Bonne année!

The CSIM website is introducing something new, a blog called “Cogitation”.  It is a bilingual forum for sharing reflections and exchanging opinions on all matters pertaining to general internal medicine.

Some years ago, before I was even an internal medicine resident, I had the good fortune of doing an elective with Dr. Linda Snell and other inspiring general internists at the Royal Victoria Hospital at McGill University.  It was a career changing experience, because it taught me to be reflective (as opposed to reflexive) in the practice of medicine and drove me to become a general internist as well.

Of course, being thoughtful is not a trait exclusive to internists, but it is one that we cherish deeply.  Sir William Osler referred to cogitation as the fifth manoeuvre (along with inspection, palpation, percussion, and auscultation).(1)  For example, we often see evidence of cogitation in the internist’s approach to clinical reasoning, strategy for investigations, management of multiple concurrent medical issues, discussion with patients and their families, consultations with colleagues, mentorship of trainees, and dealings with health organizations and policy makers.  And, hopefully, internists are also mindful of their roles within their families and their communities.

Cogitation is thus an open space for us to share with other internists our unhurried thoughts, insights, opinions, or comments.  Hopefully, this will be a useful opportunity for exchanging ideas, provoking conversations, obtaining broader input, and deepening the sense of community among CSIM members.

Les articles de blog et les commentaires peuvent être en français, en anglais, ou bilingue.  Send your blog posts to  I look forward to hearing from as many of you as possible.

Meilleurs voeux pour 2014!

Benjamin Chen, MD
President, CSIM
Napanee, Ontario

(1) Sapira JD. The Art and Science of Bedside Diagnosis. 1st ed. Baltimore: Williams & Wilkins, 1990:309.