Podcasts about racp

There is evidence that six months or more off the job leads to some loss of practical skills and knowledge and certainly, many doctors a loss of self-confidence. People take time out from medical practice for many different reasons but career breaks to raise children are more common than ever before. Paediatrics is one specialty where female representation exceeds 70 percent and it is also becoming more common for new fathers to take leave as primary carers. Senior staff at Sydney Children's Hospital have developed a day-long workshop to help medics brush off the cobwebs before they return to practice. It involves rehearsal of specific skills, refreshers on calculation and interpretation tasks and a high-fidelity critical care simulation. Just as importantly, there is open discussion and mentorship to support the transition back to work. The program is called Paediatric Returnees after Maternity or Extended Leave (PRAM) this podcast was recorded during a live workshop at the Kids Simulation Centre, Randwick.  GuestsWorkshop participants: Elodie, Eliza, Emma, April, Stephanie, Lucy and Paula. PRAM creators:Dr Josephine Goodyer FRACP (Sydney Children's Hospital, Randwick) Dr Sasha Symonds FRACP FACEM (Sydney Children's Hospital, Randwick) Renee Byrne (Sydney Children's Hospital, Randwick) ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Elm Lake' by Elm Lake, ‘Quiet Waters' by Walt Adams, ‘Illuminations 4' by Johannes Bornlöf, ‘Feeling Minnesota by Gavin Luke, and ‘Maybe This Time' by Major Tweaks. Image by Maskot licenced through Getty Images. Editorial feedback kindly provided by RACP physicians Sasha Taylor, Stephen Bacchi,Simeon Wong, Zac Fuller, Hugh Murray, Aidan Tan, Sern Wei Yeoh, Sasha Taylor and Stella Sarlos. Thanks also to RACP staff Arnika Martus and Kathryn Smith. Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity.  

In this episode we hear about an emergency presentation to a South Australian hospital, of a 74-year-old male with shortness of breath. The curve ball is that he had undergone ablation for drug-refractory atrial fibrillation less than two weeks prior. This discussion gives an overview of developing technologies for AF treatment and developing knowledge about the possible complications. We also have some multiple choice questions to test your understanding.Guest Dr Shaun Evans, FRACP (Royal Adelaide Hospital; University of Adelaide) HostsAssociate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide)Jasmine Le (University of Adelaide) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Hugh Murray, Aidan Tan, Aafreen Khalid, Sebastiaan Lambooy, Amy Hughes and Lauren Gomes.  Key Reference (Spoiler Alert)*****Delayed cardiac tamponade from pericarditis following pulmonary vein cryo-balloon ablation [IMJ. 2020] Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

In Aotearoa-New Zealand, the proportion of doctors identifying as Māori has doubled from where it was a decade ago to over 5 percent. But there is still a long way to go before the workforce is representative of the broader population which is 17 percent Māori.The Auckland and Otago Medical Schools have in recent years turbocharged their intake of Māori and Pasifika students but these graduates don't seem to have trickled through to the RACP in great numbers. Just 3.5 percent of general physicians and 4.8 percent of paediatricians identify as Māori, and Pasifika doctors make up a further 1 and 2 percent respectively.In this podcast, three Māori medics discuss how the culture of training environments can be made more welcoming to junior doctors with diverse ethnic backgrounds. This discussion takes place in light of an independent review into the clinical examination for paediatrics in Aotearoa-New Zealand which found issues with standardization, transparency and cultural safety. 2024 was a tough year for Māori Health more broadly, as it saw the disestablishment of a dedicated Health Authority, Te Aka Whai Ora, after just twelve months of operation. Guests Dr Danny de Lore FRACP (Rotorua Hospital; University of Auckland)Dr Matthew Wheeler FRACP (Tauranga Hospital; University of Auckland)Dr Ngaire Keenan PhD (Sydney Children's Hospital, Westmead; University of Otago)ProductionProduced by Mic Cavazzini DPhil. Music provided courtesy of FreeMusicArchive includes ‘Periodicals', ‘In Paler Skies' by Blue Dot Sessions and ‘Wake Up' by Kai Engel. Music licenced from Epidemic Sound includes ‘Subdivision of the Masses' by Philip Weigl and ‘Abyss' by Luwaks. Image of Dr Danny de Lore property of RACP  Editorial feedback kindly provided by RACP physicians Zac Fuller, Aidan Tan, Hugh Murray, Sasha Taylor, Anne-Marie Juengling and Simeon Wong. Thanks also to RACP staff Nick McCurdy and Sarah Millar. Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app. 

This case report comes to you from Brigham and Women's Hospital in Boston, a huge teaching hospital that serves the Harvad Medical School. The 52-year-old female presented with clumsiness and paresthesia of the right hand that had persisted for several days. She also had a headache and three weeks prior to presentation had undergone a suboccipital craniotomy for a Chiari I malformation. To complicate things, there was a past medical history of migraines and a family history of a Factor V Leiden mutation. The identified diagnosis is one in which evidence is limited for aspects of management, and the topics of uncertainty and mentorship in medicine also arise in this discussion.Guest Galina Gheihman, MD D (Brigham and Women's Hospital; Harvard Medical School) HostsAssociate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide)HaeLynn Gim (Harvard Medical School) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by Dr Sebastiaan Lambooy.Key Reference (Spoiler Alert)* * * * *Isolated Cortical Vein Thrombosis [Neurohospitalist. 2023]  Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Andrew Black from Tasmania, Australia. They discuss his paper that systematically reviewed the evidence for RACP clinics. If you enjoy the show, please leave us a podcast review wherever you get your podcast. Link to published paper: https://heart.bmj.com/content/110/24/1395

Welcome to the Sustainable Clinical Medicine Podcast! In this episode our host Dr. Sarah Smith is joined by Dr. Susannah Ward, a rehabilitation specialist with a deep commitment to wellness in medicine. Dr. Ward shares her journey through the challenges of the public health system in Australia, her discovery of holistic wellness practices like yoga, and her advocacy for a nurturing and diverse medical culture. Together, they explore the importance of self-awareness, acceptance, and adaptive self-care in creating sustainable clinical practices. Dr. Ward's insights offer valuable perspectives on cultivating resilience and wellness among healthcare professionals, as well as her ongoing work to improve workplace culture through initiatives such as retreats and her book, "Mastering Real Wellness." Join us to hear how Dr. Ward is making strides towards a more supportive and inclusive medical environment. Here are 3 key takeaways from this episode: Personalized Wellness: Dr. Ward emphasizes the significance of personalized wellness practices in medicine, advocating for mindfulness and holistic approaches like yoga to cultivate self-compassion, discipline, and mastery. Transforming Medical Culture: There is a pressing need for nurturing and inclusive environments within healthcare settings. Dr. Ward highlights successful initiatives focusing on improving relationships, ensuring psychological safety, and fostering diversity and inclusion. Empowering Diversity and Self-Acceptance: By understanding and embracing neurodiversity, and acknowledging various strengths and challenges, healthcare professionals can design careers that align with personal values, fostering both professional success and personal satisfaction. Dr. Susannah Ward Bio: Dr. Susannah Ward is a Specialist Physician of Rehabilitation Medicine. She was awarded the Royal Australasian College of Physicians (RACP) fellowship Basmajian Prize in 2018. She has a special interest in well-being and is passionate about holistic health. She has been involved in research piloting wellness and mindfulness sessions in hospitals and was awarded the Advancement in Medicine Grant with Avant in 2018. She enjoys medical writing with several publications on health professional wellness and is a published author of the self-help book Mastering Real Wellness. In addition to her clinical work, she founded Ataraxia Collective, a health and wellness business offering doctor CPD & well-being retreats, well-being workshops and a blog. She is an accredited yoga teacher RYT200 with Yoga Alliance. She was a board director for the RACP 2016-2018 and is the Chair of the Member Health & Wellbeing Committee (RACP) & director for Mood Active a NFP that promotes exercise as a mental health intervention. Dr Ward hopes to encourage a compassionate and mindful medical culture that supports holistic health for patients and health professionals. -------------- Would you like to view a transcript of this episode? Click here **** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine. Learn more at https://www.chartingcoach.ca **** Enjoying this podcast? Please share it with someone who would benefit. Also, don't forget to hit “follow” so you get all the new episodes as soon as they are released. **** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life. **** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

Professor Gary Lee established the first dedicated pleural service in the southern hemisphere in 2009, at the Sir Charles Gairdner Hospital in Perth. He says that pleural disease has finally come to be regarded as an area of subspeciality interest in its own right, not just a complication of other comorbidities. In this podcast he presents a potted history of key developments in the management of pleural effusion in particular. This is diagnosed in about 60,000 people every year in Australia, mainly as a result of infection or malignancy. With mentors in the UK, Professor Lee conducted some of the earliest trials on fibrinolytics and DNAses to break down purulent effusions. They also put to the test protocols for pleurodesis via talcum insufflation that date back to the 1930s. Professor Lee's more recent clinical research has focused on the use of indwelling pleural catheters that a patient can use to drain pleural effusate when feeling breathless. He has also a made an important contribution to conservative management guidelines for primary spontaneous pneumothorax. This story is great example of how clinical practice emerges imperfectly from a soup of evidence, accidents, human biases and system. Guest Prof Gary Lee PhD FRACP FRCP FCCP (Pleural Service, Sir Charles Gairdner Hospital in Perth; University of Western Australia).Co-hostDr Marion Leighton FRACP (Wellington Hospital).ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Reconstruct' by Amaranth Cove, ‘Nagba Algooah' by Ebo Krdum. ‘Vittoro' by Borrtex provided courtesy of FreeMusicArchive. Image by ilbusca licenced through Getty Images.   Editorial feedback kindly provided by RACP physicians Aidan Tan, Maansi Arora, Simeon Wong, Hugh Murray and Vanessa Wong.Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

This case report describes a 42-year-old male from Arizona with a complex course characterised by fever following an orthotopic liver transplant. A general approach to fever in the post-transplant patient is discussed, along with specific considerations regarding travel in post-transplant patients or those on immunosuppressants for other indications. A/Prof Camille Kotton and Dr Simran Gupta from the Massachusetts General Hospital and Brigham and Women's Hospital take listeners through the case and related issues in a step-by-step manner at a level targeted for trainees and generalists.Guest A/Prof Camille Kotton (Massachusetts General Hospital, Harvard University)Dr Simran Gupta (Brigham and Women's Hospital, Harvard University) HostsAssociate Professor Stephen Bacchi FRACP (Fulbright Fellow, Mass General Brigham; University of Adelaide)Christina Gao (University of Adelaide)ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by doctors Maansi Arora, Brandon Stretton, Matt Lim and Ben Cook.Key Reference (Spoiler Alert)* * * * *Coccidioidal Meningitis after Liver Transplantation in a Nonendemic Region: A Case Report [Transplantation 2006]Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

In the previous episode we heard how some rationally-designed therapies work on almost any cancer with the right molecular signature. Tumour-agnostic medications could be godsend for patients with rare cancers which have classically been overlooked by drug developers, and those with advanced cancers of unknown origin. 15,000 such patients have undergone comprehensive genome profiling of their tumours through the organisation, Omico. In this podcast, Omico's founder explains that while the majority have received recommendations about matched therapies, clinical trials are typically the only way to enable access. Professor David Thomas discusses why Australia's Health Technology Assessment process appears to be so conservative and how the market price of next-generation oncotherapies might be brought down by changes across the local ecosystem. Guest Prof David Thomas FRACP PhD (Director, Centre for Molecular Oncology UNSW; Founder and Chief of Science, Omico)  Professor Thomas or Omico have received grants, consultancies or research support from Roche, Astra Zeneca, Pfizer, Eisai, Illumina, Beigene , Elevation Oncology, RedX Pharmaceuticals, SunPharma , Bayer, George Clinical, Novotech , Merck Sharpe and Dohme, Boehringer Ingelheim, Hummingbird, Microba , BioTessellate , PMV Pharma, Australian Unity and Foundation Medicine. ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes  ‘Multicolor' and ‘Pulse Voyage' by Chill Cole. ‘Impulsing', ‘the City of Hope' ‘Over Again', and ‘Going Undercover' by Borrtex provided courtesy of FreeMusicArchive. Image by Guido Mieth licenced through Getty Images.  Editorial feedback kindly provided by RACP physicians Simeon Wong, Stephen Bacchi. Thanks also to Kym Bramich and Arnika Martus on staff with Omico and RACP respectively.  Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

The genomic understanding of cancer has transformed a tissue-based classification model that had been dominant for 150 years or more. The last three decades have seen highly targeted therapies developed at blistering pace, and unprecedented improvements in patient outcomes. To date, these advances have been focused on more common cancers. The financing model for drug development means that rare cancers get overlooked, given the small pool of potential buyers relative to the costs and risks of investment. However, the molecular targets characterised in more common cancers are often found in cancers of a different histotype. As such, precision therapies will sometimes have tissue-agnostic efficacy and offer a lifeline for patients with neglected diseases or cancers of unknown origin. Professor David Thomas has founded an NGO called Omico to enable such patients to undergo profiling for hundreds of potential molecular targets. In this interview he explains the rationale for the most promising pan cancer therapies, and in the next episode we discuss changes to the regulatory and funding model required to sustain this screening program. Guest Prof David Thomas FRACP PhD (Director, Centre for Molecular Oncology UNSW; Founder and Chief of Science, Omico) Professor Thomas or Omico have received grants, consultancies or research support from Roche, Astra Zeneca, Pfizer, Eisai, Illumina, Beigene , Elevation Oncology, RedX Pharmaceuticals, SunPharma , Bayer, George Clinical, Novotech , Merck Sharpe and Dohme, Boehringer Ingelheim, Hummingbird, Microba , BioTessellate , PMV Pharma, Australian Unity and Foundation Medicine. ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘the Orchard' by Jakob Ahlbom, ‘Dusty Electronics' and ‘Pulse Voyage' by Chill Cole, ‘Tam' by LJ Kruzer, ‘See you soon' and ‘Going Undercover' by Borrtex. Image by filo licenced through Getty Images. Editorial feedback was kindly provided by RACP physicians Nichola Ball, Stephen Bacchi, Aafreen Khalid, Simeon Wong, Maansi Arora and Aidan Tan.Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

This case report describes a 35-year-old Caucasian male presenting with 5 weeks of progressive weakness in the proximal limbs and trunk and associated changes to the skin. The man was previously well and not taking any regular medications. There are many pathways this undifferentiated patient could go down. Consultant physician, Professor Josephine Thomas demonstrates a systematic way to work through the differential diagnoses as would be expected in a long-case presentation for basic physician training exams. She's the Clinical Dean for the Adelaide Medical School at the Northern Adelaide Local Health Network.GuestProf Josephine Thomas FRACP FRACGP FANZAPHE PhD (Northern Adelaide Local Health Network; University of Adelaide)HostsAssociate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide)Dr Caleb Chong (Northern Adelaide Local Health Network) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by Dr Brandon Stretton and Ben Cook.Key Reference (Spoiler Alert)*****A case of haemorrhagic myositis with concurrent anti-Ro52 and anti-NXP-2 antibodies treated with plasmapheresis [Rheumatology. 2020]Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

In 2019 a man was referred to Royal Adelaide Hospital with worsening breathlessness and a productive cough. He was a 47 year old electrician with a history of tobacco smoking who'd been well before the onset of symptoms. Over a couple of admissions the patient's condition progressed to type 2 respiratory failure. While the ultimate explanation for this presentation was a bit of a unicorn, the dramatic escalation of examinations and interventions runs through some textbook respiratory medicine; ECMO, infectious diseases, bronchoscopy, CT, interpretation of blood gases and the alveolar gas equation, stenting and ultimately transplantation. This is discussed in the careful manner expected of a long-case presentation in the physician training exams.GuestDr Thomas Crowhurst FRACP (Northern Adelaide Local Health Network)HostsAssociate Professor Stephen Bacchi (Lyell McEwin Hospital; University of Adelaide)Dr Brandon Stretton (Central Adelaide Local Health Network)ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan and Fionnuala Fagan.Key Reference (spoiler alert)*****Case report of severe bronchial web-like stenoses after 'surviving the unsurvivable' [BMC Pulm Med. 2019] Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

Thrombectomy for acute ischaemic stroke has undergone great advances in the last decade, but the expertise and technology is restricted to tertiary hospitals. Outside of large metropolitan centres, thrombolytic treatment can buy a patient time, but for almost 30 years the first line agent has remained unchanged. Alteplase is an analog of the human tissue plasminogen activator which activates plasmin to dissolve fibrin blood clots. For many years it was assumed that alteplase should be administered within 3 hours of symptom onset, thus it was a big deal when in 2008, research showed that that window could be safely broadened out to four and a half hours.Today's guests have over the intervening years been pushing the envelope even further, in an effort to help the more than two thirds of stroke patients who present after that threshold. In this podcast, Professors Bruce Campbell and Mark Parsons discuss a trial of the relatively novel agent, tenecteplase. The publication in the New England Journal of Medicine showed that tenecteplase could improve patient outcomes even if administered up to 24 hours out from a large vessel occlusion. The researchers explain the steps that led up to their study, and the importance of perfusion imaging to identify candidates with salvageable brain tissue. Key ReferenceTenecteplase for Ischemic Stroke at 4.5 to 24 Hours without Thrombectomy [NEJM. 2024]GuestsDr Duncan Austin PhD FRACP MRCP (Cabrini Health) Professor Bruce Campbell PhD FRACP (Cabrini Health; Royal Melbourne Hospital; University of Melbourne) Professor Mark Parsons PhD FRACP, FAAHMS (Sydney Neurointerventional Specialists; Consulting in Neurology, Maitland). ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Things to Sort Out' by Walt Adams and ‘the Appalachian Trail' by Hunter Quinn. Image produced and copyrighted by RACP.Editorial feedback kindly provided by RACP physicians Stephen Bacchi, Aidan Tan, Courtney Dowd, Saion Chaterjee and David Arroyo.  Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

This podcast follows the case of a 48-year-old male with a 3-month history of diarrhoea and associated lymphadenopathy. A complex constellation of symptoms accompanies this presenting complaint, along with a key radiological finding that enabled the treating team to arrive at the correct diagnosis. Can you arrive at the correct diagnosis before the treating team? This case was managed at the Queen Elizabeth Hospital and is presented by Dr Andrew Vanlint from the Northern Adelaide Local Health Network and University of Adelaide.CreditsDr Andrew Vanlint FRACP AFRACMA (Northern Adelaide Local Health Network and University of AdelaideAssociate Professor Stephen Bacchi (Lyell McEwin Hospital; University of Adelaide) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physician David Arroyo.Key Reference (Spoiler Alert)* * * * *Lessons from practice: Low attenuation lymphadenopathy on computed tomography leading to diagnosis of Whipple disease [Vanlint; Med J Aust. 2020] Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

This recording comes from the launch of the 2nd Monitoring and Evaluation Report on Hepatitis C Elimination in NSW. The work was conducted through the Kirby Institute under the guidance of infectious diseases specialist, Professor Greg Dore. As presented in this seminar, data show that the state is on track to meet the 2025 target set by NSW Health, and the national target for 2030, but there have been surprises along the way that have required an adaptable approach to surveillance and intervention. This is particularly true in correctional settings which typically have high rates of hep C transmission due to the amount of injecting drug use that takes place coupled with an absence of needle exchange programs. Presenting on this theme was Colette McGrath, who is General Manager of Population and Preventative Health for Justice Health NSW. Her very pragmatic approach is informed by almost a decade of experience working with this population.  Key ReferenceHepatitis C Elimination in NSW: Monitoring and Evaluation Report, 2024 [Kirby Institute]Video Recording from launch eventGuestsProf Greg Dore FRACP (Kirby Institute, Viral Hepatitis Clinical Research Program Head; St Vincent's Hospital). Colette McGrath (Population and Preventative Health, General Manager, Justice Health NSW)ProductionRecorded by Kirby Institute staff. Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Southern Sun' and ‘Quiet Waters' by Walt Adams, ‘Train Ride' by Alex Kehm and ‘The Appalachian Trail' by Hunter Quinn. Image produced and copyrighted by RACP.Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox or any podcasting app. 

Dr Karan Singh loves his job as a registrar in nuclear medicine but he thinks there isn't enough exposure to the specialty during medical school and basic training. In this podcast we spend a day in his department at Prince of Wales Hospital Sydney and get a taste of the many different referrals that come his way; a bone scan for a young man experiencing leg spasms after recovering from a car crash; myocardial perfusion imaging for an elderly gentleman with coronary artery disease; staging for prostate and breast cancer; and radiation therapy for a toxic multinodular goiter. The “reality audio” format gives a good sense of the daily tasks and responsibilities involved in this career pathway.CreditsDr Karan SinghStaff and patients at Prince of Wales Nuclear Medicine and PET DepartmentProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Salty Sails' and ‘Nuna' by Sindrandi, ‘Between Four Eyes' by Czar Donic, ‘Organic Textures 2' by Johannes Bornlöf and ‘Punjabi Swag' by Aks and Lakshmi. Image by JohnnyGreig licenced through Getty Images. Editorial feedback kindly provided by RACP physicians Jamie Bellinge, Joseph Lee, Sern Wei Yeoh, Zac Fuller and Stephen Bacchi.Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. 

The LACE index is a prognostic algorithm for predicting the likelihood that a newly discharged patient will come back into hospital within 30 days because of complications. Today's IMJ paper describes a validation of the LACE index in a regional Victorian setting. Identifying patients who are at risk could allow for better targeted care at the first admission, reducing harm to patients and inefficient use of healthcare resources.  The researchers also tested a novel classification tool for scoring which readmissions are avoidable and which are just an unfortunate outcome of the patient's illness. This could help more accurately track quality of care within and between healthcare service providers.GuestsProf Christian Gericke PhD FRACP FAFPHM AFRACMA FRCP Edin FEAN FAAN (Calvary Mater, Newcastle; University of Newcastle; University of Queensland) Dr Reinhardt Dreyer (South West Medicine ; University of Stellenbosch) Dr James Gome FRACP (South West Medicine, Clinical Director General Medicine) ProductionProduced by Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Treetops' by Autohacker and ‘The Cold Shoulder' by Kylie Dailey. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan, Joseph Lee, David Arroyo and Stephen Bacchi.Key ReferenceCauses for 30-day readmissions and accuracy of the LACE index in regional Victoria, Australia [IMJ. 2024]Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

This podcast follows the case of a 58 year old man who presented to the haematology department at Flinders Medical Centre with intravascular coagulation and leukocytosis. He was diagnosed with acute myeloid leukaemia and treated on standard cytarabine and daunorubicin combination therapy. Nine days after initiation, the patient developed painless diplopia and ptosis, and the story is picked up with a referral to the neurology department. GuestsAssociate Professor Stephen Bacchi (Lyell McEwin Hospital; University of Adelaide)Dr James Triplett FRACP (Flinders Medical Centre, consultant neurologist) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan and Brandon Stretton.Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity.Key Reference and Learning Points (Spoiler Alert)********Painless progressive mononeuritis multiplex secondary to AML associated neuroleukemiosis [J Neuroimmunol. 2023]  (1) Chemotherapy can have neurological complications, including chemotherapy induced peripheral neuropathy (e.g., oxaliplatin).(2) A third (oculomotor) cranial nerve palsy has multiple possible causes, which can be divided into painful vs painless causes, and compressive (classically with pupillary involvement) vs non-compressive (can spare pupil, as with microvascular insult) causes.(3) Conduction block is shown by a significant reduction in compound muscle action potential, between proximal and distal stimulation, the criteria for which varies by nerve.(4) Ascertaining whether conduction block occurs at compressible vs non-compressible sites can be a useful distinguishing feature for the various possible causes e.g. including compression, demyelination, and ischaemia, and (5) Mononeuritis multiplex, while classically associated with a vasculitic neuropathy, has a number of causes, including leukaemia. This is the very rare condition known as neuroleukemiosis.

The RACP Congress in May this year was opened by a fascinating lecture on mental health in the medical workforce, which has been trimmed down for audio. Professor Neil Greenberg is an occupational psychiatrist with more than 23 years in the UK Armed Forces. His extensive research within defence and health settings has informed a very pragmatic understanding of the impact of trauma and relationships in the workplace. Professor Greenberg overturns some entrenched beliefs we have about the presentation and management of mental illness, as does guest host Dr David Beaumont from the College Member Health and Wellbeing Committee. He reflects on the role of the Committee and how his own understanding of health has shifted in response to personal distress.GuestsProfessor Neil Greenberg FRCPsych, FHEA, MFMLM, MInstLM, MEWI, MFFLM (Kings College, London; March on Stress) Dr David Beaumont FAFOEM (Positive Medicine, Director; RACP Member Health and Wellbeing Committee)ProductionProduced by Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Blacklight' by John B. Lund and ‘Lukas Got Lucky' by Rate 44. Image by Richard Drury licenced through Getty Images.Editorial feedback kindly provided by RACP physicians David Arroyo, Stephen Bacchi, Nele Legge, Ronaldo Piovezan, Rachel Murdoch, Aidan Tan and Rachel Bowden.Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.Counselling SupportCollege EAP Member service provided by TELUS Health Australia: 1300 361 008Aotearoa-NZ: 0800 155 318 (Aotearoa New Zealand). See also the TELUS wellbeing app.Doctor's Health Advisory Service HelplineAotearoa-NZ:  800 471 2654NSW/ACT: 02 9437 6552VIC:      03 9280 8712TAS:     03 9280 8712SA:       08 8366 0250NT:       08 8366 0250QLD:    07 3833 4352WA:     08 9321 3098 LifelineAustralia: 13 11 14. Aotearoa-NZ: 0800 54 33 54

Starting in 2023, the Medical Board of Australia and the Medical Council of New Zealand brought in what were called “Strengthened CPD” requirements. These put more focus on reviewing performance through self-reflection and peer feedback described in the RACP's MyCPD Framework as a Category 2 activity. To help synchronise CPD seamlessly with practice, the value of supervision as a reflective activity has been recognised in the 2024 framework. Time spend supervising trainees can now be counted towards Category 2 CPD “Reviewing Performance” rather than Category 1. In this short and insightful podcast, two of the RACP's most passionate medical educators explain the rationale for this shift, and how to use MyCPD tools to streamline the process of planning and recording CPD. GuestsAssociate Professor Kudzai Kanhutu FRACP GAICD (College Dean; Royal Melbourne Hospital; University of Melbourne)Professor Martin Veysey FRACP, FRCP (Gastro Healthcare; Australian National University) Production CPD OnDemand project production by Rebecca Lewis and David Tarr. Audio editing by Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Bookies' by Jones Meadow and ‘Love Thing' by Paisley Pink. Image created and copyrighted by RACP.For more podcasts that you can credit to Category 1 CPD , please visit the Pomegranate Health web page. And there are many more educational videos and eLearning resources at RACP Online Learning.    

This case report has been developed by Trainees, to assist their peers with preparation of long-case presentations. It is not a fully-vetted Education resource but a “passion project” from editors of the Pomegranate Health podcasts.  The case is that of a 32-year-old woman presenting with constant and dull abdominal pain that had been sudden in onset. The pain is accompanied by nausea and vomiting but bowel habits were unchanged. The patient has a history of type 1 diabetes and a simultaneous pancreas-kidney transplant two years prior to the presentation. There is no history of rejection of pancreatitis and serum creatinine appears normal.  The attending nephrologist walks through the elimination of differential diagnoses typical of any patient and also of particular relevance to a transplant patient.  GuestsDr Chiang Sheng Lee FRACP (Lyell McEwin Hospital; University of Adelaide)Dr Stephen Bacchi (Lyell McEwin Hospital)Dr Amitjeet Singh (Lyell McEwin Hospital)ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan, Brandon Stretton, David Arroyo, Keith Ooi and Fionnuala Fagan. Thanks also to Adelaide medical students Benjamin Cook, Srishti Sharma and Prakriti Sharma.Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Key Reference (Spoiler Alert)*********Gadolinium-Induced Acute Graft Pancreatitis in a Simultaneous Pancreas-Kidney Transplant Recipient [Case Rep Nephrol. 2022]

Australia is a big continent and sparsely populated continent. 28 percent of Australians live in areas classified regional, rural or remote and their access to health services is much more limited. It's estimated that between 2009 and 2011 there were 19,000 excess deaths in regional and remote areas as compared to the major cities. No doubt, socioeconomic disadvantage is factor in that mortality gap, but inequitable access to healthcare is also a major driver. In this podcast we focus specifically on the shortage in health practitioners in the regions. Even in regional centres, the density of physicians by population count is two thirds what it is in the major cities. By the time you get to large rural towns it's just over a third that baseline. In this podcast we discuss opportunities to lift recruitment and retention. This means improving the experience for trainees and the esteem for rural medicine in the eyes of the profession at large.Guests​Adjunct Professor Graeme Maguire PhD FRACP MHM MPHTM (President Adult Medicine Division, RACP and Director of Medical Education, WA Country Health Service)Dr Sarah Straw FRACP (WACHS Kimberley Regional Physician Team; Northern Hospital, Melb; Rural, Regional and Remote Working Group, RACP)​Associate Professor Matthew McGrail PhD (Head Regional Training Hub Research, University of Queensland)ProductionProduced by Mic Cavazzini DPhil. Music courtesy of FreeMusic Archive includes ‘The Envelope', ‘Cast in Wicker' and ‘Planting Flags' by Blue Dot Sessions. Music licenced from Epidemic Sound includes ‘The Mission' by J. F. Gloss. Photo by Pearshop on behalf of RACP. Editorial feedback kindly provided by RACP physicians Steve Flecknoe-Brown, Zac Fuller, Aidan Tan, Sasha Taylor, Jia Wen Chong, Joseph Lee, Fionnuala Fagan, Stephen Bacchi, Chris Leung, David Arroyo, Nele Legge, Li-Zsa Tan and Thazin Thazin.Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app. 

澳紐皇家內科醫學會（RACP）在昨天（5月23日）發表一項聲明指,澳洲一些主要藥物短缺的情況正影響本地一些最脆弱的病患者，包括患有神經發育障礙的兒童、寧養患者及一些性病患者。

Pomegranate [Case Report] is a Q&A style podcast developed by trainees, for trainees. In our debut episode, we hear about w a who man presented to the emergency department reporting sudden onset vision loss in his right eye lasting several hours. He was 68 year old with a history of type 2 diabetes mellitus. Three differential diagnoses being considered were optic neuropathy, vitreoretinal disease, or corneal oedema following from potential uveitis. In this podcast consultant ophthalmologist, Dr Sumu Simon, walks through an approach to this presentation and an exploratory therapy.GuestsDr Sumu Simon FRANZCO (Queen Elizabeth Hospital; Royal Adelaide Hospital) Dr Brandon Stretton (Royal Adelaide Hospital) Dr Stephen Bacchi (Lyell McEwin Hospital)ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan and Fionnuala Fagan. Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Key Reference and learning points (spoiler alert)The Role of Tocilizumab in Glucocorticoid Resistant Giant Cell Arteritis: A Case Series and Literature Review [J Neuroophthalmol. 2023;43(1)] 1.      This case underscores the critical nature of timely diagnosis and aggressive treatment in conditions like giant cell arteritis (GCA), where delayed treatment can lead to irreversible complications such as vision loss. Thorough history taking and clinical acumen are still key elements in establishing a diagnosis of GCA.2.      The patient's initial response and subsequent decline in vision illustrate the need for ongoing monitoring and readiness to adapt the treatment approach. It also shows the necessity of close monitoring of inflammatory markers and clinical symptoms.3.      Amaurosis fugax warrants urgent referral to an ophthalmologist.4.      High index of suspicion for GCA and prompt referral of GCA suspects will ensure best outcome for patients.5.      Progressive visual loss and elevated inflammatory markers should alert the clinician to glucocorticoid-resistant GCA.6.      The effectiveness of tocilizumab in this case highlights its role as a valuable treatment option for refractory GCA, especially when traditional therapies are not sufficiently effective. Targeted biologic agents may open up new treatment approaches in the future particularly in patients with progressive visual loss despite administration of intravenous methylprednisolone. 7.      Managing complex cases like GCA often requires a collaborative approach involving rheumatologists, ophthalmologists, and other specialists to ensure comprehensive care and optimal outcomes.8.      There is often value in case reports to start the evidence cascade that is required to bring new, life altering treatments to the forefront. 

Dr Sarah Arachchi is a paediatrician, soon to be author, speaker, mother of two boys and a strong advocate for women. She has organised conferences and events for medical parents and currently co-convenes the RACP educational sessions for paediatricians as well as being a member of the AMA Women in medicine committee. We discuss: - How mentorship and support are crucial in a medical career - Being a parent and a doctor - Fertility in medicine - Representation matters For coaching with Isabella go to balancedmedics.com/coaching Reach out to Sarah Instagram

Type 1 diabetes has a very high treatment burden in terms of direct costs, inconvenience and lost productivity for patients and their carers. Further, all the glucose checking, hormone replacement and consults don't abolish the vascular complications associated with poor glycaemic control. Only in the last few years has it been possible to pharmacologically alter the course of type 1 diabetes and other auto-immune diseases without generating intolerable side effects.Teplizumab is an antibody to CD3 which was presented to the world in 2019 as delaying the onset of type 1 diabetes in high-risk individuals thanks to its protective effect on pancreatic β-cells. It has not yet been registered by the Therapeutic Goods Administration but another immunomodulatory drug called baricitinib has. Baricitinib is an inhibitor of Janus Kinases indicated for the for the treatment of rheumatoid arthritis, alopecia areata, atopic dermatitis and even COVID-19.  In December of last year the results of a Phase 2 trial in patients with new-onset type 1 diabetes were published in the New England Journal of Medicine. After almost a year of taking the oral therapy, patients were found to have better glycaemic control and evoked C-peptide levels than those taking placebo, indicating a preserved ability to secrete insulin. In today's episode, Pomegranate's in-house endocrinologist interviews two of the study authors.   Key ReferenceBaricitinib and β-Cell Function in Patients with New-Onset Type 1 Diabetes [NEJM. 2023. 7;389(23)]GuestsProf Jenny Couper FRACP FAHMS (Women's and Children's Hospital, University of Adelaide) Dr Michelle So FRACP (Royal Melbourne Hospital, Northern Hospital) Guest HostDr Rahul Barmanray FRACP (Royal Melbourne Hospital)ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Things to Sort out' and ‘Quiet Waters' by Walt Adams and ‘The Appalachian Trail' by Hunter Quinn. Music courtesy of FreeMusic Archive includes ‘I am a Man Who Will Fight For Your Honor' by Chris Zabriskie. Image produced and copyrighted by RACP.Editorial feedback kindly provided by RACP physicians Amy Hughes, Stephen Bacchi, Fionnuala Fagan and Aidan Tan.  Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

Today's guests are the hosts of This Medical Life, a wonderful podcast that delves into the archives of medical history. Dr Travis Brown describes the period after World War I when the Spanish Flu was killing tens of millions around the world. In the USA, whiskey was thought to be a powerful prophylactic but distribution was not an easy thing. Later in the episode (22min) is the equally unlikely tale of how the pomegranate made its way from ancient myth onto this podcast by way of Henry VIII and some mystical symbolism.GuestsDr Travis Brown MBBS, FRCPA (ClinPath Pathology) Steve Davis MBA FAMI CPM (Talked About Marketing) ProductionProduced by Mic Cavazzini DPhil. Music courtesy of FreeMusic Archive includes ‘Mendo Mulcher' by Polyrhytmiques, ‘Bach's March fur die Arche' by The United States Army old Fife and Drum Corps and ‘Notre Dame' by Jahzzar. Music licenced from Epidemic Sound includes ‘Salat Alsabah' by Feras Charestan and ‘Savannah Nights 1' by Martin Gauffin. Image courtesy of Wikimedia Commons. Recording of Allegri's Miserere from Trinity College under Creative Commons licence from archive.org.Editorial feedback kindly provided by RACP physicians Chris Leung, Aidan Tan, David Arroyo, Ronaldo Piovezan, Rahul Barmanray and Ian Woolley. Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

There's calls for a complete ban on the deadly engineered stone, primarily used in bench tops. The Australasian College of Physicians is urging the New Zealand Government to follow Australia's lead on the stone, which can give stonemasons the incurable lung disease, silicosis. RACP spokesperson Dr Alexandra Muthu says the organisation is calling for an outright ban on the material being imported into New Zealand. LISTEN ABOVESee omnystudio.com/listener for privacy information.

There's calls for a complete ban on the deadly engineered stone, primarily used in bench tops. The Australasian College of Physicians is urging the New Zealand Government to follow Australia's lead on the stone, which can give stonemasons the incurable lung disease, silicosis. RACP spokesperson Dr Alexandra Muthu says the organisation is calling for an outright ban on the material being imported into New Zealand. LISTEN ABOVESee omnystudio.com/listener for privacy information.

Last November an NHS Hospital Trust in Nottingham sought permission from the UK High Court to withdraw life support from a seven-month old girl called Indi Gregory. The devastated parents did not want to give up on her although they were advised there was no hope of treatment for her profound developmental disability. The family and the medical teams returned to court two more times, right up to the day that Indi was to be extubated. Conflicts over care have always existed but their frequency has increased as medicinal advances present more options for intervention even in the sickest patients. Added to that, the online media environment allows advocacy campaigns to grow until they spill onto the streets outside hospitals and courtrooms. This heightened tension causes moral injury both to parents and healthcare staff looking after child patients. The Medical Mediation Foundation has developed a conflict management framework to help avoid or de-escalate such disputes and keep attention focused on the best interests of the patient. In this podcast we hear from the director of the foundation, as well as three staff from the Starship Hospital, Auckland who have undertaken this training. GuestsSarah Barclay (Director, the Medical Mediation Foundation)Dr Louise Webster MBChB RANZCP FRACP (Paediatric Consult Liaison Team, Starship Hospital)Dr Fiona Miles FRACP FFICANZCA (Paediatric Intensivist, Starship Hospital)Fiona McIver (nurse specialist, Starship Hospital)ProductionProduced by Mic Cavazzini DPhil. Recording assistance in Auckland from Dinesh Kumar. Music courtesy of FreeMusic Archive includes ‘December' by Kai Engel. Music licenced from Epidemic Sound includes ‘Ikigai' by Twelwe and ‘Pulse Voyage by Chill Cole. Image by Photodisc licenced from Getty Images.Editorial feedback kindly provided by RACP physicians Michael Herd, Rosalynn Pszczola, Rachel Murdoch, Sasha Taylor, Zac Fuller, Rahul Barmanray, David Arroyo, Rachel Bowden, Chris Leung, Fionnuala Fagan, Thazin Thazin and Aidan Tan. Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

Median survival for patients diagnosed with advanced cirrhosis is around 2 years and quality of life is poor. Fewer than a quarter of such patients receive referrals to palliative care and advanced care plans are also rare. Existing research from abroad suggests that hepatology staff aren't familiar with referral criteria and assume that palliative services become involved only at the very end of life.  To try and reduce barriers to referral, clinicians at Royal Brisbane Hospital developed a model called Hepatocare. They adapted a palliative care referral algorithm to include cirrhosis specific markers and continuity of care between the teams was provided by a clinical nurse consultant. The model was piloted model in 30 consecutive patients to the liver clinic, and its impact was assessed on rate of referrals, incidence of unplanned admissions, length of patient stay and rates of polypharmacy. GuestsProfessor James O'Beirne FRCP FRACP (Sunshine Coast Hospital and Health Service; University of the Sunshine Coast)Dr Richard Skoien MBBS FRACP (Royal Brisbane and Women's Hospital; University of Queensland)Dr Alison Kearney FRACP MRCP (Royal Brisbane and Women's Hospital; University of Queensland)Olivia Cullen (Royal Brisbane and Women's Hospital)Key Reference Alison Kearney, Neha Tiwari, Olivia Cullen, Amy Legg, Ismail Arbi, Carol Douglas, Barbara Leggett, Mary Fenech, Joanne Mina, Paris Hoey, Richard Skoien. Improving palliative and supportive care in advanced cirrhosis: the HepatoCare model of integrated collaborative care. Intern Medicine Journal. 2023 Nov;53(11):1963-1971ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘After the Freak Show' by Luella Gren and ‘The Cold Shoulder' by Kylie Dailey. Image by sturti licenced from Getty Images. Editorial feedback kindly provided by RACP physicians Aidan Tan and David Arroyo.Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox or any podcasting app.

Semaglutide, branded as Ozempic or Wegovy, is an analogue of glucagon-like peptide 1 which has glucose-dependent effects on insulin secretion. In this episode we discuss how semaglutide performs as an antihyperglycaemic agent compared to previous GLP-1 analogues and the soon-to-be launched tirzepatide. This dual agonist also binds receptors to glucose-dependent insulinotropic polypeptide, GIP.GLP-1 and GIP are incretin hormones, secreted after food intake and involved in regulating gastric motility and appetite. The analogue therapies have resulted in weight loss of 10 to 20 percent in trials on patients with obesity or other weight-related comorbidities. For various reasons, however, they remain unsubsidised by the Pharmaceutical Benefits Scheme. This hasn't stopped social media influencers driving up off-label demand from the wider public, creating a problem for regulators and the diabetic patients most in need.GuestsProfessor Chris Rayner MBBS PhD FRACP (Gwendolyn Michell Professor, Adelaide Medical School; Consultant Gastroenterologist, Royal Adelaide Hospital) Professor Gary Wittert MBBch, MD, FRACP (Mortlock Professor, Adelaide Medical School; Senior Consultant Endocrinologist, Royal Adelaide Hospital)ProductionProduced by Mic Cavazzini DPhil. Music courtesy of Free Music Archive includes ‘Mister S' by Tortue Super Sonic. Music licenced from Epidemic Sound includes ‘Multicolor' and ‘Flower Fountain' by Chill Cole, ‘Blacklight' by John B Lund, and ‘Habitual' by Ava Low. Image by Ketut Subiyanto courtesy of Pexels. Editorial feedback kindly provided by RACP physicians Stephen Bacchi, Aidan Tan, David Arroyo, Joseph Lee, Jia-Wen Chong, Li-Zsa Tan, Fionnuala Fagan, Stella Sarlos and Marion Leighton.Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox or any podcasting app.

This is the final episode in a five-part series about artificial intelligence in medicine. We start by weighing up the costs and benefits of automation in a health system that's increasingly pushed beyond capacity. One of the biggest time sinks for health practitioners is filling out and searching through medical records. Some of this could be performed by natural language processors which are becoming more accurate thanks to deep learning.   The power of large language models has been demonstrated by the meteoritic uptake of ChatGPT and doctors are among those who have used it to summarise literature or draft letters. But professional organisations have raised concerns around the accuracy and privacy of the model and there have also been spooky demonstrations of its capacity for common sense and theory of mind. Guests>Professor Brent Richards MBBS FRACP JJFICM (Gold Coast Hospital and Health Service; Director, IntelliHQ)>Affiliate Associate Professor Paul Cooper PhD FAIDH CHIA AFHEA GAICD (Deakin University) >Associate Professor Sandeep Reddy MBBS PhD IPFPH ECFMG CHIA FAcadTM FAIDH FCHSM SFHEA (Deakin University; Founder, MedAI)ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Kryptonite' by Blue Steel and ‘Thyone' by Ben Elson. Music courtesy of Free Music Archive includes ‘Headway' by Kai Engel, ‘Gramaphone' by Jahzarr and ‘Numbers' by Krowne. Image by VM licenced from Getty Images. Computerised voice from Online Tone GeneratorEditorial feedback kindly provided by physicians David Arroyo, Stephen Bacchi, Aidan Tan, Ronaldo Piovezan and Rahul Barmanray and RACP staff Natasa Lazarevic PhD. Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox or any podcasting app. 

This is the fourth part in a series on artificial intelligence in medicine and we try and unpick the causes and consequences of adverse events resulting from this technology. Our guest David Lyell is a research fellow at the Australian Institute of Health Innovation (Macquarie University) who has published a first-of-its kind audit of adverse events reported to the US regulator, the Federal Drugs Administration. He breaks down those that were caused by errors in the machine learning algorithm, other aspects of a device or even user error.   We also discuss where these all fit in to the four stages of human information processing, and whether this can inform determinations about liability. Uncertainty around the medicolegal aspects of AI-assisted care is of the main reasons that practitioners report discomfort about the use of this technology. It's a question that hasn't been well tested yet in the courts, though according to academic lawyer Rita Matulonyte, AI-enhanced devices don't change the scope of care that has been expected of practitioners in the past. Guests>Rita Matuolynte PhD (Macquarie Law School, Macquarie University; ARC Centre of Excellence for Automated Decision Making and Society; MQ Research Centre for Agency, Values and Ethics)>David Lyell PhD (Australian Institute of Health Innovation, Macquarie University; owner Future Echoes Business Solutions) ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Kryptonite' by Blue Steel and ‘Illusory Motion' by Gavin Luke. Music courtesy of Free Music Archive includes ‘Impulsing' by Borrtex. Image by EMS-Forster-Productions licenced from Getty Images. Editorial feedback kindly provided by physicians David Arroyo, Stephen Bacchi, Aidan Tan, Ronaldo Piovezan and Rahul Barmanray and RACP staff Natasa Lazarevic PhD. Key References More than algorithms: an analysis of safety events involving ML-enabled medical devices reported to the FDA [Lyell, J Am Med Inform Assoc. 2023]How machine learning is embedded to support clinician decision making: an analysis of FDA-approved medical devices [Lyell, BMJ Health Care Inform. 2021]Should AI-enabled medical devices be explainable? [Matulonyte, Int J Law Inform Tech. 2022]Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox or any podcasting app. 

Dr Jemma Hogan is a doctor specialising in both medical administration (RACMA) and paediatric medicine (RACP). She is currently working as the Director of Medical Services and as a Paediatric Advanced Trainee! This episode we shine a light on med admin, a lesser known medical specialty, and speak about dual training. We discuss: - Why she chose to do dual training in Paediatrics and Medical Administration - What working as a Director of Medical Services involves - What Medical Administration is - What the day to day role is like - The hours - What it's like being a dual trainee - The requirements for RACMA & different pathways  Find out more about RACMA here For coaching go to balancedmedics.com/coaching

In today's podcast we try and understand the impact that racial bias makes on variation in clinical care. For example, racialized patterns in the use of analgesia were brought to light over 20 years ago but are still occurring today. In research from the UK published in March it was found that women of African or South Asian extraction were significantly less likely to receive an epidural during vaginal birth, or instrumental assistance with the delivery. The direct reasons for this variation were not revealed by the study, and could simply reflect the preferences of different cultural groups. But if that's the case, it behoves us to address gaps in health education in a culturally sensitive way. This podcast highlights the subtle drivers of racialized disparity at different layers of service delivery. At an individual level implicit bias can affect clinical decision-making. At an institutional level there may be known resourcing issues not being addressed, like availability of translators to help diverse patients understand what they're consenting to. And all this takes place within the context of structural racism, the inequity that was long ago baked into society's power structures. That's particularly true in colonised countries like ours, so we also ask what it means to “decolonise” medicine. GuestsWendy Edmondson PhDc (Cultural Advisor, RACP)Dr Kudzai Kanhutu FRACP GAICD MPH (Dean, RACP; Deputy Chief Information Office, Royal Melbourne Hospital) ProductionProduced by Mic Cavazzini DPhil. Recording assistance from Jon Tjhia in Melbourne and Fiona Croall in Adelaide. Music licenced from Epidemic Sound includes ‘You break down' by Czar Donic and ‘Repurposed' by Cody Francis. Music courtesy of Free Music Archive includes ‘New Times' by 4T Thieves and ‘Chasing Shadows' by Scott Holmes. Image by rubberball licenced from Getty Images. Editorial feedback on this episode kindly provided by physicians Sern Wei Yeoh, Aidan Tan, Rachel Murdoch, Priya Garg, Fionnuala Fagan, Phillipa Wormald, Amy Hughes and RACP staff Fiona Hilton, Rebecca Lewis, Michele Daly, Alexandra Kinsey. Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox, or any podcasting app.

Analiza, gestiona y haz crecer tu presencia digital con Metricool: https://my.mtr.cool/FNOIHG Hoy tenemos el placer de contar con uno de los creadores de contenido más destacados del Ecuador en las plataformas de Facebook, TikTok y YouTube. Este creador de contenido ecuatoriano cuenta con una trayectoria muy extensa a lo largo de los años, y aunque ha enfrentado altibajos, continúa logrando sacar sonrisas a su público a través de sus parodias, música y escenas teatrales. Además, ha estado envuelto en polémicas, incluyendo un ataque de hackers que puso en riesgo todo su trabajo. Por ello, en el episodio de hoy del podcast hablaremos de ciberseguridad, gestión de redes sociales, y conoceremos más acerca de la persona detrás del éxito de Romel R.A.C.P.

Evidence-Based Clinical Practice Guideline For Attention Deficit Hyperactivity Disorder (ADHD) .This clinical practice guideline is for the identification, diagnosis, and treatment of people with ADHD.It outlines a roadmap for ADHD clinical practice, research and policy, now and in the future, with a focus on everyday functioning and quality of life for people who are living with ADHD and those who support them.The Guideline includes eight chapters covering the identification, diagnosis, and treatment of people with ADHD, as well as considerations for subgroups, service & policy and further research.1. Identification2. Diagnosis3. Treatment & Support4. Non-Pharmacological Interventions5. Pharmacological Interventions6. Considerations – Subgroups7. Considerations – Service & Policy8. Considerations – ResearchApprovalsThis guideline has been approved by the NHMRC and endorsed by APS, RACP, RACGP, Speech Pathology Australia, Occupational Therapy Australia, ACPA, AAPI, ADHD WA, ADHD Foundation, RANZCP, ADHD Australia and the World Federation of ADHD.The guidelines can be downloaded at the link below:https://aadpa.com.au/guideline/

Associate Professor Sonya Burgess is an interventional cardiologist based in Sydney, Australia, having graduated from Otago Medical School with distinction, before finishing her fellowship with RACP. She completed her interventional fellowship in Liverpool hospital, Sydney, and her PhD in the University of New South Wales. She has 90 peer reviewed publications, but she is passionate about medical education and teaching, and on addressing workforce gender equity issues, particularly in cardiology. In this episode, we discuss her journey into choosing medicine and interventional cardiology, the roots of her passion for academia, her research in gender equity issues in cardiology and in particular, interventional cardiology, and of course - all things intervention. Support the showAs always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me. Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9Y

Pomegranate Health is seeking fresh ears on the Podcast Editorial Group.Responsibilities of group members are to> discuss new podcast topics> suggest themes to explore and people to interview> listen to audio drafts and provide feedback before publicationGroup communication is done informally by email and there's a time commitment of approximately 90 minutes per month. Please download an application form and return it before February 2023 to podcast@racp.edu.au. ******About two thirds of Australians use complementary and alternative medicines but only around half of these people will mention it to their doctor. Patients in palliative care settings may be more inclined than most to try therapies from outside the box. But they are also more vulnerable to side effects and interactions given that their drug metabolism and clearance mechanisms are often impaired. In this podcast you'll hear the authors of a Clinical Perspectives article titled "Complementary and alternative therapies in the palliative setting." It's published in the in the October issue of the Internal Medicine Journal which can be accessed by all RACP members at the login page racp.edu.au/fellows/resources/journals.Professor Jennifer Martin and Joanne Patel describe how cannabinoid products, especially, have become more readily accessible to patients in recent years and often considered a panacea for many different symptoms. But given the wide variety of products each with a different concentration of active ingredients, drug effects are not always as a patient or doctor might expect. These compounds also have suppressive effects on P450 and other clearance enzymes which can alter the outcomes of other prescribed drugs.  But practitioners also need to consider their relationship with a patient when giving advice on the use of complementary medicines.     GuestsDr Jonathan Brett FRACP FAChAM (St Vincent's Hospital, Sydney)Professor Jennifer Martin FRACP (University of Newcastle, John Hunter Hospital)Dr Joanne Patel FRACP FAChPM (University of Newcastle, John Hunter Hospital)ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Crossing Borders' by Mindserver Unlimited. Image by DrAfter123 licenced from Getty Images.Please visit the Pomegranate Health web page for a transcript and supporting references. To claim learning credits login to MyCPD at this link, review/amend the prefilled activity details and click save. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox, or any podcasting app.

This is the first episode of a new format called “IMJ On-Air” inspired by the RACP's Internal Medicine Journal. Each episode will be have as guest-host a section editor or reviewer of the IMJ interviewing authors of a recent article. Often these will be Clinical Perspectives reviews which summarise the latest in management of major medical disorders. In this episode we have leading respiratory physicians from the Royal Melbourne Hospital presenting current best practice in the diagnosis and treatment of severe asthma. They explain why inhaled corticosteroids have become so ubiquitous and also the remarkable impact that monoclonal antibodies have made to the field. They also discuss the lifestyle factors that can be modified to improve outcomes, and why so many people with severe asthma go undiagnosed. Finally, they reflect on the lessons learned from the 2016 “asthma storm” that send 3000 people to emergency rooms in over a single evening.  GuestsAssociate Professor Daniel Steinfort FRACP (Royal Melbourne Hospital; Principal Research Fellow, University of Melbourne)Dr Ashleigh Witt (Royal Melbourne Hospital)Associate Professor Nur-Shirin Harun FRACP (Royal Melbourne Hospital; Peter MacCallum Cancer Centre)Professor Jo Douglass FRACP FThorSoc (Director of Research, Royal Melbourne Hospital; University of Melbourne) ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Tree Tops' by Autohacker, ‘Crossing Borders' by Mindserver Unlimited. Image by Karl Tapales licenced from Getty Images.Please visit the Pomegranate Health web page for a transcript and supporting references. To claim learning credits login to MyCPD at this link, review/amend the prefilled activity details and click save. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox, or any podcasting app. ReferencesOverview of recent advances in asthma management [Witt 2022, IMJ]Access to IMJ, JPCH and OMJ for RACP membersAsthma action plan templates [Asthma Australia]Global Initiative for Asthma [GINA]Overview of recent advances in asthma management [Witt 2022, IMJ] Thunderstorm-triggered asthma: what we know so far [Harun 2019, J Asthma Allergy]Thunderstorm asthma in seasonal allergic rhinitis: The TAISAR study [Douglass 2022, J Allergy Clin Immunol]

The National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders in Australia aspires to streamline referral pathways so that children can get the right help as early as possible. But despite the best intentions of many clinicians, there are drivers in the health system that make implementation difficult. There are constraints in the way specialists can be reimbursed for time spent managing a case through the diagnostic process. And the extent of developmental disorders in the community may not be reflected in the depth of training in this area. We also hear about some breaking research into a highly accurate diagnostic screening tool that could reveal just how prevalent ASD is in the community.GuestsDr Paul Hotton FRACP (Staff Specialist in Community Child Health and Child Protection, Sydney Children's Hospital Network; Chair of CCCH at RACP)with input from Associate Professor Josephine Barbaro (Olga Tennison Autism Research Centre, La Trobe University) ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Falling from the Clouds' by Sven Lindvall, ‘Lantern Room (Instrumental)' by Torii Wolf and ‘Not Blue' by Kylie Dailey. Image by Elva Etienne licenced from Getty Images.Please visit the RACP website for a transcript and supporting references. RACP members can claim CPD credits for listening via MyCPD. 

The average age at which autism spectrum disorder is four, though signs are often present well before that. Even where families and GPs may have concerns early in a child's development, it can take a year or more for a consult with a paediatrician to become available. There are similar waiting lists to see other allied health and sub-specialists who may contribute opinions to a diagnosis. And there is some inconsistency as to what kind of supporting documentation is required to access support services at different layers if government. The Autism Cooperative Research Centre published a national guideline with 70 recommendations to streamline this process and improve equity for families from different backgrounds and living in different parts of the country. In this podcast we hear from a GP and a paediatrician working in regional practice about how this can help their patients receive early intervention in the critical developmental years. In Part 2 we get a response from the RACP's Chair of Child and Community Health about underlying structural challenges including the paediatric training curriculum and the NDIS. GuestsDr Jo McCubbin FRACP (Fitzpatrick House, Sale, VIC)Dr James Best FRAGCP (Junction Street Medical Centre, Nowra NSW)ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Sleeping Starchild' by Daniel Fridell, ‘Falling from the Clouds' by Sven Lindvall, ‘Lantern Room (Instrumental)' by Torii Wolf and ‘Not Blue' by Kylie Dailey. Image by Elva Etienne licenced from Getty Images. Please visit the RACP website for a transcript and supporting references. RACP members can claim CPD credits for listening via MyCPD.  

In the last episode we heard some powerful examples of the challenges faced by some practitioners in medicine. Every situation has its idiosyncrasies, but most people start out with a passion for what they're doing. In today's podcast we hear from doctor-career coaches Ashe Coxon and Sarah Dalton who help medics solve the workplace challenges, and remember what drew them to the profession. Associate Professor Peter Connaughton describes burnout as an occupational health issue, that needs to be solved organisationally. Those presentations were recorded at Congress 2021, but we also get a call from a listener wanting to share a simple gesture that can make a world of difference between colleagues stretched thin at a busy hospital. GuestsDr Stephen Philpot FCICM (Alfred Health, Cabrini Hospital)Dr Ash Coxon FRACGP (Townsville Hospital; Medical Career Planning)Dr Sarah Dalton FRACP (Westmead Children's Hospital; Associate Professor Peter Connaughton FAFOEM (Curtin University; University of Notre Dame) ProductionWritten and produced by Mic Cavazzini DPhil. Written and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes and ‘Exploring the Lake' by View Points and ‘Into the Bone' by Taylor Crane. Photo image licenced through Getty Images. Feedback on this episode was kindly provided by physicians of the RACP's Podcast Editorial Group; Vicka Poudyal, Michael Herd, Rhiannon Mellor, Nele Legge and Amy Hughes.Please visit the RACP website for a transcript and supporting references. RACP members can claim CPD credits for listening via MyCPD. 

For Matariki, we have Dr. Zoe Raos! Dr. Zoe Raos (Te Āti Awa) is a gastroenterologist in Waitematā, Tāmaki Makaurau. She lives on the Shore with her husband Ben, their two tamariki and their dog. She completed medical school, basic and advanced gastroenterology and general medical training in Auckland, and was involved with leadership roles throughout her training, becoming the Chair of the Binational College Trainees' Committee which included being a Director of the RACP Board. She won the RACP Trainee of the Year Award, prior to starting a three-year clinical fellowship at the John Radcliffe Hospital in Oxford in General Medicine, Hepatology, Inflammatory Bowel Disease and Endoscopy. Zoe has worked at Waitematā DHB since her return from the UK, and collaborated to set up the transition clinic for patients with IBD moving between paeds and adult services. She has written a popular study guide for the RACP exams, now in its second edition, with other collaborative publications themed around quality care. She is a RACP examiner for the Clinical Exam, and a Training Supervisor.Zoe joined the New Zealand Society of Gastroenterology Executive, was elected as president-elect and is the current President until November 2022. She has led the NZSG through times of great change, including developing a cohesive pandemic response, whilst navigating the Society through major externally-led structural changes. Zoe collaborates with other NZSG equity warriors, who have made positive steps towards celebrating diversity and, through governance, creating a future equitable gastroenterology workforce that honours Te Tiriti. She has lost count of the committees she is on – one of the most influential is a global Green Endoscopy Whatsapp group - and spends too much time on Twitter. She loves teaching and mentoring, and is proud to have received awards for both over the years. Zoe loves skiing, cooking and running, spending time with her beautiful whānau, hanging with wonderful friends and colleagues, playing the ukulele and has just started weaving tāniko as part of her cultural journey as a proud wahine Maori.In this episode, we discuss her journey into gastroenterology, indigenising medicine & gastroenterology, navigating motion sickness in scopes, The Aunties and their kaupapa, parenting and neurodiversity, environmental sustainability within medicine and of course, her love for gastroenterology. Mentioned in podcast:Peter Raos: https://peterraos.com/ & https://peter-raos.business.site/The Aunties: https://aunties.co.nz/about-the-aunties‘Autism' in Te Reo Māori: tangata whaitakiwātanga As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show

Not a day goes by that there isn't a headline about the overstretched health service and the struggling professionals within it. It isn't COVID that has created this situation. The pandemic was just the straw that broke the camel's back.At the RACP Congress in May, ENT surgeon Eric Levi explained why burnout should be considered not as a mental health condition but as an occupational disorder. And apart from the stressors of the job itself and the work relationships, the medical profession has a way of consuming one's personal life. Associate Professor Michelle Telfer talked about being hounded for two years by the conservative press over her work with young people struggling with their gender identity. And pain specialist Olivia Ong described how she'd been driven by an unhealthy professional identity until a traumatic spinal injury forced her to reconsider the meaning of self-care. Both physicians found the courage to take control of the situation and define their roles on their own terms.GuestsEric Levi FRACS (Royal Children's Hospital; St Vincent's Hospital; Ear, Nose and Throat Victoria)Associate Professor Michelle Telfer FRACP (Director Adolescent Medicine, Director Gender Service at Royal Children's Hospital Melbourne; Murdoch Children's Research Institute)Dr Olivia Ong FAFRM FFPMANZCA (Monash Health, Advance Healthcare)ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Into the Bone' by Taylor Crane, ‘Below the Horizon' and ‘Haunted Heart' by Dawn Dawn Dawn and ‘Exploring the Lake' by View Points. Photo image by Paul R. Giunta licenced through Getty Images. WellbeingDoctor's Health Advisory Service Helpline Aotearoa-NZ:  800 471 2654NSW/ACT: 02 9437 6552VIC:      03 9280 8712TAS:     03 9280 8712SA:       08 8366 0250NT:       08 8366 0250QLD:    07 3833 4352WA:     08 9321 3098LifelineAustralia: 13 11 14.Aotearoa-NZ: 0800 54 33 54 Converge International  Aotearoa-NZ: 0800 666 367 Australia : 1300 687 327Subscribe to email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify, Castbox, or any podcasting app. Fellows of the RACP can claim CPD credits for listening via MyCPD. For a transcript and further references please visit our website. 

In episode 78 we heard from some physicians who found themselves taking up the role of advocate, not just for their own patients but for broader system change. And health policy lobbyist Patrick Tobin explained how physicians and the College as whole can best get the attention of parliamentarians. For example, the RACP's Healthy Climate Futures campaign calls on Government to make the healthcare system more resilient against the shocks of climate heating and extreme weather events.To complete this series, this episode focuses on what happens to advocacy issues after they land on an MP's desk, and how they get churned through the Canberra machine to eventually become policy. We hear the perspectives of two physicians turned politicians in interviews that first appeared as part of an RACP documentary called The Advocate's Journey. Dr Mike Freelander practiced for 37 years as a paediatrician in Sydney's southwest before being  elected to the federal Division of Macarthur in 2016. for the Labor party. Dr Katie Allen was elected in 2019 as the Liberal Member for Higgins after practicing at the Royal Children's Hospital and directing the Australian Centre of Food and Allergy Research.While the federal election in May 2022 rearranged some of the chairs at the table, the RACP is proud of all its members who have taken the brave steps of entering the political fray. The represent all colours of the political spectrum and we are grateful to have such influential champions for health policy.Guests Dr Rob Lethbridge FRACP (Perth Children's Hospital) Dr Mike Freelander MP FRACP Dr Katie Allen MP (at time of interview)ProductionWritten by RACP Professional Practice team. Music licenced from Epidemic Sound includes ‘Ikigai' by Twelwe and ‘No Show (Instrumental Version)' by Penny Lane. Photo courtesy of Michael@UnsplashPlease visit the RACP website for a transcript. RACP members can claim CPD credits for listening via MyCPD. 

The globe has already warmed by more than one degree Celsius over pre-industrial levels and is on track to exceed two degrees by the end of the century. It doesn't sound like a lot but this will have profound effects on human health with Australia being particularly vulnerable. Most obviously, Australia's biggest cities will become furnaces in summer with a more than doubling of heat-related mortality. The rising temperatures will also increase frequency of the climate oscillations that delivered us record-breaking temperatures and bushfires in 2019-2020, followed by historic rains and floods last summer.  In this podcast we discuss the effects of this increasingly volatile climate on the health of Australians, from infectious disease to respiratory and even mental health. Professor Lynne Madden explains how the health system can become more resilient to these demands and what measures the RACP is asking Federal Government to commit to in preparation for this.  Find out more about the "Health Climate Future" campaign here.  Guest Prof Lynne Madden FAPHM (University of Notre Dame) ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Kauko' and ‘Ikigai' by Twelwe. Music courtesy of FreeMusicArchive includes ‘Nothing Else Matters' by Mystery Mammal, ‘Namaste' by Jason Shaw. Image credit; Jamie Kidston, Multimedia and Production Manager at Australian National University.Please visit the RACP website for a transcript and supporting references. RACP can claim CPD credits for listening via MyCPD. 

Immune checkpoint inhibitors have revolutionised care for patients with advanced melanoma and other cancers. These days around half of patients with unresectable metastatic melanoma can expect to live to five years after a regime of agents such as nivolumab and pembrolizumab. That's up to ten times the survival rate of patients a decade ago, when the chaemotherapy Dacarbazine was the front-line treatment. Over half of these patients who respond to immune checkpoint inhibitors will go on to survive long-term but it's still not possible to identify responders in advance. On top of this, some of the immune-related side-effects of therapy can be serious enough to require stopping therapy. Oncologist Matt Carlino explains how to approach the challenging conversations with patients about hopes around expectations for prognosis and quality of life. The risk-benefit equation becomes harder to balance when considering treatment for grade III or even grade II melanomas, as an adjuvant to surgery. Associate Professor Carlino also discusses the process of getting these new indications listed on the PBS, or how treatment can be funded when they are not. Guest Associate Professor Matteo Carlino FRACP (Westmead Hospital; Blacktown Hospital; Melanoma Institute Australia; University of Sydney)ProductionWritten and produced by Mic Cavazzini DPhil. Music courtesy of FreeMusicArchive includes ‘Headway' and ‘Denouement' by Kai Engel, ‘Tavern' by Sergey Cheremisinov, ‘New Times' by 4T Thieves. Music licenced from Epidemic Sound includes ‘Dusty Decks' by Soul Single Serenade. Image licensed from Getty Images.Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

The core work of being a physician is demanding enough. But if you're seeing patients come in day after day with ailments that have social determinants behind them, you may start to feel like Sisyphus; heaving that boulder up the hill only to have to start from the bottom every time it slips your grasp. Surely it would be better to change those socioeconomic drivers but where do you even begin? In fact, the three word mission statement of the RACP is Educate - Advocate – Innovate.  In this podcast, former General Manager of Policy and Advocacy, Patrick Tobin, explains how the College helps physicians put cases of health equity to those in power.  We hear from Kids off Nauru champion Dr Helen Young, and Dr Jin Russell explains how to harness social media to capture the attention of politicians and journalists. The interviews are drawn from an RACP-produced documentary called The Advocate's Journey hosted by Dr Robert Lethbridge. It is ever-more relevant given the high profile of public health in recent times. GuestsDr Rob Lethbridge FRACP (Perth Children's Hospital)  Dr Helen Young FRACP (Royal North Shore Hospital; The Children's Hospital at Westmead) Patrick TobinDr Jin Russell FRACP (Starship Children's Hospital; University of Auckland) ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Missing Memories' by Christopher Moe Ditlevesen, ‘Kauko' by Twelwe, ‘Full House Dusk' by River Foxcroft and ‘No Show (Instrumental)' by Penny Lane. Image licenced from Getty Images. Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

Note to listeners: Please consider joining the Podcast Editorial Group for 2022. Key responsibilities are to: (1) Discuss potential new podcast topics and prioritise them for development (2) For a chosen topic, suggest themes to explore and people to interview (3) Listen to audio drafts and provide feedback to the producer to improve it before publicationCorrespondence is conducted entirely via informal emails and the time commitment averages under 90 minutes per month. More information at https://www.racp.edu.au/podcast This episode is shared from the Essential Ethics podcast produced at the Royal Children's Hospital in Melbourne. It is presented by paediatric respiratory physician John Massie and clinical ethicist Lynn Gillam who are respectively the Clinical Lead and Academic Director of the Children's Bioethics Centre.In a series titled “Deciding with Children” they raise the following questions. When can a child be considered to have autonomy to make healthcare decisions for themselves? What intrinsic rights does a young patient have up to this age of so-called Gillick competence? How should responsibility for difficult decisions be shared between the patients, the parents and clinicians? And is it possible to minimise the moral injury when the wishes of the patient need to be over-ruled? For the full series go to rch.org.au/podcasts/essential-ethics. GuestsProf Lynn Gillam (Academic Director, Children's Bioethics Centre, University of Melbourne) Prof John Massie FRACP (Royal Children's Hospital Melbourne, University of Melbourne)Assoc Prof Clare Delany (Children's Bioethics Centre, University of Melbourne) Assoc Prof Daryl Efron (Murdoch Children's Research Institute, University of Melbourne)ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Kryptonite' by Blue Steel, ‘Going Undercover', ‘I Have a Plan', ‘See you Soon' by Borrtex and ‘By the Harbor' by Mhern. Image courtesy of Jin Han Tan at Flickr. Feedback on this episode was kindly provided by the following members of the Podcast Editorial Group.Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

This is the third podcast in a series about medical injury. First we talked about what victims of injury want to hear from the health system after such an event. And then we discussed the guilt and compromised professional identity that doctors might feel when they've been involved in a patient harm. We also heard how fear of medicolegal suits is a major obstacle to greater transparency. At least that's the case in Australia, where litigation is virtually the only way for victims to get financial compensation for their hardship and ongoing care. New Zealand, by contrast, operates a no-fault compensation scheme where all such costs are born by the government, for harms from care that are relatively unpredictable. We'll look at the advantages this system has, for patients and practitioners, but also at some of the issues that remain unresolved. Guests Associate Professor Marie Bismark FAFPHM (Melbourne School of Population and Global Health University of Melbourne). Associate Professor Katharine Wallis FRACGP FACRRM (Head, Primary Care Clinical Unit, University of Queensland) ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Circular' by Silver Maple, ‘Into the Bone' by Taylor Crane, ‘Heart of the River of the Sun' by Lama House, ‘Disconnect' by Gavin Luke, and ‘Five Below' by Torii Wolf. Image licensed from Getty Images. Feedback on this episode was kindly provided by the following members of the Podcast Editorial Group; Loryn Einstein, Phillipa Wormald and Lisa Mounsey.Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

In the last episode we talked about what patients or their families want to hear after a iatrogenic injury. Despite best practice standards for open disclosure, this occurs far less often that it should. The reluctance from health practitioners to be more transparent is in part due to a misplaced fear of exposure to liability, but perhaps the greatest barrier to incident disclosure is culture of medicine itself. The historic tropes of the infallible physician and the heroic surgeon are still strong today. Though team-based practice has become the norm, many doctors find it hard to admit to a mistake, not just to patients and colleagues but even to themselves. This podcast explores the guilt that can come about from having caused harm, and the cognitive dissonance this creates in one's professional identity as a healer.  Guests Associate Professor Stuart Lane  FCICM  (Nepean Hospital; FMH lead for Education, University of Sydney) Professor Simon Willcock FRACGP (Program Head of Primary Care and Wellbeing at Macquarie University; Clinical Program Head of Primary and Generalist Care, Wellbeing and Diagnostics at MQ Health)ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Far Away from Home' by John Glossner, ‘Illusory Motion' by Gavin Luke, ‘Heart of the River of the Sun' by Lama House and ‘Struck By You' by Seroa. Music courtesy of Free Music Archive includes ‘Harbor' by Kai Engel. Image licensed from Getty Images. Additional voiceovers by Michael Pooley.Feedback on this episode was kindly provided by the following members of the Podcast Editorial Group; Li-Sza Tan, Saion Chaterjee, Vicka Poudyal, Paul Cooper, Rhiannon Mellor and Lisa Mounsey.Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

I'm so excited to be sharing another weight loss success story in this episode! Dr. Josephine Braid is a rehabilitation medicine doctor from Australia who specializes in traumatic brain injuries, and she joins me today to share all about her time in Weight Loss For Doctors Only. You can find show notes and more by clicking here: http://www.katrinaubellmd.com/250

Medical injury occurs at a rate of about 12 per cent of admissions, and errors without consequence at a higher rate still. According to Australian and New Zealand guidance documents, disclosure of error “is a patient right, anchored in professional ethics, considered good clinical practice, and is part of the care continuum.” But many practitioners are fearful of the medicolegal consequences of disclosure, or unsure about how to present the details of a challenging episode in care. In this podcast we hear how they can provide victims of adverse healthcare incidents with the comfort they seek. Guests Professor Rick Iedema (Director Centre for Team-Based Practice & Learning in Health Care, King's College London) Professor Simon Willcock FRACGP (Program Head of Primary Care and Wellbeing at Macquarie University; Clinical Program Head of Primary and Generalist Care, Wellbeing and Diagnostics at MQ Health)ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Floating Kite by Tellsonic, ‘April Snow' by Gavin Luke and ‘Five Below' by Torii Wolf. Music courtesy of Free Music Archive includes ‘Cherry Blossom' by Daddy Scrabble, ‘January' by Kai Engel and ‘Remember the Archer' by Scott Holmes. Image licensed from Getty Images. Additional voiceovers by Michael Pooley.Feedback on this episode was kindly provided by the following members of the Podcast Editorial Group; Loryn Einstein, Lisa Mounsey, Rhiannon Mellor, Nele Legge, Sern Wei Yeoh, Joseph Lee, Marion Leighton, Oliver Dillon, Ilana Ginges, Rosalynn Pszczola, Lucy Haggstrom, Paul Cooper, Atif Mohd Slim, Victoria Langton and Ellen Taylor.Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

There are many layers of public health interventions that can reduce the rate of transmission of the novel coronavirus. Social distancing, mask wearing, lockdowns and vaccines each nudge the reproduction number down. But you need all of them working together to make a significant impact, and that means you need the community on board. In this podcast we discuss the challenges and strategies around communicating public health messages to the public during a time of such high anxiety. Jessica Kaufman is a research fellow in the Vaccine Acceptance, Uptake and Policy Research Team at the Murdoch Children's Research Institute who presented her work to the RACP Congress in May. She outlined the principles and clarity, transparency and consistency that are needed to win the public's trust when tough social restrictions need to be adhered to.    We also hear an interview with Professor Allen Cheng FRACP, who's played this game harder than most. As Deputy Chief Health Officer of Victoria, he advised on implementation of the lockdown that brought Melbourne's second wave to a halt after four long months. If being part of fun police wasn't enough responsibility, he also co-chaired the COVID-19 Group at the Australian Technical Advisory Group on Immunisation which had to weigh up the suitability of the Astrazeneca vaccine as reports of rare side-effects and death were emerging in real time. He describes the fine balance between providing enough information for the public to be able to make informed decisions.Guests Dr Jessica Kaufman (Murdoch Children's Research Institute) Professor Allen Cheng FRACP (Alfred Health; Monash University; ATAGI; TGA)ProductionWritten and produced by Mic Cavazzini DPhil. Music courtesy of Free Music Archive includes ‘Passages' and ‘Snowfall Intro' by Kai Engel, ‘Become Death' by Jahzarr. Music licenced from Epidemic Sound includes ‘Sunstorm' by ELFL. Image licensed from Getty Images.  Feedback on this episode was kindly provided Frank Beard of the RACP COVID-19 Expert Advisory Group, and the members of the Podcast Editorial Group.Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

The COVID-19 pandemic has brought to public attention, like never before, the work of public health physicians as well as epidemiologists, statisticians and computer modelers. The crisis also shown how hard it is to take decisions affecting the lives of millions when there is so little evidence to go on. Models of viral spread and interventions to mitigate these have become everyday discussion points, but few people understand how hard these are to put together. In this podcast we share expert talks that were presented at the RACP Congress in April and May. While they precede the latest developments of the delta strain and the National Plan to curb it by increasing vaccination rates, they clarify some of the first principles that go into creating these simulations, and the pressures of giving critical public health advice.Guests Professor Michael Baker FAFPHM (University of Otago)Professor Tony Blakely (Melbourne School of Population and Global Health, University of Melbourne) Professor Jodie McVernon FAFPHM (Director of Epidemiology, Doherty Institute) ProductionWritten and produced by Mic Cavazzini DPhil. Music courtesy of FreeMusic Archive includes, ‘Namaste' by Jason Shaw, ‘Snowfall Intro' by Kai Engel, ‘Become Death' by Jahzarr, ‘The Time is Now' by Borrtex. Music licenced from Epidemic Sound includes ‘Organic Textures' by Johannes Bornlöf  and ‘Sunstorm' by ELFL. Image licensed from Getty Images.  Feedback on this episode was kindly provided Frank Beard of the RACP COVID-19 Expert Advisory Group, and the following members of the Podcast Editorial Group; Rosalynn Pszczola, Seema Radhakrishnan, Duncan Austin, Sern Wei Yeoh, Paul Cooper, Adrienne Torda, Nele Legge, Keith Ooi, Lisa Mounsey, Marion Leighton, Stella Sarlos and Rhiannon Mellor. Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

aIn 2017, Victoria was the first state in Australia to pass voluntary assisted legislation and has been followed by Western Australia, Tasmania and now South Australia. Aotearoa-New Zealand passed its End-of-life Choice Bill two years ago and that will go live in November. This podcast draws on the experience of some very committed Victorian clinicians who share the lessons they've learned  over the last two years about practical implementation of VAD.The presenters were recorded at this year's RACP Congress held in May. Palliative care physician Danielle Ko explained how Austin Health has prepared and supported its healthcare staff through this shift in practice. Palliative care Greg Mewett described the challenge of consulting remotely with patients in regional Victoria. Professor Paul Komesaroff reflected on some other points of friction in Victoria's law as it stands and the practicalities of medical practice. And Professor James Howe talked of his work as a neurologist in a Catholic healthcare institution, and how tensions over assisted dying had been resolved. Guests  Dr Danielle Ko FRACGP FAChPM (Clinical Ethics Lead, Austin Health; VAD Review Board, Safercare Victoria)Dr Greg Mewett FRACGP FAChPM DRCOG (Ballarat Rural Health; Grampians Regional Palliative Care Team)Professor Paul Komesaroff FRACP (Alfred Hospital; Monash University)Adjunct Assoc Prof James Howe FRACP (VAD Review Board, Safercare Victoria)Dr George Laking FRACP (Auckland City Hospital; RACP President Aotearoa New Zealand)ProductionWritten and produced by Mic Cavazzini DPhil. Music courtesy of Epidemic Sound includes ‘Like Clockwork', by Benjamin Kling, ‘September Skies' by Silver Maple, ‘Mistranslations by Rand Aldo, ‘Elm Lake' by Elm Lake, Finally B by ‘Twelwe. Image licensed from Getty Images.Feedback on this episode was kindly provided by physicians of the RACP's Podcast Editorial Group; Paul Cooper, Rhinnon Mellor, Loryn EinsteinPlease visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

Acute Kidney Injury makes a greater contribution to early mortality than acute myocardial infarction and it's been argued we should consider the concept of “kidney attack” to give it the weight that it deserves. But the presentation of kidney injury isn't as overt or timely as a heart attack often is. While serum creatinine is a pretty good reporter of chronic impairment in kidney function it's very insensitive to acute injury, so for two decades there's been a concerted search for more proximal biomarkers of AKI. The three most promising candidates are neutrophil gelatinase‐associated lipocalin (NGAL), tissue inhibitor of metallo-proteinase 2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGBFP-7). Commercial assays for these exist that can predict moderate to severe AKI with a lead time of many hours in at-risk patients. But many questions remains as whether these are specific enough to be useful at point of care whether we have the interventions to respond to the information they provide, and what ‘false positives' might indicate.Guest  Professor Rinaldo Bellomo AO FRACP FCICM FAHMS (Director of Research Intensive Care, Austin Hospital; University of Melbourne; Monash University). author of “Novel renal biomarkers of acute kidney injury and their implications” (2021) Internal Medicine Journal 51;3 pp316-318ProductionWritten and produced by Mic Cavazzini DPhil. Music courtesy of FreeMusicArchive includes ‘Downhill Racer', by Blue Dot Sessions, ‘Making a Change' by Lee Rosevere, ‘Fryeri' by Kai Engel, ‘Subscribe to the New Internationalist' by Tzara. Image licensed from Getty Images.Feedback on this episode was kindly provided by physicians of the RACP's Podcast Editorial Group; Vicka Poudyal, Paul Cooper, Rhiannon Mellor, Duncan Austin, Seema Radhakrishnan, Phillipa Wormald, Victoria Langton,  Oliver Dillon and Loryn Einstein.  Please visit the RACP website for a transcript and supporting references. Fellows of the College can claim CPD credits for listening and additional reading. 

This is the third and final part of our series on gendered medicine. We step back and look at the way that health care and research are funded. It’s been said that the health needs of women are undervalued by our existing fee-for-service model, down to individual item numbers in the Medicare Benefits Schedule. There’s also evidence that disease predominantly experienced by female patients receive less research investment. Is this blatant sexism or a symptom of other structural imbalance? And what do we do about it? Guest  Dr Zoe Wainer BMBS, PhD, MPH (Director of Clinical Governance, BUPA)ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Lullaby’ by OOy, ‘Cocktail’ by Major Tweaks, ‘Soul Single Serenade’ by Dusty Decks, ‘Elm Lake’ by Elm Lake, ‘Kauko’ by Twelve, ‘Fugent’ by Lupus Nocte. Voice acting by Ai Leen Quah. Image by Claudius Vesalius courtesy of Wikimedia Commons. Feedback on this episode was kindly provided by physicians of the RACP’s Podcast Editorial Group; Ilana Ginges, Sern Wei Yeoh, Lucy Haggstrom, Nele Legge, Ketih Ooi, Adrienne Torda, Li-Zsa Tan, Loryn Einstein, Vicka Poudyal, Rhiannon Mellor, Rosalynn Pszczola. Other reviewers include Dr Lucy Mitchell and Rebecca Lewis, Elyce Pyzhov, Michelle Daley, Cristiana Palmieri PhD and Dr Anna Sidis DCP. Please visit the RACP website for a transcript and embedded citations. Fellows of the College can claim CPD credits for listening and additional reading. 

Gender can be considered a social determinant of health, in the different pressures and expectations it puts on women and men. For example, the taboos around menstruation are so profound that many young women are dangerously naïve about their own reproductive health. Meanwhile, endometriosis, chronic fatigue syndrome, and other conditions associated with chronic pain have a stigma around them that means self-reports are often not taken seriously by health professionals. Historic notions of hysteria have a more profound impact on medical thinking than we might imagine, and in this podcast we ask what can be done to erase these. GuestGabrielle Jackson (Associate News Editor Guardian Australia, Author Pain and Prejudice)  ProductionWritten and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Elm Lake’ by Elm Lake, ‘Soul Single Serenade’ by Dusty Decks, ‘Desert Hideout’ by Christopher Moe Ditlevsen, ‘September Skies’ by Silver Maple, ‘Fugent’ by Lupus Nocte. Image licenced from Getty Images. Voice acting by Paul Curtis. Feedback on this episode was kindly provided by physicians of the RACP’s Podcast Editorial Group; Ilana Ginges, Sern Wei Yeoh, Lucy Haggstrom, Nele Legge, Ketih Ooi, Adrienne Torda, Li-Zsa Tan, Loryn Einstein, Vicka Poudyal, Rhiannon Mellor, Rosalynn Pszczola. Other reviewers include Dr Lucy Mitchell and Rebecca Lewis, Elyce Pyzhov, Michelle Daley, Cristiana Palmieri PhD and Dr Anna Sidis DCP.Please visit the RACP website for a transcript embedded with citations. Fellows of the College can claim CPD credits for listening and additional reading.  

Smith Memorial Playground & Playhouse opened in the city’s East Fairmount Park in 1899 and has been offering free family fun for 121 years. The non profit organization just received a $1 million grant by Governor Tom Wolf and PA's RACP for its Preserving Play Campaign. Frances Hoover, Executive Director of Smith Memorial Playground & Playhouse talks about the grant and the upcoming play season. Come out to Smith on March 27th for their annual Play-A-Palooza to celebrate the beginning of the Spring/Summer play season!     See omnystudio.com/listener for privacy information.

Prof John Wilson AM, BSc (Hons), MBBS, PhD, FRACP, FCCP, MAICD. John Wilson graduated with a MBBS from the University of Melbourne in 1980. Following his physician training at The Royal Melbourne Hospital, with a special interest in intensive care and respiratory medicine John completed a PhD in the role of inflammation in asthma before moving to the UK to join a major asthma research group in 1988. John's work is in the treatment of patients with lung disorders, including cystic fibrosis, asthma and pneumonia. His research interests include the use of new pharmacological treatments, video-conferencing in delivering care programs in CF lung disease, the application of electronic health records to improve clinical care. John is Chair, Senior Medical Staff Associations at Alfred Health and Victoria. President-elect, RACP, and Chair of the College's Education Committee. John is a consultant to government and industry bodies in Australia and overseas. Dr Louise Segan Dr Louise Segan is a final year Cardiology trainee in Victoria. She will commence a PhD in cardiac electrophysiology in 2021. Louise is passionate about promoting gender diversity in medicine, with a particular focus on cardiology and its subspecialties. This stemmed from her own experiences as one of only two female cardiology trainees in her year of training.

Wow, what great news we have from the RACP. Please take the time and read it for yourself, don't just take my word on it. https://www.racp.edu.au/news-and-events/media-releases/racp-statement-on-gender-dysphoria/?fbclid=IwAR1gdovPOeNTF2W5vjSeSCMgEHuyeu0eXuOaVX_HDwiYaK8ur2fUiiXVutQ I am also giving you some crazed parenting that is part of my life as well in this episode. Then I am closing out the show with an update on the up and come book The Choice.

"More is not always better when it comes to healthcare" is the mantra of the Choosing Wisely Australia campaign, which seeks to reduce unnecessary medical interventions. In this episode, Dr Joanna Lawrence, medical lead of the Choosing Wisely campaign at RCH, talks with A/Prof Ed Oakley about low value care. They discuss clinician reasons for performing low value tests and the potential harms. Ed discusses examples of low value care in the setting of bronchiolitis and pneumonia and how to approach discussing this issue with families. They reflect on the recommendation to treat on clinical grounds, trust your clinical judgement and reflect on the conscious decision to not perform tests. Resources:Top 5 'not to do practices' (low value care) as nominated by the RACP, Paediatric and Child Health division Royal Australasian College of Physicians PaCHd Lawrence J, Andrew L, Bracken J, Voskoboynik A, Oakley E, South M, Middleton K, Scanlan B, Marshall T, Hiscock H. Bronchiolitis at a specialist paediatric centre: The electronic medical record helps to evaluate low value care. Journal of Paediatrics and Child Health/ Early View. Published online 25 August 2019 https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.14602 PODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

Geoff graduated from the University of Melbourne in 1985 and completed his residency years/Gastroenterology training at The Royal Melbourne and Austin Hospitals, followed by a PhD in Neurogastroenterology in Adelaide supervised by Prof Michael Horowitz and Prof John Dent and then a postdoctoral position in Zurich Switzerland. He returned from Zurich and was appointed as a Gastroenterologist at the Repatriation General Hospital in Adelaide prior to his current appointment as Director of Gastroenterology and Hepatology at The Royal Melbourne Hospital in 2002 (to the present time) and Clinical Associate Professor in the University of Melbourne. His academic interests are in Neurogastroenterology and data acquisition/processing. Other appointments include Gastroenterology Advanced Training Committee of the RACP, and on the Council of the Australasian Neurogastroenterology and Motility Association. Geoff’s clinical interests are in patients with complex functional gastrointestinal disorders, but he has quite enough of them and does not need any new referrals. What we covered: Functional digestive disorders Neurogastroenterology a relatively new area of Gastroenterology Differences between Inflammatory Bowel Disease and Functional Digestive disease “There is no nothing wrong with you is explained” We touch on Placebo and Nocebo effect and the importance of Doctor patient relationship How Geoff got into the area of Upper GI We talked about Gastroparesis Functional Dyspepsia Belching or Burping and farting Bloating and Gurgling We talked about the Bowel and its role in digestion We touch on the effects of diet on gut We talked about constipation and whether constipation toxify the body? Passage of Mucus from Bowel Gut bacteria and evolutionary benefits

Physician and Intensivist Steve Warrilow, Director of the Austin Hospital ICU, talks about everything from Physician Generalism to Surgical Super Specialisation. Stephen is a man that can communicate. Stephen Warrilow is in many respects my ideal Intensivist. Trained as a physician (aka Internal Medicine), a generalist by anyones standards, he specialised in ICU and was good enough to become the Director of the same unit that brought you Rinaldo Bellomo. He brings a calm, measured, intelligent voice to all he does. He makes people like me look bad. I sat down and chatted to Stephen at the CICM ASM and was hoping to find some sort of flaw, something that I could use against him, but no. I liked him even more after we talked. We did get stuck into some important stuff starting with Stephens own path from Physician Trainee to Intensive Care. He would know a little bit about it too as he not only ran the regional physicians training consortium for 7 years but he still examines for the Royal Australian College of Physicians. Having completed the RACP process himself he had to deal with the rather important fact that he doesn’t really like out-patient clinics. Hmmmm. So Stephen was one of those brave people that starts in an ICU even though, in his own words, he “couldn’t intubate, couldn’t do lines”. Stephen is in a great place to compare and contrast RACP and CICM training. At the CICM ASM Stephen was one of the leaders of the Consultant Only ICU Update Pre-Conference workshop which was about communication. So he was teaching the supposed experts how to do what they are supposedly experts at! That sounds a bit difficult. We get into paternalism, (The College also ran a Trainee Only Pre-conference event. Have a listen to Jellybean 62 Sarah Yong speaking about that and there is a soon to be released Jellybean with one of her co-co-ordinators, Naomi Diel.) Despite the physician back story we end up talking about surgical hyper specialisation and what it might mean. The Jellybean Podcast is about the stories in between the obvious stuff in Medicine, nursing and paramedicine. It's good to talk.

Doctor jobs and the training pathway! In part 1 we cover all the hoops (jobs) you have to jump through to get from medical student to consultant.. TI, house officer/surgeon, SHO, registrar (training or non-training), fellow, consultant. We also look at how these different levels of doctor come together as an unbeatable medical team. Stay tuned for part 2, where we'll be looking in more detail at specialty training pathways, and the key professional colleges like RNZCGP, RACP, RACS, RANZCOG, ACEM and others...