ESIM Summer Course, Ede (The Netherlands) 25-29 June 2018

http://www.esim2018.org

FDIME Awarded Bursaries to 2 Young Internists:
Dr Veronika Madesova (Latvia), Dr Samar Derbal (Tunisia)

Dr Veronika Madesova, 2nd year Resident in Internal Medicine, Riga East University Hospital, Latvia

This summer (24 June – 30 June) I had an opportunity to participate in European Summer School of Internal Medicine (ESIM) which was held in Netherlands, Ede. The mains goals were to promote medical education and to make a place for exchange and friendship for young internists from sixteen different European countries. The central theme was “Internal Medicine in Harmony” and included several topics like basic problems in internal medicine, clinical reasoning, patient safety and care in virtual world, sonography for internists and multidisciplinary work in harmony. Summer School of Internal Medicine was organized and consisted of several theoretical lectures, interactive workshops, practical lessons in ultrasonography and clinical case presentations which were prepared by participants.

I was impressed by the quality of theoretical presentations and high level of lecturers. One of the most memorable lectures was about obesity – “Is obesity a disease” which was prepared by dr. Dicker – head of Internal Medicine Department and Obesity in Israel. He showed us recent researches about pathophysiology and development of obesity, the main differences in metabolism between obese and unobese patients and treatment strategies. I really enjoyed the way how lecturers handed their experience to the audience – young doctors who are towards the end of their training in Internal medicine. They tried to demonstrate their wide experience and knowledge through simple, but sometimes also through complicated clinical case study presentations. I found this way very attractive and effective for the audience - it was easy to perceive the information and analyze mistakes and failures.

Participants from each country should prepare and demonstrate at least one clinical case presentation for Summer School of Internal Medicine. First of all, it was really exciting to hear these presentations and participate in development of investigational plan for patients, discuss about possible differential diagnoses and analyze mistakes and failures in diagnostics. It was also instructive to hear advises and offered solutions from professors. Secondly, it was very interesting to see at selected clinical cases from different countries. It allowed us to look at diagnoses which were surprising for each country. For example, participants from Italy demonstrated clinical case about patient with leptospirosis. In turn, in Latvia we have seen several patients with leptospirosis – so this disease is quite known for us. In the contrary we demonstrated patient with syphilitic aneurysm of aorta and it was the first such a case in our country, but some colleagues have already had such an experience. In my opinion, these clinical case presentations gave us an opportunity to look at similarity of investigational plan and clinical reasoning and also at differences in countries.

We also participated in several interactive workshops. Especially I enjoyed one workshop about patient safety. We were divided in few groups and had to work with the same clinical situation – create a plan of investigations and choose appropriate treatment choice for patient. It reminded me another side of treatment of patient – we always have to think some steps forward and we have to remember about all aspects (not only medical) while making a decision. Another thing is that we have to think about our own safety – that it is why we need to think about what and how we are filling medical documents. One more very interesting and useful workshop for me was about the art of presenting science. Daily we are used to work in relatively small groups, but sometimes we become distracted while speaking in front of the audience and communicating with hundreds of people. This workshop gave me some keys which could help in such situations.

Due to the high prevalence of chronic and complex diseases that are associated with lifestyle and demographic changes, internists have a fundamental role in modern healthcare system nowadays. Internists have to be a medical expert, professional, communicator, collaborator, scholar, health advocate and leader. But it is quite impossible to reach these goals if we do not have adequate “work - life” balance. It describes the balance between time allocated for work and other aspects of life like family, personal interests, social or leisure activities. Because of different social, economic, cultural factors we have to work and study a lot and sometimes it is very easy to forget and disturb this balance. One of the most important “take home” messages for me would be to always keep in mind and provide this balance otherwise professional part of life will suffer.

Although all Summer School of Internal medicine course was intense, I found it very interesting, useful and memorable. I am sure that all knowledge will have an effect on my way of thinking, working and studying in future, but especially on patient safety and clinical reasoning. I would like to express my gratitude to all lecturers, organizers, participants and Foundation for the Development of Internal Medicine in Europe for such an amazing opportunity to participate in this unforgettable project.

Dr Samar Derbal, 4th year Resident in systemic and autoimmune diseases, Internal Medicine Department, Habib Thameur Hospital, Tunisia

I want to thank the FDIME for this great opportunity for granting me the opportunity to attend the ESIM in the Netherland from Sunday (24.06.2018) to Saturday (30.06.2018).
It was a very rich program full of a big range of subjects. The level of the learning and my study visit was over my expectation. I was surprised as the program was different from the classic sessions and courses. The learning sessions were very interactive. The organization and the commodities were also good. I was excited to attend some speakers’ conferences. Some of which were funny but they succeeded to have my all attention.
The best aspect of my educational visit was the discussion about the health care system problems that helped me asses that we are facing the some heath care problems all over the word. I concluded also that error in prescription is more common than I thought and we must find solution to face it. Many participants gave their point of view. We also discussed how to get over them and to improve our practice. Such educational visit are very important and interesting because it gave me the chance to meet medicine students from many European countries. We shared our experiences, our problems and our expectations. This helped me to note that we have many similarities and differences, especially in the session “European Curriculum in Internal Medicine”. I came back to my country and I had already discussed that with my head of department and the members of our «Junior Association Of internal medicine”. In fact I noticed that we have a different CV and I was kind of disappointed. So maybe we can change things to improve our Tunisian Internal Medicine CV. We are young but we can always dream to change things. This is the lesson that I wanted to transmit to my colleagues. The workshops in groups were also so beneficial for me. We could exchange ideas and I prefer this methods of learning over classic conferences. This is a way to improve our self-confidence and to express our point of view. We can improve our knowledge and our way of thinking front of different medical situations. The lecture “Clinical reasoning” was impressive and it was an occasion to remind me that “we are not as good at clinical decision making as we think” and that we must always learn and practice more and more.
The “gender medicine” lecture was a surprise for me because I look to myself as women and a doctor in a different way. It was funny until I concluded that “re-admission after ACS is associated with femininity”.
The clinical cases presented by the medical students were interesting especially the case of “purple urine syndrome”. I don’t really like nephrology, but the lecture “lecture and salt” was a different way for me to learn and to discuss the clinical cases of nephrology in a different way and to refresh some renal physiopathology knowledge.

I concluded also that for some “rare disease”, this definition depends on its prevalence which can be vary from one country to another. “Verbal and non-verbal communication in presenting” was a very great session for me personally because I learned a lot. This will help me to improve my presentation skills. The “ultrasound” session was a big surprise, it was the first time that I have to handle an ultrasound. It made me happy and sad in the same time. Why only radiology residents have the right to use it in Tunisia? It was one subject that I discussed with my colleagues later. We think that things must change. The Saxophone workshop was a real pleasure.
I also noticed that it was an occasion to improve my spoken English. All the students were great. We laughed a lot and I got to know many funny and great people with beautiful minds. The social program was impressive. I especially adored the visit by bicycle to museum Kroller Muller.
It allowed me to remember when I used to cycle with my father when I was young. I want to thank you because I already bought a new bike and each time I use it, I send a photo to my father who can’t use it anymore.
It was a great chance for me to discover Ede and Amsterdam for the first time. But I regret that I haven’t much free time to know more about Ede, its culture and traditions.

The ESIM summer school was a great opportunity to learn more about my specialty. This course will help me to make progress for myself and to take all that I learned back to my country and to share it with my colleges to encourage them to look for such opportunities. I was also delighted to meet other residents to exchange our culture, knowledge, experiences and projects. I always believe that doctors don’t have one nationality and they must be opened on the other country medical experiences. This was the first step for me and I hope other Tunisian medical student will have this chance in the future.