Internal Medicine Meeting 2024 Pre-Courses

Tuesday and Wednesday, 8:00 a.m.-5:00 p.m.

Fred A. Lopez, MD, MACP
Professor of Medicine, Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA

Cynthia J. Brown, MD, MSPH, FACP
Chair, Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA

Whether preparing for the initial board examination or refreshing your knowledge for maintenance of certification, this popular 2-day Pre-Course provides an effective, fast-paced overview of core topics in internal medicine designed to focus on material that has a high probability of being included on the ABIM General Internal Medicine examinations. Taught by a faculty of clinician-educators, each an expert in their subspecialty, this condensed, high-yield review uses audience-response polling to actively engage participants and allow them to compare their answers with those of their peers. Each topic is introduced with a clinical case and a related multiple-choice question, the rationale for the correct answer is explained, and key clinical points are emphasized to promote learner retention. Participants also receive valuable tips for successful test-taking strategies included with course materials. This Pre-Course is an efficient way to prepare for an ABIM examination if you are short on time and seek a high-quality review.

Learning Objectives:

1. Enhance your knowledge of internal medicine by working through challenging clinical cases and questions guided by expert faculty.
2. Become adept at working through difficult examination-type questions logically and successfully.
3. Implement changes in clinical practice in accordance with recent advances and evidence-based guidelines.

Tuesday and Wednesday, 8:00 a.m.-5:00 p.m.

Noelle Northcutt, MD, FACP
Associate Professor, Division of Hospital Medicine, Denver Health, Aurora, CO

David Tierney, MD, FACP
Program Director, Internal Medicine Residency, Director, Internal Medicine Bedside Ultrasound (IMBUS) Program, Abbott Northwestern Hospital, Minneapolis, MN

This hands-on 2-day course is designed to teach core POCUS skills to internal medicine physicians, centering on the skills needed to use ultrasound as a patient assessment tool in a variety of settings.

If you are interested in the potential for POCUS to expand your clinical reasoning skills, join this course taught by internationally acclaimed faculty. Online prelearning assignments and live lectures will provide a comprehensive foundation of core ultrasound knowledge. Utilizing a small-group, hands-on format, attendees will practice ultrasound scanning on live models to support the development of bedside image acquisition skills.

Learning Objectives:

1. Identify indications and rationale for performing the following examinations: pulmonary ultrasound, focused cardiac ultrasound, kidney and bladder ultrasound, evaluation of abdomen for free fluid, and evaluation of lower extremity for deep venous thrombosis.
2. Perform the ultrasound examinations listed above.
3. Interpret normal and abnormal images for the applications listed above. 
4. Interpret POCUS findings in clinical case scenarios.
5. Describe the principles of ultrasound operation, artifacts, and image optimization. 

Note: This is a POCUS foundation course. Internal medicine physicians who complete this course will meet prerequisite training requirements for enrollment in additional internal medicine POCUS courses that will be offered by ACP. Visit acponline.org/pocus for more information.

Tuesday, 8:00 a.m.-5:00 p.m.

Robert A. Balk, MD, MCCM, MACP, FCCP Professor of Medicine, Rush Medical College, Division of Pulmonary, Critical Care, and Sleep Medicine, Associate CMO for Critical Care, Director, Critical Care, Rush University Medical Center, Chicago, IL

This Pre-Course will provide the opportunity to discuss a focused update on the diagnosis and management of common clinical issues encountered in the management of patients in the intensive care unit. Particular attention will be placed on new developments in the recognition of disease process, acute management of critical illness, and prevention of complications in the critically ill adult patient.

Some of the topics discussed include management of acute coronary syndromes and myocardial infarction, acute stroke, acute respiratory failure (including acute respiratory distress syndrome), circulatory shock, pulmonary embolism, sepsis and septic shock, surgical emergencies (i.e., ischemic bowel and necrotizing fasciitis), and severe pneumonia. In addition, the management of patients with acute encephalopathy and methods for preventing common complications in the critically ill patient will be discussed.

Learning Objectives:

1. Update the clinician on common disorders and diseases encountered in the intensive care unit.
2. Review the diagnostic techniques used in the management of the critically ill adult.
3. Discuss recommendations for the management of common critical illnesses encountered in the intensive care unit and strategies for the prevention of complications of critical illness.

Tuesday, 8:00 a.m.-5:00 p.m.

Irl B. Hirsch, MD, MACP
Professor of Medicine, University of Washington School of Medicine, University of Washington, Seattle, WA

In the United States and around the world, the number of people with diabetes continues to increase, with youth diagnosed with type 2 diabetes and those with type 1 diabetes living to older ages. With obesity and longer durations of diabetes, more people develop microvascular complications as well as cardiovascular disease and stroke. Fortunately, therapeutic options are advancing rapidly, giving greater opportunities to improve the health of our patients, but the complexity of care is also increasing. This Pre-Course will discuss the diagnosis of prediabetes and diabetes, including atypical forms of diabetes in adults. Faculty will review the role of lifestyle interventions as well as appropriate indications and practical use of weight loss medications. The growing role of diabetes technology will be addressed. The risks and benefits of new insulin and noninsulin pharmacologic therapies will also be presented. The role of diabetes medications, cholesterol-lowering agents, and blood pressure control to reduce cardiometabolic risk will be thoroughly discussed.

Learning Objectives:

1. Review current guidelines for the management of patients with diabetes and prediabetes.
2. Provide guidance on the evaluation, classification, and treatment of diabetes, including less common atypical forms of diabetes.
3. Review new insulin products and diabetes technology (including new pens, pumps, and sensors) available for patients with type 1 and 2 diabetes.
4. Review the rapidly expanding role of noninsulin therapeutics in the management of type 2 diabetes.
5. Discuss the role of nutrition and medication use for weight management in patients with obesity and diabetes.
6. Discuss the prevention and treatment of cardiovascular disease in patients with diabetes.
7. Within a panel discussion format, review questions and challenges that arise in your practice.

Tuesday, 8:00 a.m.-5:00 p.m.

Helen Fernandez, MD, MPH
Professor, Vice Chair, Education, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

Sonia Malhotra, MD
Associate Section Chief and Director of Palliative Medicine, General Internal Medicine/Geriatrics/ Palliative Medicine, Tulane School of Medicine/University Medical Center New Orleans, New Orleans, LA

With an increasing aging population worldwide and a shortage of specialty geriatrics and palliative care clinicians, there is a pressing need to improve the geriatric and palliative care skills of internal medicine physicians who have a central role in the care of older and seriously ill patients. This Pre-Course will focus on practical, evidence-based strategies that the internal medicine physician can use across care settings to better identify and treat serious and chronic conditions common to older populations, such as cognitive impairment; function assessment, frailty, and falls; depression and anxiety; and hazards of hospitalization. Expert faculty will discuss primary palliative care approaches, including strategies for clinical decision making and deprescribing in the setting of complex medical conditions; providing a systematic approach to pain and symptom management; applying principles of prognostication to those with serious illness and advanced age; and serious illness communication skills.

Learning Objectives:

1. Understand how disease manifests differently in older adults and disease management in older adults using the Geriatrics 5Ms (mind, mobility, medications, multicomplexity, and what matters most) approach.
2. Apply practical strategies to identify and address geriatric syndromes that are common among older adults.
3. Identify hazards of hospitalization for older adults and review methods to minimize these risks.
4. Review options for transitions of care for older adults and those with serious and chronic illness.
5. Gain an understanding of palliative care management of common symptoms and complex medical conditions.

Tuesday, 8:00 a.m.-5:00 p.m.

Geno J. Merli, MD, MACP, FHM, FSVM
Professor, Medicine & Surgery, Interim Chief Medical Officer, Co-Director, Jefferson Vascular Center, Department of Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA

Howard Weitz, MD, MACP, FRCP (Lond.), FACC
Professor of Medicine, Division of Cardiology, Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA

This Pre-Course will review the preoperative assessment, risk stratification, optimization, and postoperative care of patients who undergo non-cardiac surgery. In addition to comprehensive topic reviews the pre-course will feature “Clinical Pearls” which will focus on many of the clinical challenges faced by internal medicine physicians, hospital medicine physicians and advanced practice providers involved in the care of patients who undergo surgery. There will be a special focus on the integration of new information to patient care as well discussion of which concepts previously adhered to are no longer relevant. Among the topics to be presented are anesthesia essentials for the non-anesthesiologist, preoperative cardiac risk evaluation: the 2024 approach, the assessment of function and frailty and their role in perioperative care, venous thromboembolism prophylaxis, medication management in the perioperative period, and identification and management of postoperative complications. Course faculty are all clinician educators who are actively involved in perioperative care.

Learning Objectives:

1. Understand the assessment and management of patients with medical comorbidities undergoing inpatient surgical procedures.
2. Review guidelines and best practices for common anesthesia related issues, preoperative cardiac risk assessment, and medications.
3. Review preoperative validated risk assessment tools, strategies to mitigate risk, and management of patients with a variety of pre- and post-surgery cardiac.
4. Understand management of cardiac indicated antiplatelet agents and the appropriate use of direct oral anticoagulants (DOACs) in the perioperative period, which will include rescue and reversal agents for emergent surgery.
5. Assess key management strategies for assessing frailty or delirium.
6. Use of “Clinical Pearls” as a teaching modality to highlight management issues related to perioperative care.

Wednesday, 8:00 a.m.-5:00 p.m.

Douglas S. Paauw, MD, MACP
Professor of Medicine, Rathmann Family Foundation Endowed Chair for Patient-Centered Clinical Education, Department of Medicine, University of Washington School of Medicine, Seattle, WA

This Pre-Course will focus on pearls to help the practicing internal medicine physician maximize the utility of drug therapies. Newer medications and new uses for older medications will be covered. Current recommendations for “best therapy” for different diseases will also be covered. Common adverse effects of medications will be emphasized. Faculty will provide practical information on medications used for common medical problems, diabetes, and infectious diseases; safe use of medications in older patients; and drug interactions.

Learning Objectives:

1. Prescribe appropriate drug therapies for diseases commonly seen in the office.
2. Understand safe drug prescribing for older patients.
3. Understand the use and appropriate utility of new diabetes therapies.
4. Gain a better understanding of drug reactions and interactions.

Wednesday, 8:00 a.m.-5:00 p.m.

Howard H. Weitz, MD, MACP, FRCP (Lond.), FACC
Professor of Medicine, Division of Cardiology, Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA

David L. Fischman, MD, FACP
Professor of Medicine, Division of Cardiology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA

This Pre-Course will provide a focused update of the diagnostic, preventive, and therapeutic approaches to the patient at risk for, or with known, cardiovascular disease. Expert clinician-educators will focus on the cardiovascular disease issues that internal medicine physicians most frequently encounter and will provide “key points” to update the audience and foster patient care. Subjects covered will include identification and management of acute and chronic coronary artery disease, optimal treatment of acute and chronic heart failure, update in the treatment of hypertension, risk assessment and risk reduction for the patient with cardiac disease who undergoes noncardiac surgery, approach to the patient with valvular heart disease, indications for and interpretation of advanced cardiac imaging modalities, atrial fibrillation update, approach to the patient with lower extremity edema that is not a result of heart failure, approach to the adult who had congenital heart disease repaired as a child, and electrocardiogram case review.

Learning Objectives:

1. Update the internal medicine physician on the diagnostic and therapeutic approaches to the patient with known cardiovascular disease.
2. Become familiar with the guidelines and recent studies regarding hypertension, valvular heart disease, optimal blood pressure control, and care of the patient with cardiovascular disease who undergoes noncardiac surgery.
3. Understand approaches for decreasing the risk for complications and decreasing hospital readmissions for patients with a variety of cardiovascular issues.
4. Become familiar with optimal surgical and pharmacologic treatments for the care of patients with coronary artery disease, heart failure, valvular heart disease, atrial fibrillation, and repaired congenital heart disease.
5. Become familiar with the transition of care after hospital discharge for patients with a variety of cardiac issues.
6. Become familiar with the role of technologic advances in cardiac care that the internal medicine specialist may use in patient care: electrocardiography, echocardiography, cardiac CT imaging, cardiac MRI, cardiac PET scan, and wearable cardiac rhythm monitoring devices.
7. Become familiar with the approach to the adult who underwent repair of congenital heart disease as a child.

Wednesday, 8:00 a.m.-5:00 p.m.

Jamie Newman, MD, MHA, MACP
Associate Professor, Department of Hospital Medicine, Mayo Clinic, Rochester, MN

The hospital is a complex environment. Navigating it on behalf of our patients requires a broad and constantly growing body of clinical knowledge combined with an understanding of the systems that support them. This Pre-Course will provide an update on key medical issues, take you through the challenges of common and uncommon clinical conundrums, and address how to improve the value of care we provide to our patients.

First and foremost, we will keep in mind the needs of the patient, as well as the impact on the hospital and the hospitalist. Individual lectures will include review of up-to-date medical care using a case-based format and audience-response polling. This Pre-Course will present an advanced and practical perspective of hospital medicine.

Learning Objectives:

1. Review inpatient management of complex patients in case-based presentations.
2. Explore options for improving patient safety and quality. 
3. Provide updates on the latest hospital medicine literature.

Wednesday, 8:00 a.m.–5:00 p.m.

Edward (Ted) Parks, MD
Associate Professor, Department of Medicine, University of Colorado, Denver, CO

Musculoskeletal symptoms and sport-related injuries are common in primary care, but internal medicine physicians receive little instruction in office-based orthopedics. Most of these conditions do not require surgery and can therefore be managed by the knowledgeable internal medicine physician. This Pre-Course is designed to provide participants with the knowledge and tools needed to correctly evaluate, diagnose, and treat most orthopedic complaints seen in the internal medicine office. The Pre-Course will use a case-based approach to familiarize participants with basic joint and tendon anatomy and landmarks and make participants comfortable with performing a concise, targeted office examination. This will be combined with knowledge of the epidemiology of musculoskeletal complaints in primary care to develop an accurate diagnostic approach. Treatment of these common conditions will be discussed, with special emphasis on a practical, evidence-based, and cost-effective approach to physical therapy and medical devices (e.g., splints).

Learning Objectives:

1. Know the epidemiology of the most common orthopedic and sports medicine conditions seen in the internal medicine office.
2. Identify basic joint and tendon anatomy in major joint and musculoskeletal regions.
3. Perform targeted, practical, and evidence-based diagnostic maneuvers for common musculoskeletal complaints.
4. Feel competent and confident in diagnosing musculoskeletal problems through history and physical examination.
5. Recognize indications for judicious use of imaging.
6. Develop treatment plans, including medication, exercises, and use of splints or braces.
7. Identify clinically appropriate resources for patient education and for home exercise plans.
8. Recognize which patients require further testing or orthopedics consultation and which can be safely treated under the guidance of the internal medicine physician.

Wednesday, 8:00 a.m.-5:00 p.m.

Robert M. McCarron, DO, Member
Professor, Department of Psychiatry and Human Behavior, Director of Education, Susan Samueli Integrative Health Institute, Associate Dean, Continuing Medical Education, Director, UCI Train New Trainers Primary Care Psychiatry Fellowship, Divisions of Psychiatry and Human Behavior, Medical Education, and Susan Samueli Integrative Health Institute, University of California, Irvine School of Medicine, Irvine, CA

Jane P. Gagliardi, MD, MHS, FACP
Professor of Psychiatry and Behavioral Sciences, Professor of Medicine, Duke University School of Medicine, Durham, NC

Internal medicine physicians are often on the “front lines” in both specialty and primary care settings for the assessment and treatment of common psychiatric disorders. Most psychiatric disorders are treated by nonbehavioral specialists, and more than 80% of antidepressants are prescribed by nonpsychiatrists. Formal psychiatric training for internal medicine physicians is often extremely limited and does not cover foundational topics, which are relevant to everyday practice in the general medical setting.

This Pre-Course will provide a practical, evidence-based update for internal medicine physicians on approaches to interviewing patients with the goal of recognizing, diagnosing, treating, and/or referring patients with commonly encountered mental health disorders. Expert clinician-educators with training in both internal medicine and psychiatry will emphasize the importance of a patient-centered approach, motivational interviewing, and quick cognitive behavioral techniques that can be quickly used in medical settings. A practical overview of psychopharmacology strategies in the general medical setting will also be discussed. Faculty will focus on psychiatric diagnoses that are prevalent in general medical practice, including major depressive disorder, anxiety disorders, trauma-related disorders, substance use disorders, chronic pain, and bipolar mood disorders, with a goal of improving recognition, confidence in management, and effectiveness of referral. 

Learning Objectives:

1. Update the internal medicine physician on practical patient-centered interview strategies to detect treatable mental illness. 
2. Provide the internal medicine physician with familiarity about current best practices regarding management of depression, anxiety, and substance use disorders in primary care and specialty medical settings. 
3. Provide the internal medicine physician with a practical approach to prescribing and monitoring common psychotropic medications, with a goal of facilitating management as well as communication with psychiatric care providers. 
   • Antidepressants in medical practice.
   • Antipsychotics in medical practice.
   • Drug–drug interactions relevant to psychotropic medications.
4. Give the internal medicine physician an overview and examples of the use of motivational interviewing in a busy medical practice. /li>

Wednesday, 8:00 a.m.-5:00 p.m.

Julie L. Oyler, MD, FACP
Professor, Department of Medicine, University of Chicago, Chicago, IL

Darlene Tad-y, MD, MBA, SFHM, FACP
Professor of Medicine, Division of Hospital Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO

ACP's annual quality improvement (QI) leadership training program provides meaningful QI implementation support based on principles of clinician engagement, patient and family partnership, team-based care, promotion of health equity, and promotion of clinician well-being. Participants will receive step-by-step guidance, based on the ACP Advance QI approach, to help them through their QI journey, including how to establish the what and why for change, identify how to measure change, plan for change and identify solutions, and implement and sustain change.

Participants will have the opportunity to work in small groups to design their own QI action plan to address their top practice challenge(s) under the guidance of national expert physician coaches. At the conclusion of this Pre-Course, participants will be able to understand and apply QI strategies to tackle a wide range of practice issues that are meaningful to their highest priority challenges. This full-day Pre-Course will launch participants on their QI journeys and provide them with the skills needed throughout their careers and to lead the way through the changing tides of health care.

Learning Objectives:

1. Describe the four steps of the ACP QI approach, including establishing the what and why for change, identifying how to measure change, planning for change and identifying solutions, and implementing and sustaining change.
2. Explain the rationale for integrating clinician engagement, team-based care, patient and family partnership, promotion of health equity, and promotion of clinician well-being.
3. Identify and apply practical strategies for QI implementation using ACP resources and tools.