European School of Internal Medicine: a window of opportunity for RCP activities in Europe

Structure

The ESIM has been held for one week each year, usually in September. Alicante was the first venue under the auspices of the Miguel Hernandez University where Professor Merino held the Chair of Internal Medicine. In 2006, after a successful period in Alicante, the school moved to Lisbon where it continued to flourish under the new director, Dr Antonio Martins Baptista.

Each year 50–70 residents attend from over 20 countries. They are selected and funded by their national societies with a maximum of four from any one country. This means that no one country dominates the proceedings and allows the residents to interact freely which is rarely possible at larger meetings. Residents attend at a similar stage in their training (equivalent to years 3–5 in the UK specialist registrar (SpR) training programme) so that their level of knowledge is comparable. They share the same anxieties about career prospects, work–life balance and hours of work that are such an important focus of discussion among registrars in this country.

The faculty for the school is, like the residents, drawn from the member societies of EFIM. Societies are asked to nominate one or more speakers for a wide range of topics, and faculty members are encouraged to participate in case presentations and interactive workshop sessions. The language throughout is English, and several UK speakers nominated by the RCP have contributed every year, and have found the experience very rewarding.

There is a full educational programme for the week, with lectures, case presentations and workshops. One free day allows for more social activities. The attendance at the sessions is uniformly good with very little absenteeism, perhaps because of the high degree of interaction between residents and lecturers. A popular element has been the case presentations and clinical-pathologic conferences, now much less of a feature in UK meetings, and which provide interesting reflections on the approach to disease management in different countries.

Since the move to Lisbon, greater time has been given to workshops when groups of 10 residents discuss not just clinical scenarios, but ethical and professional issues. This has given a much clearer picture of the training programmes across Europe, highlighting significant differences, but also many similarities. Many of the issues facing internal medicine in the UK have their counterpart in Europe – hours of work, supervision, part-time training, and relations with subspecialties – to name but a few.

Development of European Young Internists

Professor Merino's initial objectives for the school were twofold: the first to share knowledge on important advances in internal medicine among residents in training, and the second to forge links with future leaders of internal medicine across Europe. The mixture of academic activity and social interaction during the week has fulfilled this well, and many have formed links which have been maintained ever since.

As a result of these friendships, and a desire to promote internal medicine as an important element of modern healthcare, a group from the ESIM has formed the Young Internists Section of the Federation. The young internists have now created their own website and plan to establish on-going educational and professional links with their colleagues across Europe (www.younginternists.efim.org). They now have regular sessions at the annual EFIM congresses.

The European School of Internal Medicine in London

The UK has sent two to four residents to the ESIM each year, with some being specifically sponsored by the Scottish colleges. All have found the experience valuable, reflected in the reports that they have provided for the RCP International Office and the College Commentary.^1–3 As a result of their enthusiasm, there was strong support for the RCP to host the ESIM in 2009–10 when it moved from Lisbon. The RCP bid, supported by the Acute and GIM Committee and the International Office, has been successful, and the first London school will be held at the Greenwich Maritime University in September 2009.

The current ESIM format will be preserved and the aim is to involve as many UK trainees as possible. With this in mind, the RCP will host a European Training Day at the end of the ESIM which will be open to SpRs in GIM from the London Deanery and enable a wider group of UK residents to make contact with their European colleagues.

Holding the ESIM in London offers an exciting opportunity for the RCP and other interested UK bodies (there is strong interest from the Society of Acute Medicine for example) to establish new links across Europe. As Professor Merino envisaged, these residents may well become future leaders in their respective countries, and will help to shape internal medicine as it evolves in the different healthcare systems. Investing in such a network might well reap rich future dividends for the RCP.