As well as learning some interesting medicine we saw the differences in access to investigations between countries as well as the clinical management decisions. Day 1 for example, brought a juxtaposition of a lecture on osteoporosis and end of life decisionmaking. This was followed by an interactive workshop discussing the escalation plan for a patient admitted with an exacerbation of severe COPD. It was fascinating to discuss each trainee’s view and ultimately the ‘country’s’ view on treatment, ITU and resuscitation. We heard how some trainees were taught that everyone who was critically ill should be moved to ITU and intubated regardless of other considerations.

Daily we had a session where each country presented an interesting or unusual clinical case. The presentations were of a high quality ranging from heavy metal poisoning to multiple endocrine neoplasia (MEN). As well as learning some interesting medicine we saw the differences in access to investigations between countries as well as the clinical management decisions. I presented the case of polycythemia vera in a young patient with repeated episodes of acute stroke. The presentations were made available after the school too.