Honestly, I think I prefer and use Medscape more often than UtD; its format of intro, presentation, ddx, workup, and treatment is very concise and easier to find what I want than wading through UtD articles, though those do have their place.
To answer OP, I'm sure you could manage without one, but it would be more difficult. Especially when course directors or whoever are sending time-sensitive emails throughout the day. Otherwise you could probably make it work with all the workstations around, or if you used a tablet for on the go things.