MER Internal Medicine for Primary Care: Derm/Endo/Gyn/Vasc 2026

Dermatology • Endocrinology • Gynecology • Vascular Medicine

July 13–16, 2026 | Porto, Portugal

Build practical knowledge across four important areas of adult medicine with MER Internal Medicine for Primary Care: Derm/Endo/Gyn/Vasc 2026, organized by Medical Education Resources (MER).

The original conference was held July 13–16, 2026, at the InterContinental Porto – Palacio das Cardosas in Porto, Portugal.

This multidisciplinary primary care program delivers clinically relevant updates across:

• Dermatology
• Endocrinology
• Gynecology / Women’s Health
• Vascular Medicine
• Internal Medicine
• Primary Care

Major topics include:

• Atopic, contact, irritant, nummular, seborrheic and exfoliative dermatitis
• Papulosquamous diseases
• Psoriasis
• Lichen planus
• Pityriasis rosea
• Cutaneous manifestations of systemic disease
• Actinic keratosis
• Bowen’s disease
• Squamous cell carcinoma
• Basal cell carcinoma
• Melanoma
• Abnormal uterine bleeding
• Abnormal Pap smears
• High-risk HPV
• Cervical cancer screening
• HPV vaccination
• Menopause
• Hormone replacement therapy
• Breast cancer screening
• BRCA-related cancer risk assessment
• Hypothyroidism
• Hyperthyroidism
• Thyroid nodules
• Thyroid cancer
• Osteoporosis
• DEXA
• FRAX
• Bisphosphonate therapy
• Pituitary disease
• Peripheral vascular disease
• Atherosclerosis
• Lipid-lowering therapy
• Antiplatelet therapy
• Embolic stroke
• Aortic and peripheral aneurysms
• Venous thrombosis

Course Details

• Course: Internal Medicine for Primary Care: Derm/Endo/Gyn/Vasc
• Provider: Medical Education Resources – MER
• Year: 2026
• Official Dates: July 13–16, 2026
• Duration: 4 Days
• Venue: InterContinental Porto – Palacio das Cardosas
• Location: Porto, Portugal
• Primary Focus: Internal Medicine / Primary Care
• Specialties: Dermatology / Endocrinology / Gynecology / Vascular Medicine
• Original MER Activity: 16 Credit Hours
• MedicalAmboss Delivery: Google Drive
• CME Points with MedicalAmboss: Not Included
• Certificate with MedicalAmboss: Not Included
• Language: English

Course Overview

Primary care clinicians frequently encounter patients whose problems cross traditional specialty boundaries.

A single clinic day may include patients with:

• A new rash
• Psoriasis
• A suspicious pigmented lesion
• Thyroid dysfunction
• A thyroid nodule
• Osteoporosis
• Abnormal uterine bleeding
• Abnormal cervical screening
• Menopausal symptoms
• Peripheral arterial disease
• Suspected thrombosis
• Stroke risk

The MER Derm/Endo/Gyn/Vasc program brings these areas together in a practical primary care format.

A useful clinical pathway is:

Recognize the Presentation → Build the Differential → Select Appropriate Testing → Treat → Counsel → Follow Up / Refer

Learning Objectives

Upon completion of the original educational activity, participants should be better able to:

• Differentiate common forms of dermatitis.
• Distinguish atopic, irritant contact, allergic contact and nummular dermatitis.
• Recognize major papulosquamous disorders.
• Differentiate psoriasis, lichen planus, pityriasis rosea and related scaly eruptions.
• Identify cutaneous findings that may reflect systemic disease.
• Recognize premalignant and malignant skin lesions.
• Review office-based biopsy principles.
• Evaluate abnormal uterine bleeding.
• Review current approaches to abnormal Pap results and high-risk HPV.
• Apply cervical cancer screening recommendations.
• Counsel patients about HPV testing and vaccination.
• Review menopausal symptoms and available treatment options.
• Discuss benefits and risks of hormone therapy.
• Review current breast cancer screening recommendations.
• Understand BRCA-related cancer risk assessment and genetic counseling considerations.
• Recognize abnormal thyroid function.
• Review hypothyroidism and hyperthyroidism.
• Evaluate thyroid nodules using ultrasound and cytologic principles.
• Review thyroid cancer assessment.
• Interpret DEXA and FRAX in osteoporosis evaluation.
• Review benefits and risks of bisphosphonate therapy.
• Diagnose and manage common pituitary disorders.
• Recognize the spectrum of peripheral vascular disease.
• Review atherosclerosis and medical vascular therapy.
• Understand the presentation and management of embolic stroke.
• Review medical, surgical and interventional stroke-treatment concepts.
• Evaluate aortic and peripheral aneurysms.
• Review diagnosis and treatment of venous thrombosis.

DERMATOLOGY

Dermatitis

The dermatology curriculum reviews common inflammatory skin disorders including:

• Atopic dermatitis
• Allergic contact dermatitis
• Irritant contact dermatitis
• Nummular dermatitis
• Seborrheic dermatitis
• Exfoliative dermatitis

The course also addresses common manifestations such as:

• Blistering
• Oozing
• Crusting
• Flaking

Differentiating Common Dermatitis Patterns

A practical dermatologic approach considers:

Morphology + Distribution + Exposure History + Symptoms + Chronicity

rather than relying on appearance alone.

Atopic Dermatitis

Relevant clinical features can include:

• Pruritus
• Chronic or recurrent inflammation
• Characteristic distribution
• Associated atopic disease
• Skin-barrier dysfunction

Treatment should be individualized according to severity and clinical pattern.

Contact Dermatitis

Contact dermatitis may be:

Irritant Contact Dermatitis

Caused by direct injury to the skin barrier.

Allergic Contact Dermatitis

Produced by delayed hypersensitivity to a specific allergen.

A detailed exposure history is therefore particularly valuable.

Papulosquamous Diseases

The course provides a focused review of red, raised and scaly dermatologic conditions.

Major disorders include:

• Psoriasis
• Lichen planus
• Pityriasis rosea
• Lupus erythematosus-related eruptions

Psoriasis

Psoriasis is an important chronic inflammatory disorder that may involve:

• Skin
• Nails
• Joints

Primary care clinicians should recognize characteristic morphology and understand when systemic disease or specialist referral should be considered.

Lichen Planus

Lichen planus can involve:

• Skin
• Mucous membranes
• Nails

and may enter the differential of several papulosquamous eruptions.

Pityriasis Rosea

Recognition of classic morphology and distribution can help distinguish pityriasis rosea from other generalized scaly eruptions.

Skin Manifestations of Systemic Disease

Skin findings can provide important clues to disorders involving other organ systems.

The curriculum reviews cutaneous findings associated with:

• Rheumatologic disease
• Endocrine disease
• Gastrointestinal disease
• Psychological / systemic conditions

The skin can therefore function as a visible marker of internal disease.

Premalignant & Malignant Skin Tumors

The program reviews recognition of:

• Actinic keratosis
• Bowen’s disease
• Squamous cell carcinoma
• Basal cell carcinoma
• Melanoma
• Other selected skin tumors

Actinic Keratosis

Actinic keratosis is associated with chronic ultraviolet exposure and is important because of its relationship to squamous malignancy.

Bowen’s Disease

Bowen’s disease represents squamous cell carcinoma in situ and requires appropriate recognition and treatment.

Basal Cell Carcinoma

Primary care clinicians should be able to identify lesions suspicious for basal cell carcinoma and arrange appropriate biopsy or referral.

Squamous Cell Carcinoma

Risk assessment can depend on:

• Site
• Size
• Clinical appearance
• Patient characteristics
• Immune status
• Histopathologic findings

Melanoma

Early melanoma detection remains critical.

Suspicious changing or atypical pigmented lesions require appropriate evaluation rather than empiric treatment.

Skin Biopsy

The curriculum reviews procedures including:

• Punch biopsy
• Excisional biopsy

with emphasis on matching the procedure to the suspected diagnosis.

Skin Cancer Risk Reduction

Primary care clinicians can contribute through:

• Sun-protection counseling
• High-risk patient recognition
• Evaluation of changing lesions
• Timely referral

GYNECOLOGY / WOMEN’S HEALTH

Abnormal Uterine Bleeding

The course reviews:

• Normal menstrual physiology
• Abnormal menstrual patterns
• Ovulatory bleeding
• Anovulatory bleeding
• Other menstrual disturbances
• Diagnostic evaluation
• Treatment options

AUB Clinical Approach

A useful framework is:

Age → Pregnancy Status → Bleeding Pattern → Medication History → Structural vs. Nonstructural Causes → Appropriate Testing

Treatment should be directed toward the underlying cause whenever possible.

Abnormal Pap Smears & High-Risk HPV

The curriculum reviews management of cervical cytologic abnormalities including:

• ASC-US
• LSIL
• HSIL
• Atypical glandular cells

within the context of contemporary cervical screening and HPV-based management.

HPV Testing

The course discusses appropriate incorporation of HPV testing into clinical practice.

The clinical objective is to identify patients at increased risk for cervical precancer while avoiding unnecessary intervention in low-risk patients.

HPV Vaccination

The program also reviews:

• HPV vaccine use
• Missed-dose considerations
• Administration
• Storage considerations

within a practical primary care setting.

Cervical Cancer Screening

Screening decisions should account for:

• Age
• Previous screening results
• HPV status
• Prior cervical disease
• Guideline recommendations

Menopause Transition

The curriculum reviews common symptoms such as:

• Hot flashes
• Night sweats
• Genitourinary / vaginal atrophy

as well as longer-term health considerations.

Menopause & Health Risks

Clinical discussions include:

• Osteoporosis
• Breast cancer
• Cardiovascular disease
• Colon cancer
• Quality of life

Hormone Replacement Therapy

The course reviews:

• Hormone therapy
• Estrogen-based approaches
• Alternatives to hormone therapy
• SERMs
• Individualized risk-benefit counseling

Individualizing Menopausal Treatment

Treatment should consider:

• Age
• Time since menopause
• Symptom severity
• VTE risk
• Breast cancer history
• Cardiovascular disease
• Bone health
• Patient preferences

Breast Cancer Screening

The program compares recommendations from major organizations including:

• USPSTF
• ACOG
• American Cancer Society
• NCCN

with attention to:

• Age at initiation
• Screening interval
• Benefits
• Potential harms

BRCA-Related Cancer Risk Assessment

The curriculum also addresses:

• Family history
• Personal history
• Risk-assessment tools
• Genetic counseling
• Genetic testing

for patients potentially at increased risk of hereditary breast and ovarian cancer.

ENDOCRINOLOGY

Disorders of Thyroid Function

The endocrine curriculum reviews:

• Hypothyroidism
• Hyperthyroidism
• Prevalence
• Diagnosis
• Treatment

Hypothyroidism

Clinical evaluation may incorporate:

• Symptoms
• TSH
• Thyroid hormone testing
• Medication history
• Underlying thyroid disease

Hyperthyroidism

Potential presentations can include:

• Palpitations
• Weight loss
• Tremor
• Heat intolerance
• Anxiety
• Atrial arrhythmias

Accurate diagnosis is important because causes and treatment strategies differ.

Thyroid Nodules & Cancer

The course reviews:

• Nodule evaluation
• Ultrasound
• Cytology
• Risk assessment
• Thyroid malignancy

Thyroid Ultrasound

Ultrasound can provide information about:

• Composition
• Echogenicity
• Margins
• Shape
• Calcifications
• Size
• Lymph nodes

These features help guide decisions about further evaluation.

Thyroid Cytology

Fine-needle aspiration and cytologic interpretation can play an important role when a thyroid nodule meets criteria for sampling.

The goal is to determine:

Which Nodules Need Further Evaluation and Which Can Be Monitored?

Osteoporosis

The course includes an evidence-based review of:

• Epidemiology
• Pathophysiology
• DEXA
• FRAX
• Fracture risk
• Treatment

DEXA

Bone mineral density should be interpreted within the patient’s broader clinical context.

Relevant factors include:

• Age
• Previous fracture
• Family history
• Medication exposure
• Other osteoporosis risk factors

FRAX

FRAX helps estimate fracture probability using clinical risk factors.

The central question should not be only:

What Is the T-score?

but:

What Is This Patient’s Overall Fracture Risk?

Bisphosphonate Therapy

The course reviews both the benefits and risks of bisphosphonate treatment.

Treatment decisions may consider:

• Fracture risk
• Renal function
• Treatment duration
• Adherence
• Adverse effects
• Need for reassessment

Pituitary Disease

The endocrine curriculum also includes:

Evaluation and Management of Pituitary Disease

with emphasis on diagnosis and treatment of common pituitary disorders.

Pituitary Evaluation

Assessment can involve:

• Clinical symptoms
• Hormonal testing
• Imaging
• Evaluation of mass effect
• Referral when appropriate

Pituitary disease can affect multiple endocrine axes, so systematic assessment is important.

VASCULAR MEDICINE

Peripheral Vascular Disease & Medical Therapy

The program reviews the spectrum of disorders grouped under peripheral vascular disease.

Important topics include:

• Atherosclerosis
• Peripheral arterial disease
• Medical risk reduction
• Lipid-lowering agents
• Antiplatelet therapy

Peripheral Arterial Disease

Clinical manifestations can include:

• Claudication
• Reduced pulses
• Ischemic symptoms
• Nonhealing wounds
• Critical limb ischemia in advanced disease

Primary care plays an important role in both diagnosis and systemic cardiovascular risk reduction.

Atherosclerosis

Peripheral vascular disease should not be considered only a localized limb disorder.

Atherosclerosis may indicate broader cardiovascular risk involving:

• Coronary arteries
• Cerebrovascular circulation
• Peripheral arteries

Medical Therapy for PVD

Treatment can involve:

• Smoking cessation
• Exercise
• Lipid management
• Blood pressure management
• Diabetes management
• Antiplatelet therapy when indicated

Stroke: From Initial Presentation to Treatment

The course reviews embolic stroke from:

Recognition → Diagnosis → Medical Treatment → Surgical / Interventional Therapy

Stroke Recognition

Rapid recognition matters because treatment options can be time-sensitive.

Symptoms can include:

• Weakness
• Facial asymmetry
• Speech disturbance
• Visual symptoms
• Coordination problems
• Other focal neurologic deficits

Stroke Imaging & Intervention

Modern stroke management can require coordination among:

• Emergency medicine
• Neurology
• Radiology
• Neurointerventional teams
• Vascular specialists

Aortic & Peripheral Aneurysms

The vascular curriculum provides a primary-care-focused review of:

• Diagnosis
• Surveillance
• Medical management
• Therapeutic options

Aneurysm Management

Treatment planning depends on factors such as:

• Location
• Size
• Growth
• Symptoms
• Patient risk
• Anatomy

Not every aneurysm requires immediate procedural treatment.

Venous Thrombosis

The program concludes its vascular content with evaluation and treatment of venous thrombotic disorders.

Deep Vein Thrombosis

Clinical assessment may consider:

• Symptoms
• Risk factors
• Pretest probability
• Imaging
• Anticoagulation decisions

Venous Thromboembolism

Venous thrombosis can include conditions such as:

• Deep vein thrombosis
• Other venous thrombotic disorders
• Associated embolic complications

Treatment should be individualized according to diagnosis and clinical risk.

Cross-Specialty Connections

One of the strengths of this MER program is the overlap among its four major specialties.

Dermatology + Endocrinology

Endocrine disorders may produce cutaneous manifestations that provide clues to internal disease.

Endocrinology + Gynecology

Bone health, menopause and hormonal disorders overlap substantially through:

• Osteoporosis
• Hormone therapy
• Endocrine evaluation

Gynecology + Vascular Medicine

Women’s health decisions can require attention to:

• Venous thrombosis
• Cardiovascular risk
• Hormone therapy
• Contraceptive or menopausal treatment decisions

Endocrinology + Vascular Medicine

Thyroid disease, metabolic risk and vascular disease can coexist in adult primary care patients.

Dermatology + Systemic Disease

Skin manifestations can sometimes provide early evidence of:

• Autoimmune disease
• Endocrine disease
• Gastrointestinal disease
• Other systemic disorders

Major Dermatology Topics

• Atopic Dermatitis
• Contact Dermatitis
• Irritant Dermatitis
• Nummular Dermatitis
• Seborrheic Dermatitis
• Exfoliative Dermatitis
• Psoriasis
• Lichen Planus
• Pityriasis Rosea
• Lupus Skin Findings
• Systemic Disease Skin Manifestations
• Actinic Keratosis
• Bowen’s Disease
• Squamous Cell Carcinoma
• Basal Cell Carcinoma
• Melanoma
• Punch Biopsy
• Excisional Biopsy

Major Gynecology Topics

• Abnormal Uterine Bleeding
• Ovulatory Bleeding
• Anovulatory Bleeding
• Abnormal Pap Smears
• HPV
• High-Risk HPV
• Cervical Cancer Screening
• HPV Vaccination
• Menopause
• Hormone Replacement Therapy
• SERMs
• Breast Cancer Screening
• BRCA Risk Assessment
• Genetic Counseling

Major Endocrinology Topics

• Hypothyroidism
• Hyperthyroidism
• Thyroid Function
• Thyroid Nodules
• Thyroid Ultrasound
• Thyroid Cytology
• Thyroid Cancer
• Osteoporosis
• DEXA
• FRAX
• Bisphosphonates
• Pituitary Disease

Major Vascular Medicine Topics

• Peripheral Vascular Disease
• Peripheral Arterial Disease
• Atherosclerosis
• Lipid-Lowering Therapy
• Antiplatelet Therapy
• Stroke
• Embolic Stroke
• Interventional Stroke Treatment
• Aortic Aneurysm
• Peripheral Aneurysm
• Venous Thrombosis
• DVT
• Vascular Risk Reduction

Who Should Take This Course?

The original MER activity was designed for office-based primary care providers and other health professionals seeking clinically practical updates.

It is particularly relevant for:

• Primary Care Physicians
• Internists
• Family Medicine Physicians
• Dermatologists
• Endocrinologists
• Gynecologists
• Obstetrician-Gynecologists
• Vascular Medicine Specialists
• General Practitioners
• Hospitalists
• Residents
• Fellows
• Nurse Practitioners
• Physician Assistants / Associates

Why This Course Is Useful

MER Internal Medicine for Primary Care: Derm/Endo/Gyn/Vasc 2026 brings together four specialties that frequently intersect in outpatient adult medicine.

Learners can review:

• Common dermatitis patterns
• Papulosquamous disorders
• Systemic-disease skin manifestations
• Skin cancer recognition
• Abnormal uterine bleeding
• Pap smear and HPV management
• Menopause
• Breast cancer screening
• BRCA risk assessment
• Thyroid dysfunction
• Thyroid nodules
• Osteoporosis
• DEXA and FRAX
• Pituitary disorders
• Peripheral vascular disease
• Stroke
• Aneurysms
• Venous thrombosis

The curriculum can be summarized as:

Skin Disease → Women’s Health → Endocrine Disease → Vascular Medicine

within a practical primary-care framework.

Original MER Accreditation

The original MER conference was listed as:

Internal Medicine for Primary Care: Derm/Endo/Gyn/Vasc – 16 Credit Hours

Important MedicalAmboss CME Notice

The MedicalAmboss product page states that:

CME points and certificate are not included.

Therefore, do not advertise the MedicalAmboss product as:

• 16 CME Credits Included
• Official MER CME Included
• MER Certificate Included

unless official MER registration and credit eligibility are actually included.

Use:

Original MER Activity: 16 Credit Hours

and separately:

MedicalAmboss Product: CME / Certificate Not Included

Product / Delivery Information

• Product: MER Internal Medicine for Primary Care: Derm/Endo/Gyn/Vasc 2026
• Provider: Medical Education Resources – MER
• Official Dates: July 13–16, 2026
• Venue: InterContinental Porto – Palacio das Cardosas
• Location: Porto, Portugal
• Specialties: Dermatology / Endocrinology / Gynecology / Vascular Medicine
• Original Activity: 16 Credit Hours
• Delivery: Google Drive
• CME Points: Not Included
• Certificate: Not Included

4. Short Description

MER Internal Medicine for Primary Care: Derm/Endo/Gyn/Vasc 2026 provides a multidisciplinary update across dermatology, endocrinology, gynecology, and vascular medicine.

Topics include dermatitis, psoriasis, lichen planus, skin manifestations of systemic disease, actinic keratosis, BCC, SCC, melanoma, abnormal uterine bleeding, abnormal Pap/HPV, menopause, breast cancer screening, hypothyroidism, hyperthyroidism, thyroid nodules, osteoporosis, DEXA/FRAX, pituitary disease, peripheral vascular disease, stroke, aneurysms, and venous thrombosis.

Topics

• Dermatitis: Overview of the causes and forms of skin irritants; Contact, atopic, irritant, nummular, seborrheic and exfoliative; Treatment of blistering, oozing, crusting and flaking; Dagnostic principles and management strategies.

• Papulosquamous Diseases: Diagnositic principles of skin lesions consisting of red or purple papules; Psoriasis, lichen planus, pityriasis rosea, lupus erythematosus; Discussion of how to tell one scaly rash from another.

• Skin Manifestations of Systemic Disease: Skin will often reflect signs of systemic diseases, be useful for diagnosis, or suffer from a complication of disease or its treatment; Diagnosis of rheumatalogic, endocrine, gastrointestinal, and psychologic conditions based on cutaneous findings.

• Abnormal Uterine Bleeding: Overview of normal/abnormal menstrual physiology/profile; Menstrual disturbances; Ovulatory and anovulatory uterine bleeding; Other menstrual abnormalities; Diagnosis and appropriate treatment options.

• Abnormal Pap Smears and High Risk HPV: Current recommendations for cervical cancer screening; Incorporating the ASCCP consensus guidelines for management of cytologic cervical abnormalities (including ASCUS, LGSIL, HGSIL and atypical glandular cells) into your practice; Algorithm for the appropriate use of HPV testing; History of HPV and effectiveness of its use; Recommendations for missed doses; Storage and administration of HPV vaccines.

• Menopause Transition and Hormone Replacement Therapy: Symptoms of menopause, including hot flashes, night sweats, and atrophy; Menopause syndromes, including osteoporosis, breast cancer, cardiac disease, and colon cancer; Estrogen analogs; Counseling patients in options and alternatives to hormone therapy; Designer estrogens; SERMS; HRTs; Discussion of risks and benefits, especially in breast cancer and CHD.

• Breast Cancer Screening: Comparison of recent breast cancer screening recommendations from U.S. Preventive Services Task Force, ACOG/ACS/NCCN, including a discussion of risks and benefits of screening at various ages; Review of the new USPSTF guideline on BRCA-related cancer: risk assessment, genetic counseling, and genetic testing, including risk assessment tools for women with a personal or family history of breast, ovarian and related cancers.

• Premalignant and Malignant Skin Tumors: Recognition of precursors of malignancies; Excisional and punch biopsies; Actinic keratosis, Bowen’s disease, squamous cell carcinoma, basal cell carcinoma, melanoma and other selected tumors; Risk reduction education.

• Disorders of Thyroid Function: Prevalence, diagnosis and treatment options of hypothyroidism and hyperthyroidism.

• Thyroid Nodules and Cancer: Diagnosis and treatment.

• Osteoporosis: Review the epidemiology and pathophysiology of osteoporosis along with interpretation of DEXA scans and FRAX risk assessment; up-to-date therapeutic options.

• Evaluation and Management of Pituitary Disease: Diagnosis and treatment of pituitary disorders.

• Peripheral Vascular Disease and Medical Therapy: Defining the spectrum of maladies under the umbrella of Peripheral Vascular Disease including the pathophysiology of atherosclerosis and treatments highlighting lipid lowering agents and antiplatelet therapy.

• Stroke: Initial Presentation to Medical and Surgical Treatment: An overview of embolic stroke including diagnosis and medical, surgical, and interventional therapy.

• Aortic and Peripheral Aneurysms: A guide for primary care outlining diagnosis, management, and therapeutic options.

• Management of Venous Thrombosis: A discussion focusing on the variety of venous thrombotic diagnoses and the multiple available treatment options.