A bit longer lunch break (not 30 minutes) would work better. I found some of the clinical case presentations too squeezed and it was not enough time to fully understand the case story. Less cases, but longer ones might work a bit better, though it strongly depended on the presenter.

Central theme this year was Internal Medicine in Harmony and it really felt so with all the serious topics surrounded by music, art, culture and physical activities. In my opinion, the right way is to keep everything on balance not only in school, but every day. I think, artistic and visual skills may enhance the ability of a doctor to become more successful physician in practice. Physical activities are great way to relax, clear mind and of course regular physical activity can produce long term health benefits. I think doctors should show example for their patients, because physicians have a key role in encouraging people to take up exercise at levels that will promote health and longevity.

I am really grateful for the opportunity what FDIME has been given for me offering the bursary to attend the ESIM in the Netherlands. It would not be possible with my National Society support only. I have met many brilliant colleagues and lecturers, made several friends, hopefully, for the life. It is thrilling to implement much of the gained knowledge in my daily work and to share with the colleagues in Latvia. I would also encourage other young internists from Latvia to apply for this great postgraduate course.



Report from Nikola Panic 5th year Resident in Internal Medicine at University Clinic, Dr Dragisa Misovic-Dedinje, Belgrade, Serbia

I had opportunity to attend European Summer School of Internal Medicine (ESIM) in Ede, Netherlands in period 25.06.2017.-01.07.2017. thanks to the FDIME Bursary. I would like to point out that Summer School has not only met my expectations but far beyond. The Course was perfectly organized from the moment I arrived to the venue to the moment we left Ede. We were warmly welcomed and assisted with helpful and kind hosts for entire length of the stay. Facilities were well suited for this kind of event. As for course itself, the lectures and workshops were designed in order to meet the needs of internal medicine residents all over the Europe. Quality of lectures was exceptional and lectures useful from the point of view of everyday clinical practice, but also teaching us how to recognize and treat some conditions we do not encounter very often. Lecturers were interactive, including and encouraging residents to participate in the discussions, keen to hear our comments and experiences. During the workshops we were encouraged to share our ideas which afterwards were critically analyzed and discussed, taking into consideration our particular healthcare settings. Among other, personally, I found very useful lecture on clinical reasoning, and what I have learned from it I will definitely implement in my clinical practice. Extremely interesting was also a lecture on role of new technologies in modern healthcare. I am sure that what we heard on this subject will help us planning our place as a clinician in modern world marked by ever growing use of artificial intelligence and internet technologies. Extra quality of this summer school was opportunity to get some hands on training in ultrasonography, as I find acquiring new skills to be a constant need for every clinician. Another very important subject was opportunity to work together and exchange ideas on new European curriculum in internal medicine that I hope will soon become universally accepted all over the Europe. From my point of view that would have great impact in unifying standards of training and bring more quality and benefit both to healthcare systems as well as individual young internists. In the end, clinical case presentation from the participants completely fulfilled my expectations as I learned a lot from their experience.
This also was a perfect opportunity to meet young colleagues from all over the Europe, hear their experiences, share problems we encounter and ideas how to resolve them. I am sure that the network we have built will result in future cooperation and collaboration between us and our institution on mutual benefit but also on the benefit of development of internal medicine in Europe. I would also want to point out the social part of the summer school, that was more than interesting and creative. Participating together in activities such as saxophone playing, bike riding, salsa dancing and others helped to make a special bond between us. Furthermore through play and fun we got opportunity to acquire new skills. The Drama teacher taught us how to present our science in interesting way, while at another workshop we learned how to properly use our gestures and voice to make our point.
This was a great and valuable experience for me, and in the end I would one more time like to thank FDIME for helping me to participate in European Summer School of Internal Medicine 2017. I definitely would recommend any young internist in Europe to take part in this great event and for those who need a support I encourage them to address FDIME with their application as I am sure that their quality, willingness to learn and desire for improvement will be recognized.