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

Dermatology • Endocrinology • Oncology • Vascular Medicine | June 21–25, 2026

The MER Internal Medicine for Primary Care: Derm/Endo/Onc/Vasc 2026 course provides a multidisciplinary clinical review of important conditions encountered in adult primary care, combining practical updates in Dermatology, Endocrinology, Oncology, and Vascular Medicine.

Presented by Medical Education Resources (MER), the original conference was held June 21–25, 2026, at Aulani, A Disney Resort & Spa in Ko Olina, Oahu, Hawaii.

The curriculum covers a broad range of clinically relevant topics, including:

• Type 1 and Type 2 Diabetes
• Insulin Therapy
• Osteoporosis
• DEXA and FRAX
• Hypothyroidism and Hyperthyroidism
• Thyroid Nodules and Thyroid Cancer
• Peripheral Vascular Disease
• Stroke
• Aortic and Peripheral Aneurysms
• Venous Thrombosis
• Dysvascular Limb Disease
• Cancer Prevention
• Evaluation of Suspected Cancer
• Cancer Survivorship
• Antiplatelet Therapy
• Oral Anticoagulants
• Dermatitis
• Cutaneous Manifestations of Systemic Disease
• Acne and Acneiform Eruptions
• Benign Skin Tumors
• Premalignant Skin Lesions
• Basal Cell Carcinoma
• Squamous Cell Carcinoma
• Melanoma

The program emphasizes practical diagnosis, risk assessment, individualized treatment, prevention, and appropriate referral strategies applicable to everyday primary care and internal medicine.

Course Details

• Course: Internal Medicine for Primary Care: Derm/Endo/Onc/Vasc
• Provider: Medical Education Resources – MER
• Year: 2026
• Dates: June 21–25, 2026
• Duration: 5 Days
• Venue: Aulani, A Disney Resort & Spa
• Location: Ko Olina, Oahu, Hawaii
• Primary Area: Internal Medicine / Primary Care
• Specialties: Dermatology / Endocrinology / Oncology / Vascular Medicine
• Original Live Activity: 20 Credit Hours
• Original Pharmacotherapeutic Content: 10.50 ANCC Pharmacotherapeutic Contact Hours
• Delivery: Google Drive
• CME / Certificate with MedicalAmboss Product: Not Included
• Language: English

Course Overview

Primary care physicians frequently encounter diseases that cross traditional specialty boundaries.

A patient with diabetes, for example, may also have:

• Peripheral arterial disease
• Stroke risk
• Skin complications
• Cardiovascular risk
• Cancer screening needs

Similarly, a patient with an unexplained skin finding may have an underlying:

• Endocrine disorder
• Rheumatologic condition
• Gastrointestinal disease
• Systemic illness

This course brings together four specialties that frequently overlap in outpatient and internal medicine practice.

A practical framework throughout the program is:

Recognize → Evaluate → Risk Stratify → Treat → Prevent → Monitor

Learning Objectives

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

• Develop individualized treatment strategies for Type 2 diabetes.
• Differentiate management approaches for Type 1 and Type 2 diabetes.
• Review practical insulin therapy.
• Identify benefits and risks of bisphosphonate treatment in osteoporosis.
• Interpret DEXA and FRAX concepts in fracture-risk assessment.
• Recognize risks associated with abnormal thyroid function.
• Evaluate thyroid nodules using ultrasound and cytology.
• Review diagnosis and management of thyroid cancer.
• Describe the clinical spectrum of peripheral vascular disease.
• Review diagnosis and treatment of embolic stroke.
• Understand medical, surgical, and interventional stroke treatment.
• Evaluate aortic and peripheral aneurysms.
• Diagnose and manage venous thrombosis.
• Evaluate lower-extremity swelling and vascular ulcers.
• Review evidence-based cancer prevention practices.
• Develop a systematic approach to suspected malignancy.
• Review health issues affecting cancer survivors.
• Understand mechanisms and clinical use of modern antiplatelet agents.
• Review contemporary oral anticoagulants and reversal strategies.
• Differentiate atopic, allergic contact, irritant, and nummular dermatitis.
• Recognize cutaneous clues to systemic disease.
• Apply a stepwise approach to acne and acneiform eruptions.
• Differentiate common benign and malignant skin lesions.
• Recognize premalignant and cancerous skin lesions.
• Understand indications for office biopsy and specialist referral.

Endocrinology

Type 2 Diabetes Mellitus

This session reviews important aspects of Type 2 diabetes, including:

• Diagnosis
• Screening
• Prediabetes
• Diabetic emergencies
• Individualized treatment
• Contemporary management principles

Modern diabetes therapy should be adapted to the individual patient rather than applying the same treatment strategy to everyone.

Important considerations can include:

• Glycemic status
• Cardiovascular disease
• Kidney disease
• Body weight
• Hypoglycemia risk
• Comorbidities
• Medication tolerance
• Patient preferences

A practical workflow is:

Assess Patient → Set Goals → Lifestyle Intervention → Select Therapy → Monitor → Adjust

Insulin Therapy for Diabetes

The program reviews insulin treatment for both:

• Type 1 Diabetes
• Type 2 Diabetes

Important concepts include:

• When insulin is required
• Insulin initiation
• Treatment adjustment
• Glucose monitoring
• Hypoglycemia prevention
• Individualized treatment

Type 1 vs. Type 2 Diabetes

Type 1 Diabetes

Treatment requires insulin replacement because of severe insulin deficiency.

Type 2 Diabetes

Management may incorporate:

• Lifestyle intervention
• Non-insulin medications
• Injectable therapies
• Insulin when appropriate

Osteoporosis

The osteoporosis session reviews:

• Epidemiology
• Pathophysiology
• Bone mineral density
• DEXA interpretation
• FRAX
• Fracture-risk assessment
• Bisphosphonates
• Contemporary treatment options

DEXA & FRAX

Bone-density results should be interpreted together with clinical fracture risk.

A practical approach is:

Clinical Risk → DEXA → FRAX → Fracture Risk → Treatment Decision

The central goal of osteoporosis treatment is ultimately:

Fracture Prevention

rather than simply improving a numerical bone-density value.

Disorders of Thyroid Function

The program reviews:

• Hypothyroidism
• Hyperthyroidism
• Thyroid-function testing
• Clinical risks
• Diagnosis
• Treatment

Abnormal thyroid function may affect:

• Cardiovascular health
• Bone health
• Metabolism
• Weight
• Mood
• Neurologic function

Thyroid Nodules & Cancer

This session reviews diagnosis and management of thyroid nodules and thyroid malignancy.

Important components include:

• Clinical history
• Risk assessment
• Thyroid ultrasound
• Nodule characteristics
• Fine-needle aspiration
• Cytology
• Surveillance
• Treatment

A practical pathway is:

Nodule Detected → Ultrasound → Risk Classification → FNA When Appropriate → Cytology → Follow-Up or Treatment

Vascular Medicine

Peripheral Vascular Disease & Medical Therapy

This session reviews the spectrum of peripheral vascular disease with emphasis on atherosclerosis and medical treatment.

Topics include:

• Peripheral arterial disease
• Atherosclerosis
• Vascular risk factors
• Lipid-lowering therapy
• Antiplatelet therapy
• Cardiovascular prevention

Peripheral Arterial Disease

Peripheral arterial disease should be viewed as a manifestation of systemic vascular disease.

Assessment should consider:

• Smoking
• Diabetes
• Dyslipidemia
• Hypertension
• Cardiovascular disease
• Cerebrovascular risk

Treatment can involve:

Risk-Factor Modification → Medical Therapy → Exercise → Vascular Evaluation → Revascularization When Appropriate

Stroke: Initial Presentation to Medical and Surgical Treatment

The course provides an overview of embolic stroke, including:

• Initial presentation
• Diagnosis
• Imaging
• Medical treatment
• Surgical treatment
• Interventional therapy

Rapid identification is essential because treatment eligibility may be highly time dependent.

Stroke Evaluation

A practical sequence is:

Recognize Neurologic Deficit → Immediate Assessment → Brain/Vascular Imaging → Determine Stroke Type → Evaluate Treatment Options

Aortic & Peripheral Aneurysms

The program reviews:

• Diagnosis
• Surveillance
• Risk assessment
• Medical management
• Therapeutic options
• Referral

Treatment depends on factors such as:

• Aneurysm location
• Diameter
• Growth
• Symptoms
• Rupture risk
• Patient comorbidities

Management of Venous Thrombosis

This session reviews venous thrombotic disorders and available treatment options.

Important concepts include:

• Deep vein thrombosis
• Venous thromboembolism
• Clinical probability
• Diagnostic testing
• Anticoagulation
• Duration of therapy
• Bleeding risk
• Recurrence risk

Venous Thrombosis Workflow

A useful framework is:

Clinical Probability → Diagnostic Testing → Confirm Thrombosis → Select Anticoagulant → Determine Duration → Follow-Up

The Dysvascular Limb: Swelling & Ulcers

Lower-extremity swelling and ulcers may result from multiple conditions.

Potential causes include:

• Venous insufficiency
• Peripheral arterial disease
• Lymphedema
• Heart failure
• Renal disease
• Neuropathy
• Medication effects

Correctly identifying the mechanism is essential before treatment.

Leg Ulcers

Important categories include:

• Venous ulcers
• Arterial ulcers
• Neuropathic ulcers
• Pressure-related ulcers
• Inflammatory ulcers
• Mixed disease

The appearance of the lesion and the vascular status of the limb can help guide evaluation.

Oncology

Cancer Prevention

Cancer prevention and screening are core components of adult primary care.

The course reviews clinical practices associated with:

• Reducing cancer risk
• Identifying high-risk individuals
• Appropriate screening
• Earlier detection

Approach to the Patient with Suspected Cancer

Potential warning features can include:

• Unexplained weight loss
• Persistent symptoms
• Abnormal bleeding
• Unexplained anemia
• New masses
• Persistent lymphadenopathy
• Abnormal imaging
• Laboratory abnormalities

A structured pathway is:

Symptoms / Signs → Cancer Risk → Focused Testing → Imaging / Biopsy → Oncology Referral When Appropriate

Management of Cancer Survivors

Cancer survivorship is increasingly part of routine internal medicine.

Important considerations include:

• Cancer recurrence surveillance
• Secondary malignancies
• Cardiovascular complications
• Endocrine effects
• Treatment-related toxicity
• Functional health
• Preventive medicine
• Long-term coordination of care

Survivorship Care

Management may require collaboration between:

• Oncology
• Primary care
• Cardiology
• Endocrinology
• Other specialists

The objective is not only monitoring cancer recurrence but managing the patient’s long-term overall health.

New Antiplatelet Agents

The course reviews:

• Mechanisms of action
• Clinical indications
• Effectiveness
• Safety
• Periprocedural management

Antiplatelet treatment may be relevant to:

• Coronary artery disease
• Cerebrovascular disease
• Peripheral arterial disease
• Post-interventional vascular care

Balancing Thrombosis & Bleeding

A major principle is:

Thrombotic Risk ↔ Bleeding Risk

The optimal treatment depends on the individual patient rather than simply the availability of a newer drug.

New Oral Anticoagulants

Topics include:

• Mechanisms of action
• Indications
• Clinical use
• Safety
• Perioperative management
• Reversal strategies

Primary care clinicians frequently manage anticoagulation for:

• Atrial fibrillation
• DVT
• Pulmonary embolism
• Other thromboembolic disorders

Dermatology

Dermatitis

The dermatology curriculum reviews:

• Atopic dermatitis
• Allergic contact dermatitis
• Irritant contact dermatitis
• Nummular dermatitis
• Seborrheic dermatitis
• Exfoliative dermatitis
• Blistering
• Oozing
• Crusting
• Flaking

Differentiating Dermatitis

A useful clinical framework considers:

Morphology + Distribution + Exposure History + Symptoms + Chronicity

Correctly classifying dermatitis can help guide appropriate treatment.

Skin Manifestations of Systemic Disease

The skin may provide diagnostic clues to diseases involving other organ systems.

Relevant associations include:

• Rheumatologic disease
• Endocrine disease
• Gastrointestinal disease
• Psychological conditions
• Systemic illness
• Treatment-related reactions

The key question is:

Is This an Isolated Skin Disorder or a Manifestation of Internal Disease?

Acne & Acneiform Eruptions

The course provides a stepwise review of:

• Open comedones
• Closed comedones
• Inflammatory acne
• Acne grading
• Topical therapy
• Systemic therapy

It also discusses conditions that may mimic or overlap with acne, including:

• Bacterial folliculitis
• Drug-induced acne
• Hidradenitis suppurativa
• Miliaria
• Perioral dermatitis
• Pseudofolliculitis barbae
• Rosacea
• Seborrheic dermatitis

Acne Treatment Strategy

A practical approach is:

Identify Lesion Type → Grade Severity → Select Therapy → Assess Response → Escalate When Needed

Benign Skin Tumors

The program reviews common benign lesions, including:

• Nevi
• Seborrheic keratoses
• Keloids
• Hemangiomas
• Other benign tumors

Important clinical questions include:

• Is the lesion benign?
• Does it require biopsy?
• Is histopathology needed?
• When should dermatology referral occur?

Premalignant & Malignant Skin Tumors

This section reviews:

• Actinic keratosis
• Bowen’s disease
• Squamous cell carcinoma
• Basal cell carcinoma
• Melanoma
• Excisional biopsy
• Punch biopsy
• Histopathology
• Risk-reduction education

Skin Cancer Recognition

Actinic Keratosis

A common premalignant lesion associated with cumulative ultraviolet exposure.

Basal Cell Carcinoma

A very common cutaneous malignancy requiring appropriate identification and treatment.

Squamous Cell Carcinoma

Recognition and appropriate treatment are important because behavior and metastatic potential vary according to lesion characteristics.

Melanoma

Early recognition is particularly important because prognosis is strongly related to stage at diagnosis.

Major Endocrinology Topics

• Type 1 Diabetes
• Type 2 Diabetes
• Insulin Therapy
• Prediabetes
• Osteoporosis
• DEXA
• FRAX
• Bisphosphonates
• Hypothyroidism
• Hyperthyroidism
• Thyroid Nodules
• Thyroid Ultrasound
• Thyroid Cytology
• Thyroid Cancer

Major Vascular Medicine Topics

• Peripheral Vascular Disease
• Peripheral Arterial Disease
• Atherosclerosis
• Stroke
• Embolic Stroke
• Aortic Aneurysm
• Peripheral Aneurysm
• Venous Thrombosis
• DVT
• Dysvascular Limb
• Lower-Extremity Swelling
• Leg Ulcers
• Antiplatelet Therapy
• Oral Anticoagulants

Major Oncology Topics

• Cancer Prevention
• Cancer Screening
• Suspected Cancer
• Cancer Diagnosis
• Cancer Survivorship
• Cancer Recurrence Surveillance
• Long-Term Cancer Care

Major Dermatology Topics

• Atopic Dermatitis
• Contact Dermatitis
• Nummular Dermatitis
• Seborrheic Dermatitis
• Cutaneous Manifestations of Systemic Disease
• Acne
• Acneiform Eruptions
• Hidradenitis Suppurativa
• Rosacea
• Folliculitis
• Benign Skin Tumors
• Actinic Keratosis
• Bowen’s Disease
• Basal Cell Carcinoma
• Squamous Cell Carcinoma
• Melanoma
• Skin Biopsy

Who Should Take This Course?

The program is particularly relevant for:

• Internists
• Primary Care Physicians
• Family Medicine Physicians
• Dermatologists
• Endocrinologists
• Oncologists
• Hematologists / Oncologists
• Vascular Medicine Specialists
• Cardiologists
• Hospitalists
• General Practitioners
• Residents
• Fellows
• Nurse Practitioners
• Physician Assistants / Associates
• Other healthcare professionals caring for adult patients

Why This Course Is Useful

One of the strengths of MER Internal Medicine for Primary Care: Derm/Endo/Onc/Vasc 2026 is the substantial clinical overlap between its four specialties.

The program can help clinicians:

• Improve diabetes treatment planning
• Review insulin therapy
• Improve osteoporosis assessment
• Interpret DEXA and FRAX
• Evaluate thyroid dysfunction
• Improve thyroid nodule assessment
• Recognize peripheral vascular disease
• Review stroke management
• Evaluate aneurysms
• Manage venous thrombosis
• Assess dysvascular limb problems
• Improve cancer prevention
• Evaluate suspected malignancy
• Manage cancer survivors
• Update antiplatelet knowledge
• Review oral anticoagulants
• Differentiate dermatitis
• Recognize systemic disease through skin findings
• Treat acne more systematically
• Identify benign skin tumors
• Detect premalignant and malignant skin lesions

Original Conference Accreditation

The original MER activity was listed as:

Internal Medicine for Primary Care: Derm/Endo/Onc/Vasc – 20 Credit Hours

with:

10.50 ANCC pharmacotherapeutic contact hours

Important CME / Certificate Notice

These credits belong to eligible participation in the official MER educational activity.

The MedicalAmboss digital product states that CME points and certificate are not included.

Therefore, do not advertise the MedicalAmboss product as:

• 20 CME Credits Included
• 20 MOC Points Included
• 10.50 Pharmacology Hours Included
• Official MER Certificate Included

Use instead:

Original MER Live Activity: 20 Credit Hours

and:

CME / Certificate Not Included with the MedicalAmboss Product

Product / Delivery Information

• Product: MER Internal Medicine for Primary Care: Derm/Endo/Onc/Vasc 2026
• Provider: Medical Education Resources – MER
• Year: 2026
• Dates: June 21–25, 2026
• Venue: Aulani, A Disney Resort & Spa
• Location: Ko Olina, Oahu, Hawaii
• Specialties: Dermatology / Endocrinology / Oncology / Vascular Medicine
• Original Live Activity: 20 Credit Hours
• Delivery: Google Drive
• CME Points: Not Included
• Certificate: Not Included

4. Short Description

MER Internal Medicine for Primary Care: Derm/Endo/Onc/Vasc 2026 provides a five-day multidisciplinary update across dermatology, endocrinology, oncology, and vascular medicine.

Topics include type 1 and type 2 diabetes, insulin therapy, osteoporosis, DEXA/FRAX, thyroid disease and nodules, peripheral vascular disease, stroke, aneurysms, venous thrombosis, cancer prevention and survivorship, antiplatelet and anticoagulant therapy, dermatitis, systemic skin manifestations, acne, benign skin tumors, melanoma, and other skin cancers.

4. Topics

Endocrinology

• Type 2 Diabetes Mellitus: Diagnosis and treatment; lessons from the DCCT; managing diabetic emergencies; screening; pre-diabetes.

• Insulin Therapy for Diabetes: Treating T2DM with insulin; T1DM.

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

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

• Thyroid Nodules and Cancer: Diagnosis and treatment.

Vascular Medicine

• 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.

• The Dysvascular Limb: How to Approach Swelling and Ulcers: An organizational approach to swelling and lower extremity ulceration focusing on the differential diagnosis, pathophysiology, and treatment.

Oncology

• Cancer Prevention: Cancer screening and clinical practices shown to prevent cancer will be reviewed.

• Approach to the Patient with Suspected Cancer: Symptoms, signs and diagnoses that raise the suspicion of cancer will be reviewed, and an approach to evaluating these patients will be presented.

• Management of Cancer Survivors: Medical issues related to cancer survivorship and approaches to surveillance for cancer recurrence will be reviewed.

• A Primary Care Review of New Antiplatelet Agents: Mechanisms of action, clinical indications, effectiveness, safety and peri-procedure management of current antiplatelet agents will be reviewed.

• A Primary Care Review of New Oral Anticoagulants: Mechanisms of action, clinical indications, therapeutic indices, perioperative management and approaches to reversal of new anticoagulant and antiplatelet medications will be reviewed.

Dermatology

• 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.

• 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.

• Acne and Acneiform Eruptions: Identification of noninflammatory open or closed comedones and inflammatory lesions; Determination of treatment therapies based on acne grading scale; Bacterial folliculitis, drug-induced acne, hidradenitis suppurativa, miliaria, perioral dermatits, pseudofolliculitis barbae, rosacea, seborrheic dermatitis; Topical and systemic therapy.

• Benign Skin Tumors: Proper diagnosis and treatment of common benign tumors; Biopsies and histopathologic examination; Nevi, seborrheic keratosis keloids, hemangiomas and miscellaneous tumors; When to refer.

• 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.