A Systematic Approach to Medically Unexplained Symptoms 2026 – Mayo Clinic | Videos + Course Materials

August 5–8, 2026 | Coronado, California

A Systematic Approach to Medically Unexplained Symptoms 2026 is a comprehensive continuing medical education program designed to help healthcare professionals evaluate and manage patients presenting with persistent, complex, and medically unexplained symptoms.

The course provides a practical, evidence-based approach to common clinical challenges including fibromyalgia, chronic fatigue syndrome (ME/CFS), POTS, chronic dizziness, headaches, insomnia, chronic gastrointestinal symptoms, hypermobility syndromes, pelvic pain, pruritus, chest pain, palpitations, brain fog, chronic pain, fatigue, and functional disorders.

Through expert-led presentations, clinical cases, Q&A sessions, and practical management discussions, participants gain strategies for evaluating complex symptoms while improving communication and establishing realistic, patient-centered treatment plans.

The 2026 program was held August 5–8, 2026 at Loews Coronado Bay Resort in Coronado, California.

Course Details

Course: A Systematic Approach to Medically Unexplained Symptoms 2026
Dates: August 5–8, 2026
Location: Loews Coronado Bay Resort, Coronado, California, USA
Format: Recorded Educational Course
Specialty: Internal Medicine / Family Medicine / Primary Care
Year: 2026

Target Audience

This course is intended for:

• General internists
• Internal medicine subspecialists
• Family medicine physicians
• Primary care physicians
• Physician assistants
• Nurse practitioners
• Other healthcare professionals caring for medically complex patients

It is particularly useful for clinicians who frequently encounter patients with persistent symptoms for which conventional diagnostic testing does not provide a straightforward explanation.

Learning Objectives

Upon completion of this educational activity, participants should be able to:

1. Differentiate between nociceptive, neuropathic, and nociplastic pain mechanisms.
2. Evaluate postural orthostatic tachycardia syndrome (POTS).
3. Critique commonly reported patient etiologies using current evidence while providing empathetic and scientifically accurate counseling.
4. Apply practical nonpharmacologic strategies for managing chronic pain, fatigue, orthostatic intolerance, and brain fog.
5. Identify treatment strategies for fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

A Systematic Approach to Medically Unexplained Symptoms 2026 – Program

Wednesday, August 5, 2026

Introduction and Brief Pathophysiologic Overview of Medically Unexplained Symptoms

Michael R. Mueller, MD

An introduction to the mechanisms and clinical concepts underlying medically unexplained and persistent physical symptoms.

Fibromyalgia

LaSonya T. Natividad, APRN, CNP, MSN

Clinical evaluation and management strategies for patients with fibromyalgia.

Biofeedback and Wearable Devices

Chris A. Aakre, MD

Exploring the role of biofeedback technologies and wearable devices in symptom assessment and management.

Approach to Breast Pain

Sandhya Pruthi, MD

Practical strategies for evaluating and managing breast pain.

Approach to Chronic Headaches

Nathan P. Young, DO

Clinical approaches to patients presenting with persistent and recurrent headaches.

Evaluation of Thyroid Hormones: Myths, Truths, and In-Between

Mabel Ryder, MD

A practical review of thyroid hormone testing, interpretation, common misconceptions, and evidence-based management.

Rapid Fire Case

Course Director

Interactive clinical case discussion incorporating concepts from the day’s presentations.

Communicate with Confidence Workshop

Wednesday, August 5, 2026

This was an optional workshop requiring separate registration and was offered in person only.

Discussion of Complex Cases, Pre-Test

Emrys Fonseca, MB, BCh, BAO, MS

Communication principles and techniques designed to build clinician-patient partnerships, educate patients, and foster hope during complex clinical encounters.

Group Case Exercise

Stephanie Grach, MD, MS

Small-group application of communication skills using clinical case scenarios.

Role Playing Case Exercise

Emrys Fonseca, MB, BCh, BAO, MS
Stephanie Grach, MD, MS

Practical role-playing exercises allowing participants to experience both patient and healthcare-provider perspectives.

Large Group Discussion, Post-Test

Emrys Fonseca, MB, BCh, BAO, MS

Patient-centered educational and therapeutic language designed to validate patient experiences, communicate scientific concepts clearly, and create momentum toward appropriate self-management, referrals, and follow-up.

Thursday, August 6, 2026

Myalgic Encephalomyelitis / Chronic Fatigue Syndrome

Stephanie L. Grach, MD, MS

Evaluation and treatment considerations for ME/CFS and persistent fatigue.

Chronic Dizziness: A New Approach to an Old Problem

Elizabeth Westby, MD

A modern clinical approach to evaluating and treating chronic dizziness.

Approach to Insomnia

Mithri Junna, MD

Evidence-based evaluation and management of persistent sleep difficulties.

Chest Pain and Palpitations

Michael W. Cullen, MD

A structured approach to evaluating patients presenting with chest discomfort and palpitations.

Postural Tachycardia Syndrome

Daniel V. Dudenkov, MD

Evaluation and management of postural orthostatic tachycardia syndrome (POTS).

Rapid Fire Case

Course Director

Interactive case discussion integrating the day’s clinical topics.

Friday, August 7, 2026

Hypermobile Ehlers-Danlos and Hypermobility Syndromes

Shilpa Gajarawala, DMSc, MPAS, PA-C

Recognition and management considerations for hypermobility-related disorders.

Approach to Chronic Gastrointestinal Symptoms

Amindra S. Arora, MB, BChir

Evaluation of patients experiencing persistent gastrointestinal complaints.

Understanding Low Cortisol and Adrenal Fatigue: Clinical Insights for Primary Care

Neena Natt, MD

An evidence-based review of cortisol abnormalities, adrenal function, and commonly encountered misconceptions.

Importance of Patient Stories and Medically Unexplained Symptoms

Denise Millstine, MD

Understanding the importance of the patient’s narrative when evaluating complex and persistent symptoms.

A Practical Approach to Pruritus of Unknown Origin

Jenny L. Link, MD

Diagnostic and management strategies for patients presenting with unexplained chronic itching.

The Dreaded Disability Form

Melanie D. Swift, MD, MPH

Practical considerations when clinicians encounter disability documentation in patients with complex or persistent symptoms.

Rapid Fire Case

Course Director

Case-based discussion incorporating the day’s major learning points.

Saturday, August 8, 2026

Psychiatric and Functional Disorders in General Medical Practice

Jeffrey P. Staab, MD

Recognition and clinical management of psychiatric and functional disorders encountered in general medical practice.

Approach to Pelvic Pain and Dysfunction

Isabel C. Green, MD, MHPE

Clinical evaluation and management strategies for persistent pelvic pain and dysfunction.

Does Menopausal Hormone Therapy Fix Everything? Reviewing Evidence and Setting Expectations

Jean Marie McGowan, MD

A practical evidence-based review of menopausal hormone therapy, appropriate indications, limitations, and patient expectations.

Physician Burnout / Taking Care of Ourselves

Greg P. Couser, MD, MPH

Recognizing clinician burnout and developing practical strategies for professional well-being.

Cross-Cultural Communication Video

Darryl S. Chutka, MD

Strategies for improving communication and understanding across cultural differences in healthcare.

Rapid Fire Case

Course Director

Final case-based discussion integrating concepts from the 2026 program.

Key Topics Covered

• Medically unexplained symptoms
• Persistent physical symptoms
• Nociplastic pain
• Chronic pain management
• Fibromyalgia
• ME/CFS
• Chronic fatigue
• Postural orthostatic tachycardia syndrome (POTS)
• Orthostatic intolerance
• Brain fog
• Chronic dizziness
• Chronic headaches
• Insomnia
• Chest pain and palpitations
• Hypermobile Ehlers-Danlos syndrome
• Hypermobility syndromes
• Chronic gastrointestinal symptoms
• Thyroid hormone evaluation
• Low cortisol and adrenal fatigue
• Breast pain
• Pelvic pain and dysfunction
• Pruritus of unknown origin
• Psychiatric and functional disorders
• Menopausal hormone therapy
• Biofeedback
• Wearable devices
• Patient-centered communication
• Cross-cultural communication
• Physician burnout
• Complex patient management

Why This Course Is Useful

Patients with persistent or medically unexplained symptoms can represent some of the most challenging encounters in internal medicine and primary care.

This program brings together experts from multiple disciplines to provide clinicians with a structured approach to these presentations. Rather than focusing solely on excluding disease, the course addresses symptom mechanisms, evidence-based treatment, patient communication, functional disorders, and practical management strategies.

It is particularly relevant for physicians and healthcare professionals treating patients with overlapping symptoms such as pain, fatigue, dizziness, palpitations, gastrointestinal complaints, sleep disturbance, orthostatic intolerance, and cognitive symptoms.

Delivery Information

Digital Course Delivery

Course materials are delivered digitally through Google Drive.

• Easy online access
• Download course files
• Keep downloaded files for future personal study
• Watch at your own pace
• No physical shipment required