Podcasts about Ross University

Lynsey Victoria Rinelli, DVM, is an emergency veterinarian in Paramus, NJ. A Wagner College graduate with a BS in Biology and major in Psychology. After her time at Ross University and clinical year at LSU, she traveled to Alaska. There she participated in the aid of canine racers in the Willow 300. She is now focused on emergency surgery, physical rehabilitation, and exotic animal medicine. She has published her first children's book as a memoir to moms in the postpartum period. Celebrated on Staten Island Live, she was able to express the inspiration for that dedication to her daughter, Gracelyn. Her second book was celebrated in November 2024 in order to help families process pet loss around the world. She has sent her book to over 80 clinics across the US and Canada.  Working with families during their most pivotal moments. "Goodbye for Now" was born.  She has officially become the first author in her family in 2024;  celebrating a NYC big book award distinguished favorite and Independent press award winner in multiple categories this May. 

Dr. Yasmine Elamir joins us to address the stigmas of obesity by sharing her personal journey of overcoming Type 2 Diabesity. A triple board-certified Endocrinologist, Obesity Specialist, and Best-Selling Author with nine years of experience, Dr. Elamir compassionately guides her patients toward curing Type 2 Diabetes and achieving sustainable weight loss through her innovative app and methods. She earned her bachelor's degree from Johns Hopkins University and her medical degree from Ross University, completing her Internal Medicine residency at Robert Wood Johnson Barnabas Health and a fellowship in Endocrinology, Diabetes, and Metabolism at Mount Sinai Beth Israel, where she was Chief Fellow. As a certified Health and Wellness Coach, Dr.Elamir's mission and trajectory is to empower individuals with the knowledge and tools to heal and live free from diabesity. Dr. Yas is one of the most endearing and compassionate individuals I have ever met.Podcast Description TemplateYou can connect with Dr. Yasmine Elamir on Instagram @diabetes_md or check out her website https://linktr.ee/Dr.Yasmine

This week on The Pet Buzz, Petrendologist Charlotte Reed talks with Ross University's retired, veterinarian Dr. Ibrihm Shokry about toxic holiday plants and Christmas Tree Designer, Kim Schribner about how to safely decorate your Christmas tree in pet owning households.

Today's Episode Charlee reviews chapter 23 from the Pediatric Morning Report book. A 10-year-old female presents to clinic reporting recurrent episodes of burning pain during urina- tion, urinary incontinence, and increased urinary frequency. She has a history of recurrent urinary tract infections (UTIs). The present urinary symptoms started 2 days ago. She denies having fever, chills, nausea, vomiting, abdominal pain, or flank pain. In between these episodes, the child denies having urinary urgency, hesitancy, and incontinence. She has one bowel movement per day and reports no history of constipation. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Learn more about Fetch Long Beach and register here today!  Boaz Man, DVM,  is the owner and medical director of Boca Midtowne Animal Hospital, an AAHA accredited facility. He is a fear free certified professional with over 20 years of experience in private practice. Man earned his bachelor's at the University of Miami and Doctorate of Veterinary Medicine from Ross University. He is a national speaker on digital cytology and laser surgery and believes in the power of social media storytelling to advance animal health care. You can find him on Instagram @bocamidtownevet.

In this episode of Speaking of Pets, Dr. Alice Jeromin and her sister Janet welcome the remarkable Dr. Lynsey Victoria Rinelli for a lively conversation about the intricate world of pet care. As a board-certified veterinary dermatologist and experienced veterinarian, Alice sets the stage for an engaging discussion that is a must-listen for any pet owner or animal lover. Dr. Rinelli, the head of exotics at the Veterinary Emergency Group in Paramus, New Jersey, shares her fascinating journey—from her studies at Wagner College and Ross University to her diverse internships across the country. She discusses the unique challenges and surprises that veterinarians encounter when working with exotic animals. Additionally, she highlights her newly released children's book, "Goodbye for Now," which helps kids cope with the loss of a pet, adding a heartfelt dimension to the episode. Dr. Rinelli's passion for animal care and her dedication to helping families navigate pet loss shine through, making her insights invaluable. With humor, warmth, and a wealth of knowledge, Alice, Janet, and Lynsey create an inviting atmosphere that encourages listeners to relate and connect. Whether you are a seasoned pet owner or considering bringing a furry friend into your life, you will find practical advice, touching stories, and perhaps a few laughs throughout the discussion. Don't miss out on this energetic and informative episode! Make sure to like, follow, and subscribe to the @SpeakingOfPets podcast to stay updated on all things pets. Support Dr. Rinelli by visiting her website, https://littlegreysbooks.com/ As a veterinarian who is a board certified allergist & dermatologist, Dr. Alice Jeromin has certainly seen her share of scratching pets. Wouldn't it be great to be able to stop the itching BEFORE it starts? Vetrimax Allergy CZN soft chews are an allergy defense supplement designed to do just that! This high potency, clinically proven supplement boosts dogs' natural defenses against allergens & illness, and dogs love them! Allergy CZN with ImmunoRISE® is a proprietary blend of probiotics, essential fatty acids, Vitamin C, quercetin and zinc and is specifically formulated for dogs 20 lbs. or more that are prone to itchy, irritated skin due to an allergic response. Proudly manufactured in the USA with Good Manufacturing Practices/cGMP in FDA-registered facilities, VetriMax Allergy CZN soft chews help stop the itching before it starts….and makes it better for you & your pet. Check out their products at VetrimaxProducts.com or visit https://www.Chewy.com/f/vetrimax_f1v400463 to save 50% on your first order by entering the promo-code ALLERGY50 at checkout! Support our sponsor for this episode Blue Buffalo by visiting bluebuffalo.com. BLUE Natural Veterinary Diet formulas offer the natural alternative in nutritional therapy. At Blue Buffalo, we have an in-house Research & Development (R&D) team with over 300 years' experience in well-pet and veterinary therapeutic diets, over 600 scientific publications, and over 50 U.S. patents. At Blue Buffalo, we have an in-house Research & Development (R&D) team with over 300 years' experience in well-pet and veterinary therapeutic diets, over 600 scientific publications, and over 50 U.S. patents. All footage is owned by SLA Video Productions.

Dr. Raheleh Sarbaziha is a medical doctor specializing in hormones, integrative medicine, and aesthetics.   She completed her medical education at Ross University and her residency at USC, followed by a fellowship in integrative medicine at the University of Arizona.   Dr. Rahi established her own cash-only business to practice integrative medicine often not covered by insurance.   Dr. Rahi emphasizes the importance of disease prevention and optimal living. She believes in a proactive approach to health rather than solely treating illnesses.   She shares how to prioritize building strong patient relationships and spending significant time understanding their lives and health concerns.   Dr. Rahi emphasizes the importance of a holistic approach to health, combining physical fitness and diet for personal well-being. Website: Dr. Rahi Integrative Aesthetics Instagram: @doctorrahimd Facebook: Dr. Rahi   Previous Episode: iam160-doctor-helps-create-health-beauty-from-the-inside-out   Check out our CEO Hack Buzz Newsletter–our premium newsletter with hacks and nuggets to level up your organization. Sign up HERE.  I AM CEO Handbook Volume 3 is HERE and it's FREE. Get your copy here: http://cbnation.co/iamceo3. Get the 100+ things that you can learn from 1600 business podcasts we recorded. Hear Gresh's story, learn the 16 business pillars from the podcast, find out about CBNation Architects and why you might be one and so much more. Did we mention it was FREE? Download it today!

Today's Episode Charlee reviews chapter 19 from the Pediatric Morning Report book. A 2-week-old female infant is seen for a follow-up visit. She was born at term after an uncom- plicated vaginal delivery. Over the past week, she has developed recurrent vomiting, diarrhea, and poor feeding. She has not been able to gain weight and appears less interactive. Her blood pres- sure is 70/40 mm Hg, pulse rate is 165 beats/min, respiration rate is 18 breaths/min, and oxygen saturation was 95% on room air. On physical examination, she appears lethargic. She has sunken fontanelles, dry mucous membranes, and decreased capillary refill. On genitourinary examination, there is significant clitoromegaly and fusion of the labiosacral folds. There is also slight hyper-pigmentation of the skin that is more prominent in the skin creases and genital area. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 18 from the Pediatric Morning Report book. A 4-year-old fully immunized male presents with 2 days of fever and irritability. His examination is normal. He is presumed to have a viral syndrome and discharged with reassurance and instruc- tions to bring him back if his fever continues or if any other symptoms of concern develop. Three days later, the patient is brought back. His fevers have persisted, rising as high as 103°F. He has been particularly irritable, and new symptoms include red eyes and a rash. There has been no recent travel or known animal exposures. He has been on no medications other than intermit- tent acetaminophen and ibuprofen for the fever. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Lynsey Victoria is an emergency Veterinarian. A Wagner College graduate with a BS focused in Biology and Psychology. She pursued her dream to become a Veterinarian in 2014. After her time at Ross University and clinical year at LSU, she traveled to Alaska. There she participated in the aid of canine racers in the Willow 300. She is focused on emergency surgery, physical rehabilitation and exotic animal medicine. Email: lynseyrinelli@gmail.com instagram

Today's Episode Charlee reviews chapter 16 from the Pediatric Morning Report book. An 11-year-old male presents with scattered petechiae and increased bruising over 3 weeks, first on his legs, then spreading to his abdomen and arms. He cannot recall any trauma preceding the bruising but does report fever, cough, rhinorrhea, and headache 6 weeks prior that resolved over several days. He had a deciduous (baby) tooth fall out (shed) 3 days prior to presentation, without excess bleeding. He does not have gingival bleeding, nose bleeds, or joint swelling. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 17 from the Pediatric Morning Report book. A 3-year-old white female presents to the emergency department with 1 week of cough, purulent sputum production, dyspnea, fever, and failure to thrive. Her symptoms have been steadily wors- ening during this time period. The parents state that they suspect she has pneumonia, because she has already had pneumonia three times in the last 2 years. Seven months ago, she required a 2-week course of intravenous antibiotics when she presented to a different hospital with the same symptoms. The patient is admitted for further workup of both her acute and chronic symptoms. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 14 from the Pediatric Morning Report book. A premature female neonate is born to a G1P0-1 mother at 24 weeks and 5 days gestation with a birth weight of 769g via spontaneous vaginal delivery after preterm onset of labor. The infant requires immediate endotracheal intubation as she is noted to be markedly pale and edematous. Oxygen saturation is in the 60%–70% range. Apgar scores are 1 and 6 at 1 and 5 minutes, respectively. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 12 from the Pediatric Morning Report book. A 12-month-old female presents for a well-child care visit. The mother is concerned that the patient is a “picky eater.” She was exclusively breast-fed until she was 6 months old and then switched to formula with the introduction of solids. At 12 months of age, the mother began giv- ing her cow's milk. The mother states that the patient refuses to eat most vegetables and instead prefers milk. She drinks four 8-ounce bottles of whole cow's milk per day. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 10 from the Pediatric Morning Report book. The obstetric service is monitoring a 33-year-old G9P2071 pregnant female with a history of a prior pregnancy ending in intrauterine fetal demise at 8 months of gestation. A prenatal ultrasound performed at 29 weeks of gestation shows worsening anemia, as evidenced by an elevated peak systolic velocity (PSV) through the middle cerebral arteries. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 7 from the Pediatric Morning Report book. A 13-month-old male presents with 10 days of fever, fussiness, and cough. The patient was seen multiple times by his primary care physician, but thus far no source of fever has been found. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 5 from the Pediatric Morning Report book. A girl is born at 35 weeks and 3 days gestation to a 26-year-old mother. Minimal prenatal care was given prior to delivery. She is born under considerable distress and is apneic on delivery. The child is noted to be cyanotic, with pulse oximetry measuring oxygen saturation of 50%. Initial resuscitation efforts are focused on ensuring adequate ventilation, but despite 100% inspired oxygen delivered via endotracheal tube, with evidence of gas exchange via carbon dioxide detector, the oxygen saturation remains at approximately 70%. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 3 from the Pediatric Morning Report book. A 15-year-old female presents with pain, trismus, and neck stiffness for approximately 5 days. She is able to eat but has pain with chewing and swallowing. She also has right ear pain and a diffuse headache. She has otherwise not had any sore throat, cough, or hoarseness. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Charlee reviews chapter 1 from the Pediatric Morning Report book. A 20-month-old child presents with 8 weeks of right leg pain and limping. She otherwise has had no fever, bleeding, or other joint pain. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Join Esmeralda Cano, DVM, on the Central Line Podcast this week as she discusses the mission of Vetspacito, a platform aimed at breaking down language barriers in veterinary care. Dr. Cano shares the challenges faced by Spanish-speaking pet owners and how Vetspacito's educational resources, including videos and brochures, are empowering veterinary professionals to connect with and serve diverse communities. Dr. Cano is a bilingual Latina, and first-generation college graduate who completed her undergraduate studies at UC Davis and earned her Doctor of Veterinary Medicine at Ross University. She is passionate about overcoming language barriers and promoting diversity and inclusion within veterinary medicine. Discover the impact of language inclusivity on fostering trust and enhancing the overall well-being of pets. Tune in for insights on the importance of cultural understanding and supporting underrepresented communities in the veterinary field. You can visit Vetspacito's website for more information: https://www.vetspacito.com/. As mentioned in this podcast, you can learn more about learn more about Blendvet: https://www.blend.vet/. Central Line is generously supported by CareCredit.   Wish you could watch these conversations? Catch Central Line on YouTube.   Got something to say? We're always up for constructive comments and conversation. Send us feedback or questions anytime at podcast@aaha.org.  This episode was produced by Clear Contender LLC with generous support from CareCredit. This content is subject to change without notice and offered for informational use only. You are urged to consult with your individual business, financial, legal, tax and/or other advisors with respect to any information presented. Synchrony and any of its affiliates, including CareCredit and Pets Best (collectively, “Synchrony”) makes no representations or warranties regarding this content and accept no liability for any loss or harm arising from the use of the information provided. All statements and opinions in the recording are the sole opinions of the speaker. Your receipt of this material constitutes your acceptance of these terms and conditions. The CareCredit health and wellness credit card is accepted at locations enrolled with CareCredit in the United States.

I am excited to welcome back to the podcast, Dr. Steve Grubbs. Dr. Grubbs is the equine technical manager at Boehringer Ingelheim. Originally from Tennessee, Dr. Grubbs grew up breeding and showing Quarter Horses on his family's farm, worked with the Anheuser-Busch Clydesdales and then attended Ross University and the University of Tennessee. He went on to work for 11 years in private practice before returning to graduate school and obtaining a Ph.D. in comparative and experimental medicine, with an emphasis on virology and immunology. Dr. Grubbs now lives in Missouri with his wife and continues his research with BI in areas such as PPID and equine respiratory diseases. Dr. Grubbs joined me this past May to discuss equine asthma on Episode 73 and now is back to discuss his other research focus, PPID. In Episode 79 we discuss:What PPID is (and what it isn't)How to manage a horse with PPIDPRASCEND, a product offered by BI to help control the clinical signs associated with PPID in horsesAnd more!This episode is brought to you by Boehringer Ingelheim.

Resources for the community https://www.enbold.com/ Obesity Telehealth https://www.ivimhealth.com/weightloss/ Telehealth for weight management https://zennutrients.com/ - Supplements Get 20% off with Plus20 Coupon CodeToday, our community story is Susan's. She struggled with obesity, and despite a very successful bariatric surgery, she eventually regained her weight and developed type 2 diabetes. Susan bravely shared her Mounjaro journey with us. We discuss the chronic disease of obesity with Dr. Angelina, an expert in bariatric surgery, weight management, and cosmetic surgery. We revisit the connection between GLP1 and bariatric surgery. Dr. Angelina addresses common challenges post-surgery, including "food noise," weight regain factors, and transfer addiction prevention. We explore how weight can return after bariatric surgery, discuss "apron bellies," and debate the timing of skin removal surgery.Dr. Angelina's BioDr. Angelina Postoev is the founder of Surgicare Arts & Aesthetics and the co-founder and the CEO of IBI Healthcare Institute. Dr. Angelina is triple board-certified by the American College of Surgery and the American Academy of Cosmetic Surgery. Triple-trained and licensed in Cosmetic, General Surgery, and Critical Care Surgery, she is an Augusta University Professor of Surgery. Dr. Postoev received her undergraduate degree from Ohio State University and then attended medical school at Ross University, where she ranked in the top five percent of her class. She completed her residency at the world-famous Cleveland Clinic Foundation, the No. 2 ranked hospital in the United States. Dr. Angelina specializes in abdominoplasty, breast augmentation and reduction, mastopexy, liposuction, buttock enhancement with fat transfer, face and neck lift, blepharoplasty, etc. She is a member of many local and national scientific societies, including the American Society of Cosmetic Surgeons. Connect with Dr. Angelina TikTok @drangelinamdInstagram @dr.angelina.posWebsite https://ibihealthcare.com/providers/dr-angelina-postoev-md-facs/https://www.surgicarearts.com__________________________________________________________________________________#zennutrients #weightloss #peptidevites #ozempic #mounjaro #weightlossSupport the showKim Carlos @DMFKimonMounjaro on TikTokJernine Trott @TheeJernine on TikTokKat Carter @KatCarter7 on TikTokLydia Roberts @mounjaro_GLP_Help on TikTok

Subscriber-only episodeResources for the community https://www.enbold.com/ Obesity Telehealth https://www.ivimhealth.com/weightloss/ Telehealth for weight management https://zennutrients.com/ - Supplements Get 20% off with Plus20 Coupon CodeToday, our community story is Susan's. She struggled with obesity, and despite a very successful bariatric surgery, she eventually regained her weight and developed type 2 diabetes. Susan bravely shared her Mounjaro journey with us. We discuss the chronic disease of obesity with Dr. Angelina, an expert in bariatric surgery, weight management, and cosmetic surgery. We revisit the connection between GLP1 and bariatric surgery. Dr. Angelina addresses common challenges post-surgery, including "food noise," weight regain factors, and transfer addiction prevention. We explore how weight can return after bariatric surgery, discuss "apron bellies," and debate the timing of skin removal surgery.Dr. Angelina's BioDr. Angelina Postoev is the founder of Surgicare Arts & Aesthetics and the co-founder and the CEO of IBI Healthcare Institute. Dr. Angelina is triple board-certified by the American College of Surgery and the American Academy of Cosmetic Surgery. Triple-trained and licensed in Cosmetic, General Surgery, and Critical Care Surgery, she is an Augusta University Professor of Surgery. Dr. Postoev received her undergraduate degree from Ohio State University and then attended medical school at Ross University, where she ranked in the top five percent of her class. She completed her residency at the world-famous Cleveland Clinic Foundation, the No. 2 ranked hospital in the United States. Dr. Angelina specializes in abdominoplasty, breast augmentation and reduction, mastopexy, liposuction, buttock enhancement with fat transfer, face and neck lift, blepharoplasty, etc. She is a member of many local and national scientific societies, including the American Society of Cosmetic Surgeons. Connect with Dr. Angelina TikTok @drangelinamdInstagram @dr.angelina.posWebsite https://ibihealthcare.com/providers/dr-angelina-postoev-md-facs/https://www.surgicarearts.com__________________________________________________________________________________#zennutrients #weightloss #peptidevites #ozempic #mounjaro #weightlossKim Carlos @DMFKimonMounjaro on TikTokJernine Trott @TheeJernine on TikTokKat Carter @KatCarter7 on TikTokLydia Roberts @mounjaro_GLP_Help on TikTok

Episode 134: Dr. Tami Singh of Aspire Health - Plantation, FLDr. Tami Singh is a board-certified Family Physician. She attended Ross University & received her Doctor of Medicine and undergraduate degrees from the University of South Florida. After training, she joined a multi-specialty practice in 2010, Clark and Daughtrey, a physician-owned group.Her patient panel grew to over 4,000 patients in 7 years. She and her staff always strived for a patient's experience in the office to be a pleasant one. However, the physician-owned practice soon merged with a large hospital, and the family feel of the office was lost. Many of the personal touches disappeared and patients felt like a number. This convinced her to seek alternative options to better care for her patients. The obstacles her patients encountered, along with her drive why she became a physician motivated her to open Aspire Health. The DPC membership at Aspire Health allows her to devote quality time to her patients and their families, getting to know them on a more in-depth level. The close relationship she develops and the time she spends with patients are personally important to her. This is the foundation of exceptional health care. In her spare time, she enjoys volunteering at the Miami Rescue Clinic, teaching, traveling, working out, yoga, cooking, and spending time with her family and friends.In this episode...Dr. Tami Singh highlights the uniqueness of DPC, the support it offers within its community, and the empowerment it gives to physicians to practice medicine on their own terms and with a focus on patient care.---------------------LISTENER'S GUIDE!NEW TO THE POD? Get started by downloading our FREE LISTENER's GUIDE with 10 Episodes that will give you a great introduction to the podcast! The Listener's guide covers the founding of DPC, how to finance your practice and how to achieve the elusive work/life balance!To get the Listener's Guide...1) RATE and REVIEW our podcast on Apple Podcasts.2) Take a screenshot ***BEFORE you hit submit*** of your review and then email it to support@mydpcstory.comand you'll find the Listener's Guide in your inbox!---------------------HELP FUND THE PODCAST!CLICK HERE to Support the show---------------------Register for Hint Summit: HEREGet Elation's New Practice Checklist: HERE RosettaFest 2023: A Work of Heart - August 7-9 at Navy Pier, Chicago, IL!WIN a FREE TICKET TODAY and Register (In-Person and Virtual) with code MYDPCSTORY50 to get 50% off RegistrationEnter to win and learn more at https://mydpcstory.com/rosettafest today!Support the showVisit the DPC SWAG store HERE!Let's get SOCIAL! Follow My DPC Story! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

In celebration of the Ross University commencement, Dr Ryan Azarkhail was nominated by his peers to represent the graduating class as this year's student speaker. Dr. Azarkhail quickly became a champion and advocate for the student body while in med school. Along with becoming the SGA President in 2019, he served multiple leadership roles, including Clinical SGA Honor Council Senator, and SGA Class Representative. He continued volunteering his time outside the classroom as a member of the Welcome Committee and the International Medical Foundations Orientation for newly enrolled students, as well as serving as a Student Ambassador.In this episode, he joins me for a conversation about his journey.

Dr. Steve Grubbs is the equine technical manager at Boehringer Ingelheim. Originally from Tennessee, Dr. Grubbs grew up breeding and showing Quarter Horses on his family's farm, worked with the Anheuser-Busch Clydesdales, and then attended Ross University and the University of Tennessee. He went on to work for 11 years in private practice before returning to graduate school and obtaining a Ph.D. in comparative and experimental medicine, with an emphasis on virology and immunology. Dr. Grubbs now lives in Missouri with his wife and continues his research with BI in areas such as PPID and equine respiratory diseases. In Episode 73 we dive into:The difference between mild/moderate and severe equine asthmaTreatment options for the different types of asthmaWhat makes a horse a good candidate for the ASERVO EQUIHALERAnd more!This episode is brought to you by Boehringer Ingelheim.

This week's episode is a special one! Today we talk with Dr. Sean Callanan, the current dean at Ross University in the West Indies, about his journey in veterinary medicine. From his childhood in Ireland, his start in pathology, his passion for teaching, and finally to becoming dean, Dr. Callanan discusses how being intentional and being aware of opportunities leads to where he is today. Along the way, we talk about research programs; diversity, equity and inclusion; emotional intelligence; and social media. We can't wait to share this conversation with you. Remember we want to hear from you! Please be sure to subscribe to our feed on Apple Podcasts and leave us a ratings and review. You can also contact us at MVLPodcast@avma.org You can also follow us on social media @AVMAVets #MyVetLife #MVLPodcast

Todays episode is geared towards medical students and junior residents as we discuss indications for chest tube placement, types of chest tubes, as well as a quick review of the 3 chamber chest tube collection system that can be daunting for new clinicians. Joining me to discuss this topic is our current Brown surgical critical care fellow Dr Jennifer Hubbard, MD. Dr. Hubbard did her undergraduate work at Umass Amherst and then went on to medical school at Ross University before doing a general surgery residency at St Mary's Hospital in Waterbury Connecticut. She is halfway through her surgical critical care fellowship here at Brown and we are excited to have her on the podcast today. Podcast Chapters: (1:29) Chest tube indications? (2:42) Where to needle decompress? (5:27) Difference between a standard chest tube and a pigtail catheter? (9:08) Technique for standard chest tube placement (14:00) Technique for pigtail catheter placement (15:30) Suction versus waterseal? (20:50) Considerations when deciding on removing a chest tube Links to Content Discussed on this episode: Article on chest tube size and hemothorax: https://journals.lww.com/jtrauma/Fulltext/2021/11000/The_small__14_Fr__percutaneous_catheter__P_CAT_.6.aspx?casa_token=mwStOr036p0AAAAA:0_RiqETsgtR70oPpOAsXUO6D1TJGTlDyLQyR-j5NFWpmR-ScFah8Z0kelctpJrRNWTW0bRP1TQPJHb0MPUD31A Behind the knife video on chest tube placement: https://www.youtube.com/watch?v=o5HuiD51Su0 One Pager on Chest tubes (and other important ICU concepts): https://onepagericu.com/chest-tubes My email: Kenneth.lynch@brownphysicians.org Please feel free to send me topics you would like me to discuss on this podcast

This week on the show, Petrendologist Charlotte Reed and Michael Fleck, DVM, talk with Ross University's veterinarian Dr. Ibrahim Shokry about dangerous holiday plants and the National Association of Professional Pet Sitters' Jessica Abernathy about prepping your pet and your home for a pet sitter during the Christmas season.

In this episode, I spoke with Dr Leslie Golden, and we talk about the reality many physicians experience of changing jobs and bringing burnout with you, and how to prevent this from happening to you.Dr Leslie Golden is a Family and Obesity Medicine Physician in Watertown Wisconsin. She received her MD at Ross University, and also holds a Masters in Public Health from Florida International University. She is currently building a coaching and education platform for people wanting to work on achieving and maintaining their goal weight for their long-term health. She enjoys biking, and is known in her town for being a resource for wildlife in need.Find Dr Golden here: Instagram: @weightingoldwellness Facebook: Weight In Gold LinkedIn: Leslie M Golden MD, MPHAre you a Physician struggling with perfectionism? Do you believe if you just worked harder you would figure it out, but you are too exhausted to try? If so, I invite you to check out my upcoming program, Healing Perfectionism in Physicians. This program is designed to help you let go of perfectionism, people-pleasing and frustration, and find more joy, authenticity and self-compassion. Click here to learn more.

Dr. Ashley Rossman was raised in Northbrook, Illinois and spent many hours at her father's veterinary clinic, Glen Oak Dog and Cat Hospital. She earned her undergraduate degree at the University of Michigan and her veterinary degree from Ross University in 2006, doing her clinical year at the University of Minnesota. After graduation, she joined the Glen Oak practice. She was certified in Acupuncture by the Chi Institute in 2007 and was mentored extensively by Dr. Ralph Weichselbaum in diagnostic ultrasound. She has also spent time at the Royal Treatment Veterinary Center and TOPS Veterinary Rehabilitation. Please enjoy this conversation with Dr. Ashley Rossman as we discuss growing up in the family veterinary practice, attending Ross University, the benefits of mentoring, and her experience representing the American Holistic Veterinary Medical Association in the American Veterinary Medical Association's House of Delegates.

Want to stay inspired with content tailored specifically to IMG's looking to create their medical success story? Sign up for the IMG Roadmap Newsletter so you never miss a beat! ***** Quick pause: If you are an international medical student or graduate seeking to start residency in any of the 135 specialties in the USA next June, then this is for you! You don't want to regret missing out on this HUGE opportunity! Join the waitlist to be considered for the next round of the IMG roadmap course. The only course that helps you become a more competitive applicant for residency. Seats are limited. Sign up here to be considered! ***** Today we have a bit of a blast from the past with Dr. Amilyn Worlobah who we interviewed in 2019. Stay tuned to hear all about her fascinating story! At the time, she was an intern in a family medicine program in Arkansas, all excited about her future. She attended the Ross University which used to be on the island of Dominica, but is now situated in Barbados after a major hurricane in 2017. Here are some of the highlights of her journey: Dr. Worlobah started medical school in January of 2013, completed her clinical rotations in the US, took her board exams in her 3rd year and then Step 2 in her fourth year. She also shares how she prepared for her USMLE exams: She took a comp exam, aimed at preparing her for the exam, used the online resource Decker for past questions and textbooks, used UWorld question banks and Master the Boards texts as well. Unfortunately, she failed the exam the first time, but was successful the second time around. She advises the following about the application process: Ensure that you have a winning personal statement as early in the process as possible. Use Google and Match A Resident to filter out programs that won't take IMG's. Capitalize on your CV–ensure that you mention all of your relevant experience. Networking is key throughout the process. Dr. Worlobah also speaks highly of her time as a medical scribe and encourages IMG's to consider this option instead of being idle during the application process. Her mantra is as follows: Never give up. Don't get in your head or be negative about your experiences. Always turn whatever negatives you encounter into learning experiences. You can't spell testimony without “test!” Listen to the full episode on Spotify, Apple & Google Podcasts! --- Support this podcast: https://anchor.fm/ninalum/support

Hang on to your hats, folks. Dr. Brooke Bowman and I cover a range of issues that equine veterinarians face - everything from racetrack practice to alternative work schedules to boundaries with clients and back around to mental illness. We also touch on racing cars and hanging out at Tootsie's Honkeytonk, so be prepared for a rowdy conversation!***Trigger Warning: This podcast does discuss mental illness and suicide at times throughout the episode.***Meet Dr. Bowman...Brooke Bowman DVMBcbowman@hotmail.comFind him on Instagram @bcbowman12Dr. Brooke Bowman is a 2010 graduate of Ross University and operates Chesapeake Veterinary Services In Chesapeake City, MD. He grew up on a TB breeding farm in Chestertown, MD and graduated from VA Tech with an Animal Science degree in 2002. In between the time he spent at VT and Ross, he worked on his parents' thoroughbred breeding farm and raced cars.A bit more about Brooke…-My mother Chris Bowman and my father Tom Bowman, DVM are my heroes.-I have two absolutely beautiful and funny children named Owen and Juliette.-I love adrenaline and the source is of no importance to me. It can be from going way too fast and trying to pass someone or watching my kids do something cool. -I believe good rap music should be playing either on your speakers or in your head at all times. Including vet appointments.-I can't wait to start my podcast to make people laugh, cry, think, and dream.Motto: Life is good…let's get it....Find out more about The Whole Veterinarian at our new website!Instagram: @thewholeveterinarianFacebook: https://www.facebook.com/thewholeveterinarian/Email: thewholeveterinarian@gmail.com

Quick pause, join the 2022 waitlist to be considered for the IMG ROADMAP live group coaching program that starts in Spring 2022. Click here to start now. As a new year begins, IMGs all over the US continue to excel in their fields, inspiring thousands to do the same. Our guest today, 3rd year Cardiology fellow Dr. Marc Katz is no exception! Keep listening to find out more about his challenging yet rewarding journey. Dr. Katz attended Ross University and completed rotations in Brooklyn, New York. He completed Internal Medicine (IM) training at the Hahnemann University Hospital. He is currently a PGY6 in Cardiovascular Diseases, a subspecialty of IM. Here are some highlights of Dr. Katz' Cardiology fellowship: He chose IM because of its wide range of subspecialty opportunities when compared to family medicine, for instance. He completed 4 years of medical school, 3 years of IM training, and 3 years of General Cardiology fellowship. While he is qualified as a general cardiologist, he appreciates the fact that he can still specialize in more specific fields such as cardiac oncology, and electrophysiology. Dr. Katz' background also helped shape his medical success story: He attended SUNY Bingham for his undergraduate degree, as a first generation American born to South African immigrant parents. Initially, he didn't know that he wanted to go into medicine, and so he earned a GPA of 3.4 and a just below average MCAT score. He didn't immediately get into any of the US medical schools to which he applied, until he gained admission at Ross University. After medical school, he felt like he was fighting an uphill battle to match into residency as an IMG. While he found that Ivy League schools mainly only take people from “prestigious” schools, He advises IMGs not to be discouraged. However, he also advises people considering becoming IMGs to be aware of the potential challenges they may face. Here are Dr. Katz' thoughts on the future of IMGs: Step 1 going pass/fail is estimated to be another hurdle since program directors will likely find another metric by which to filter out applicants. So, it is important to build a strong application otherwise. Networking is essential–Dr; Katz attributes some of his opportunities to his mentor having put in a good word for him with program directors. In day to day life, the stigma against IMGs isn't as prevalent as we may think. Every year, while there are enough US grads to take up all of the available residency spots, they continue to take IMGs. Be encouraged by that fact! IMGs often fill underserved specialties and are invaluable in the US medical system. IMGs are here to stay! You can reach out to Dr. Katz on: Instagram: @kittykatzmd Tik Tok: @kittykatzmd Youtube: @kittykatzmd Twitter: @kittykatzmd And his website: mykittykatz.com And you can also follow his cat, Pepperoni @pepperoni.the.kat! Listen to the full episode on Google Podcasts, Apple & Spotify. --- Support this podcast: https://anchor.fm/ninalum/support

Ross University students have the opportunity to participate in more than 40 clubs and organizations. No matter what your interest is, likely there is a group of like-minded students. In this episode, we will talk about the Surgery Interest Group.The SIG strives to strengthen the basic skills required to prepare our students for their surgical rounds and necessary procedural techniques for the field of surgery. My guests today are Matthew Pace and Stephen Stocker.

This week on The Pet Buzz, Petrendologist Charlotte Reed and Michael Fleck, DVM, talk with Dr. Ibrahim Shokry, a professor of pharmacology and toxicology of Ross University, St. Kitts, about holiday plant safety; and with Chris Landtroop, Vice President of Marketing & Communications of Cherry Hill Programs, about pet photos with Santa.

Ezi Ohaya is a medical student here at Ross University, Vice-President of Ross' Black Male Doctors Org., and low-key a chef on the side :). I enjoyed talking to him about his journey so far, how he takes care of his mental health, how cooking and exercise are forms of stress relief, mental health for black men, and more. To keep up with his journey - and for his entertaining stories - you can follow Ezi on instagram at @afrikvngezi! -- A few more things: If you have a moment, please SHARE this with a friend if you liked this episode! -- Don't forget to SUBSCRIBE if you're listening via iTunes/Apple Podcasts, and RATE/REVIEW - it would mean so much! -- Finally, I'd love to hear from you! Let me know what you thought of this episode and if you have any topics you'd like to hear in the future. You can DM me at instagram.com/estelleavbuere or message me through my website at creativelybyestelle.com/contact. -- May God continue to bless you as a student and creative. Stay focused, and don't forget to keep creating! -- P.S. for fun: Inspiring Musical Theatre Songs PLAYLIST --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/estelle-avbuere/message

Today's guest is Dr. Julia Mirer, MD. Julia received her medical degree from Ross University and was in her 2nd year of Pediatric Residency in Harlem, NY when she realized that she was not buying what she was selling.  Seeing the pitfalls of the current healthcare system, she decided to shift gears to explore Transformative Medicine where she has found her calling in advocacy and education.  Dr. Mirer is a Consultant in the emerging field of Psychedelic Medicine, serving as a bridge between Eastern and Western practices, committed to merging the two in order to help create a new paradigm for integrative health and wellness.  In this episode we dig into: What microdosing is and what benefits people across the spectrum from entrepreneurs, hedge funders, as well as therapy patients, are seeing The profound impact of educating doctors on this new type of therapy, Acting as a bridge between Eastern and Western practices, Favorite quotes and advice, Morning routines, And much more. Before we begin, please hit SUBSCRIBE and consider leaving a comment below to let me know what you liked and what you would like to hear more of! You can also reach out to me on Instagram @longevityandlifestyle! Please enjoy!   -- This episode is brought to you by LIFTiD Neurostimulation device! If you want to improve your memory, focus, and performance in just 20 minutes a day, this is the device for you. LIFTID is a neuroscientist-developed device that you wear like a headband on your forehead. It's lightweight, comfortable, and easy to use, and, best of all, there are no wires, just plug 'n play. LIFTID uses tDCS technology - which essentially is a mild electric current - to stimulate targeted areas of the brain for enhanced function. Who's it for? From busy professionals looking to up their performance, to university students, gamers, musicians, and athletes - to people aged 55+ wanting to maintain memory, LIFTID's easy-to-wear device can improve your performance in just 20 minutes a day. And now for you, my dear listeners - you can get 10% off when you go to GetLiftid.com today and enter the discount code - LIFESTYLE10. So check out GetLiftid.com today and start lifting your performance!   

Episode 73: Anticoagulation in Afib. When should you start anticoagulation in atrial fibrillation? What medications are appropriate? Virginia Bustamante, Charizza Besmanos and Dr Arreaza discuss this topic.  By Charizza Besmanos, MS4; Virginia Bustamante, MS4; and Hector Arreaza, MDCharizza: Hello, welcome to today's episode of Rio Bravo qWeek Podcast. My name is Charizza Besmanos, a 4th year medical student from American University of the Caribbean and I am joined here today by Virginia Bustamante.  Virginia: I'm Virginia Bustamante, an incoming 4th year medical student from Ross University.  Arreaza: And I'll be here just to make sure that you guys behave during this episode. Charizza: Before we get started on our discussion, I have a quick patient case to share with you.  This is a 66-year-old woman who is brought to the ED with sudden onset of severe difficulty speaking and weakness while having breakfast. She has hypertension, hyperlipidemia, severe left atrial enlargement seen on previous ECHO, and is noncompliant with her medications. She is a lifetime nonsmoker and does not drink alcohol. On admission, her blood pressure is 152/90 and pulse is 124/min and irregularly irregular. She is awake and alert but has difficulty finding words while trying to speak. She has severe right lower facial droop and marked weakness and sensory loss in the right arm and mild weakness in right leg. Fingerstick glucose is at 105. ECG shows atrial fibrillation. Acute stroke management is started right away. CT shows occlusion of the left MCA. What management could have prevented this complication?  Virginia: This patient clearly has multiple risk factors for thromboembolism events but given her irregularly irregular pulse consistent with atrial fibrillation, she would've warranted long-term anticoagulation to prevent stroke, which she most likely had.  Charizza: Exactly. Today's topic is atrial fibrillation, specifically the use of anticoagulation. __________________This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. __________________ Virginia: Anticoagulation is indicated to decrease the risk of thromboembolic events such as ischemic stroke in patients with atrial fibrillation (A-fib). Not all patients receive anticoagulation. Like most things in medicine, you must decide to start anticoagulation when the benefits of decreasing the risk of stroke outweighs the risk of bleeding. So, for assessing the risk of stroke in A-fib, the American College of Cardiology along with American Heart Association and the Heart Rhythm Society published a guideline in the Journal of the American College of Cardiology in 2014 and was recently updated in 2019[1] detailing in which patients anticoagulation is recommended.  Charizza: Yes, according to the guideline, “high risk patients” are all patients with valvular A-fib, and those with nonvalvular A-fib with a CHADVASC score of >/= 2 in men or >/= 3 in women, and those with nonvalvular Afib and hypertrophic cardiomyopathy. Those with “medium risk” are patients with nonvalvular Afib with CHAD2VASc score of 1 in men or 2 in women. In these patients, anticoagulation is considered but the risk and benefits are discussed with the patient. Those with “low risk” are patients with CHAD2VASc score of 0 in men or 1 in women and anticoagulation is not routinely recommended in these patients. Can you tell us briefly what CHA2DVASc score is?  Virginia: CHA2DS2-VASc score is the stroke risk assessment tool of choice by the AHA/ACC/HRS guideline. It is great because it is a mnemonic. Each letter is assignment 1 point except for 2 criteria. C stands for congestive heart failure, H for HTN defined as >140/90, A2 is for or Age>75 which is for 2 points, D for diabetes, S2 is for stroke or TIA and it's for 2 points, V for vascular disease such as MI, A for age 65-74, S for female sex.  Charizza: That certainly makes it easy to remember. Not only that, but you can also find CHA2DS2-VASc score of MDCalc to make it even easier. Virginia: Now that we've established which patients should receive anticoagulation, how do we choose which anticoagulant?  Charizza: For this discussion today, I would like to focus on nonpregnant patients. There really are 2 main anticoagulants, DOACs (or the direct oral anticoagulants) and warfarin. DOACs are the direct thrombin INH (dabigatran) and the direct factor Xa INH (rivaroxaban, apixaban, and edoxaban). DOAC is recommended as first-line in the long-term management of nonvalvular afib as trials have shown DOACs are more successful at reducing risk of thromboembolic events and have a lower risk of bleeding than warfarin and warfarin requires INR monitoring with dose adjustments. Although, in patients with valvular Afib, warfarin is preferred. Arreaza: All of them are by mouth.  Virginia: Dosing of DOACs depends on the kidney function, so it is important to obtain the creatinine clearance. For dabigatran, the direct thrombin INH, the recommended dose for patients with CrCl >30 mL/min is 150mg PO twice daily based on the results from the RE-LY trial (2), which evaluated the efficacy and safety of dabigatran with warfarin in patients with Afib. For patients with CrCl of 15-30 mL/min, the recommended dose is 75mg PO BID. Those with CrCl 1.5, patient who is > 80years old or body weight

This episode puts the spotlight on some of our IMG guests who serve in a surgeon capacity at their respective hospitals, namely Dr. Stanley Ogu, Dr. Amara Okoye, Dr. Ash Soni and Dr. Brett Johnson. Dr. Stanley Ogu DR. STANLEY OGU is a Nigerian born, international medical graduate turned board certified Plastic and Reconstructive Surgeon in Houston, Texas. Dr. Stanley Ogu is a cosmetic and reconstructive plastic surgeon with Lexington Plastic Surgeons in Sugar Land, Texas. He is a candidate member of the American Society of Plastic Surgery and an associate fellow of the American College of Surgeons. Dr. Ogu is well liked by his patients for his warm and caring personality, as well as his attention to detail. He is committed to helping patients achieve their unique desired results and become the best version of themselves, through both surgical and non-surgical techniques. Listen to Dr. Ogu's full episode here! Dr. Amara Okoye Do you ever feel like becoming a surgeon is impossible just because you went to a Caribbean medical school? Or maybe that your need for visa sponsorship for residency makes it unheard of? If you have any desire to become a surgeon, then listen on. Dr. Okoye is à Canadian- American who graduated from Ross University. She categorizes herself as a student who struggled through undergraduate education. Yet, she vowed that she wasn't going to allow herself to struggle through medical school. So what did she do? Listen to Dr. Okoye's full episode here! Dr. Ash Soni Dr. Soni attended Imperial Medical School in London. While in school he began electives in the US to get a feel for whether he would pursue residency in the US. He started with a match into a research fellowship at Cornell leading to a match into general surgery at Johns Hopkins. His time in the US was rounded out with a match in plastic and reconstructive surgery in Seattle at University of Washington, followed by a year long fellowship back in the UK. After all his training, Dr. Soni started his own private clinic, The Soni Clinic. Along with his story of determination and growth, Dr. Soni gives us a few pieces of advice to carry along our own journeys. Listen to Dr. Soni's full episode here! Dr. Brett Johnson Can an IMG have a competitive enough application to land a surgery-based residency? The short answer is yes - but not without hard work and determination! Coming to share his story of persistence, grit and consistent effort, Guyanese-born PGY2 general surgery resident Dr. Brett Johnson joins us on this episode hoping to inspire IMGs all over the world. Dr. Johnson's path to residency was not without obstacles. He faced several challenges including adjusting to the American system when it came to USMLE exams. Listen to Dr. Johnson's full episode here! --- Support this podcast: https://anchor.fm/ninalum/support

The Muslim Student Association (MSA) seeks to support the Muslim students and other students of faith attending Ross University. They also aim to provide safe and comfortable spaces of prayer and meditation, while bringing awareness to the faith of Islam. My guests today are current students and officers of the MSA.

Lauren and JJ investigate a case of sudden blindness and weight gain in a dog patient. This episode contains a detailed review of Sudden Acquired Retinal Degeneration, or SARD. References: 1. Moriyon, M. E., Morgan, R. V., & Herring, I. P. (18 February, 2021). Sudden acquired retinal degeneration. Vincyclopedia of diseases. www.vin.com 2. Yaphe, W. L. (12 April, 2004). Lecture 10: Blindness and diseases of the retina, optic nerve. Small animal medicine II course. Ross University. 3. Donnelly, T. M. (6 August, 2011). Ophthalmic Examination. Proceedings of the 2011 association of exotic mammal veterinarians annual conference. 4. Bentley, E. (2017). Sudden-onset blindness. British small animal veterinary congress. 5. Glaze, M. B. (2012). Vision loss in the clear canine eye. Western veterinary conference. 6. Sharpe, E. (2018). Acute blindness. Southwest veterinary symposium.

In the latest episode of Iorì:wase Profiles Abigail Jacobs is joined via video chat by Montana Diabo, who is in her final year of study at Ross University to become Kahnawake's first locally-practicing Veterinarian. Listen in as Montana tells about performing an emergency C-section, how the support from home is really helping, and if she could perform emergency HUMAN surgery in the zombie apocalypse!

Have your challenges and bad experiences ever made you feel like giving up? Dr. Foluwakemi Olufehinti's story will give you all of the inspiration you need to persist in the face of adversity until you achieve your goals! Nigerian-born Non-US IMG Dr. Olufehinti completed her medical education at Ross University, which was then situated on the Caribbean island of Dominica. As a student, she had to adjust to a different learning and testing style, but eventually, she gained success despite the various difficulties she faced. When it comes to the match, Dr. Olufehinti's story is far from traditional. She essentially applied on three occasions, twice in the traditional match process and once through the the Supplemental Offer and Acceptance Program (SOAP). On her first try for the 2019 match period, though she received 7 interviews, she did not match. She decided to try again through SOAP, which was also unsuccessful. Dr. Olufehinti did not let these setbacks define her and she used this as an opportunity to consult with resources such as the IMG Roadmap Course and to seek feedback from her interviewers in order to highlight areas needing improvement. With this in mind, she applied for the 2021 match period and received 20 interviews this time around! In December of 2020, however, she received an offer from one of the programs she had applied to prior to the 2021 cycle and decided to accept it. As a result of her very unique journey to the match, Dr. Olufehinti is a wealth of insight and advice. Here are a few of the topics she touches on in during this interview: The match: After not having matched the first two times, Dr. Olufehinti attributes her success thereafter to an increase in confidence and to the understanding that while she was being interviewed, she was also interviewing the program coordinators. The moment she saw herself as a potential asset to the program, the coordinators began to share the same view. Preparing for the USMLE: Dr. Olufehinti advises IMGs to study in groups if this style works for you, and to use plenty of practice questions from reputable sources. While your grades do not define you, program coordinators just want to see that you are diligent and capable of improvement. Persistence is key: Though there were times where it seemed like all the odds were stacked against her, Dr. Olufehinti was able to stop, take stock, and improve until she was able to achieve her goals. You can reach out to Dr. Olufehinti via her Instagram @fomoshgreen Watch the full episode using the links below: Apple: https://podcasts.apple.com/us/podcast/the-img-roadmap/id1490731292 Spotify: https://open.spotify.com/show/45NNJ7ewtqynqyssbwm1xz Google Podcasts:https://podcasts.google.com/?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy9mOGMzY2EwL3BvZGNhc3QvcnNz Overcast: https://overcast.fm/itunes1490731292/the-img-roadmap-podcast RadioPublic: https://radiopublic.com/the-img-roadmap-GE0MMg --- Support this podcast: https://anchor.fm/ninalum/support

Dr. Maria Dinh is a primary care physician in Atlanta, Georgia. She attended Georgia Tech for undergrad, Ross University for Medical School, and completed her residency in family medicine at Atlanta Medical Center. Dr. Dinh was born in Vietnam, immigrated to Georgia when she was two years old. She's the oldest of five children and enjoys spending time with family. [00:01 – 05:08] Healthy People Information Gas, Bloating, and Belching 30 minutes after eating Irritable Bowel Syndrome(IBS) Celiac Disease Lactose Intolerance [05:09 – 17:30] Interview with Dr. Maria Dinh An Insight into the interview with Dr. Dinh Guest background Migrating from Vietnam to the US [17:31 – 35:07] Asian in America Growing up in America as an Asian Woman The fear of being Asian with the recent attacks towards Asians Standing up and fighting against racism The influence of Social media to fight against racism [35:08 – 45:28] Asian in Atlanta Being an Asian Woman in Atlanta Asian fetishes Why should you care about the Asian Community Long-term solutions to combat hate towards Asians [45:29 – 55:08] Randy's Random Questions Songs you will always sing along to Something you wish you were good at Movie Character that made you so angry Weirdest thing you find attractive in a person Final Words Tweetable Quotes: “Everyone in the future will look the same. We'll all have the same skin color eventually, we're all gonna melt together.” - Dr. Maria Dinh “We all have the responsibility to be good to each other no matter what you look like, where you come from.” - Dr. Maria Dinh   Resources and Links Mentioned: Wilkinson, J. M., MD, Cozine, E. W., MD, & Loftus, C. G., MD. (2019). Gas, bloating, and belching: Approach to Evaluation and Management. American Family Physician, 99(5), 301-309. Lactose Intolerance - Mayo Clinic Irritable Bowel Syndrome - Mayo Clinic Celiac Disease - Mayo Clinic Stop AAPI Hate FODMAP Diet Information    https://www.healthline.com/nutrition/low-fodmap-diet To know more, you can connect with me on Instagram, Facebook, and Twitter. Also, visit my website https://hinesentertainment.com/ or email me at hinesentertainmentgrp@gmail.com    LEAVE A REVIEW AND RATING + help someone who wants to learn more about useful health information by sharing this episode or click here to listen to more episodes.

My guest today is Dr. Sarah Cohen, and she definitely has a unique perspective on her business as a veterinarian serving the Wellington Florida area, her business website for Equity Performance Equine has the description listed under the subtitle team approach, seamless concierge-style medicine, tailored to the needs of your specific team and program. Dr. Sarah was recommended to me as a guest by a previous guest, Dr. Andrea Dubé. Dr. Andrea described her as a bad-ass vet that I needed to talk to. I'll read you her bio from her website, and you'll start to understand why.  Dr. Sarah Cohen grew up in New Jersey showing in the hunters and equitation before attending Purdue University for her undergraduate training. She graduated from Ross University in June of 2007. Having completed her clinical training at Iowa State University, Sarah then joined Merritt and Associates Equine Hospital outside of Chicago for a one-year intensive internship. Then joining Miller and Associates in 2008, and finally launched Equity Performance Equine in the fall of 2020. Over her decade plus in practice, Dr. Cohen has developed a client-based consisting of some of the most well-regarded in the Hunter and showjumping community in the country. Dr. Cohen believes passionately in evidence-based medicine and putting the horse's needs at the fore of all decisions. Since 2010, she has been a regular on the international scene serving as the USEF showjumping team veterinarian in competitions in Spain, Slovakia, Belgium, France, Wellington, and other international competition locales. Sarah is president of the Northeast Association of Equine Practitioners, having served on the board of directors for five years. She is a member of the USHJA's horse and riders advocates committee. She lives in Wellington, Florida, and Waccabuc, NY  with her husband, Lance and two daughters, Evelyn and June. Dr. Andrea's recommendation was spot on and Dr. Sarah did not disappoint. I hope you enjoy the conversation as much as I did. As mentioned in the episode if you are interested in participating in the American Farriers Association Journal club please reach out to Martha Jones at mjones@americanfarriers.org

In this episode, I interview Dr. Priyana Tweet, a newly minted doctor and graduate from Ross University in Dominica. After her first residency interview, she found out about her failure on one of the USMLE examinations. She fought internally about how to handle this. She asked for help, worked hard, leveraged integrity and re-took the examination while still on the interview trail. Today, she is an intern pursuing her dreams in residency. In this episode, you will learn about her journey through a Caribbean medical school and how she overcame the challenges along the way. If you're looking for opportunities to network at conferences, check out AAFP and AMSA online. If you would like to connect with Dr. Tweet, you can email her at pritweet73@gmail.com. You can also find her on Instagram @tweet7337 (https://www.instagram.com/tweet7337/) --- Support this podcast: https://anchor.fm/ninalum/support

Dr. Kristin Ingram overcame life challenges to enter Ross University and earn her DVM degree. After a clinical year at Auburn, she returned home to her family and the city she loves to take charge of the Animal Hospital of North Charleston. With a sunny disposition and in partnership with VPP, she's leading the practice into a bright future.

Dr. Jennie and Dr. Neal discuss how common picky eating is and how to approach picky eaters from a behavioral standpoint. The doctors discuss how to avoid tantrums at meal time, when meal shakes are appropriate and  what to look for when grocery shopping for picky eaters to ensure they have a well-balanced diet and to limit snacking over nutritious meals. Dr. Nikette Neal first became interested in medicine in high school when she watched her father's successful battle with prostate cancer. This led her to attend the University of Central Florida for college, where she graduated with honors in Molecular and Microbiology while simultaneously completing four years of genetics research. Afterward, she attended Ross University for medical school. Her experience there eventually led her to complete her pediatric residency at the University of Nevada, School of Medicine in Las Vegas. She completed this program at the top of her cohort winning the award for “Outstanding Graduating Resident”. Dr. Neal began her career at Pediatric Associates as a general outpatient pediatrician. Since then, she has expanded her skillset by becoming an Assistant Professor and Clerkship Director at the Dr. Kiran C. Patel College of Medicine. In this position, she has received several accolades including the award for “40 Under 40 Black Leaders of Today and Tomorrow”, being featured by the United Way for Women's History Month, and being asked to speak at a regional conference for the American Medical Women's Association. Last year, Dr. Neal was promoted to Lead Physician for the Palmetto Bay office of Pediatric Associates. She currently serves on the Clinician Development Team and the Clinician Advisory Committee. She loves to sing, dance, read, and serve at her church. She is a devoted wife and mother of two. While she is known for her patience, dedication, and attention to detail for each individual patient case, she still finds time to put her family first. She hopes to continue to use her medical skills in order to further the field of Pediatrics, helping to improve patient outcomes and encourage the next generation of physicians. KidzDocTalk is available on all major streaming services including: iHeartRadio, Spotify, iTunes, YouTube and SimpleCast. Follow us on Instagram @Pedassociates to submit topic ideas for future KidzDocTalk episodes. What resources can I use to help with feeding my child?Healthychildren.orgHappyhealthyeatingforkids.com@elementnutrition.kids (on IG)Our Food book by Dr. Grace LinIt's Not About the Broccoli book by Dina Rose

Interested in landing the residency of your dreams despite being a non-traditional IMG? Dr. Eva Beaulieu is not only dedicated to saving lives, but is also determined to inspire, lead and guide prospective doctors all over the world to achieve their goals. Tune in this week to hear more about her unique journey and to nab some of her priceless inspirational gems, some of which were published in her instructional novel, "Paging Doctor You." Dr. Eva Beaulieu was born in Haiti and moved to the US at the age of 15 where she attended high-school and pursued her undergraduate degree at Florida Atlantic University. Both of her parents are doctors, with her late father being a radiologist and her mother being a dermatologist who eventually transitioned into family medicine after moving the US. Due to her background, she was always interested in becoming a physician, and so aligned herself with students of similar backgrounds and aspirations while at college. Partially due to their inspiration, she decided to pursue her medical degree in England for two years before transferring to the Ross University. She completed her clinical rotations in the US and qualified for residency in the state of Georgia where she currently resides and serves as in internal medicine hospitalist. As an IMG, especially one of Afro-Caribbean descent, she also noted the different perspectives of US medical graduates during residency. Though their journeys were not the same, she couldn't help but notice the similarities in the challenges they faced. As such, some of her inspirational nuggets include: Pick a specialty wisely and be realistic in your goals. Beware of self-doubt and don't let societal limitations such as the very real racial and ethnic inequality existing in the medical field be your end all, be all. Always put your best foot forward when studying, preparing personal statements, getting letters of recommendation and interviewing. Some key takeaways include: Never limit yourself - with the right motivation and consistency you will be able to land the residency of your dreams. The importance of discipline, prioritizing, preparedness and routine. The importance of having a clear and concise plan. You can learn more about Dr. Eva Beaulieu on her: Instagram @dr.evab Facebook @Dr. Eva Are you eager to get yourself a copy of Dr. Beaulieu's novel, "Paging Doctor You"? We're having a giveaway! To qualify, simply leave a review of this episode wherever you listen to your podcasts and get a chance to win a copy of this book along with Dr. Lum's book "Beyond Challenges." Listen to the full episode at the links below: Apple: https://podcasts.apple.com/us/podcast/the-img-roadmap/id1490731292 Spotify: https://open.spotify.com/show/45NNJ7ewtqynqyssbwm1xz Google Podcasts: https://podcasts.google.com/?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy9mOGMzY2EwL3BvZGNhc3QvcnNz Overcast: https://overcast.fm/itunes1490731292/the-img-roadmap-podcast RadioPublic: https://radiopublic.com/the-img-roadmap-GE0MMg --- Support this podcast: https://anchor.fm/ninalum/support

Adrienne Lally · Abdominal Care in Honolulu with Dr. Anand PatelThis week on the Team Lally Real Estate Radio Show, we interview Dr. Anand Patel. We'll talk about the innovative and unique approach to care provided by his team at Aloha Surgical Care.We also have your favorite experts providing this week's tips on property management, mortgage loans, home inspection and home insurance!Who is Dr. Anand Patel?Dr. Anand Patel is a highly skilled and respected gastrointestinal and endoscopic surgeon practicing at Aloha Surgical Care located in Oahu, Hawaii. At his private practice, he offers innovative care for issues affecting the gastrointestinal tract and abdomen to improve the lives of his patients. In 2000, Dr. Patel earned his Doctor of Medicine at Ross University in Portsmouth, Dominica. He then went on to complete general surgery residencies at Western Reserve Care System and the Cleveland Clinic Health System, both located in Ohio. To reach Dr. Patel you may contact him in the following ways:Phone: (808) 207-5044Email: aloha.surgical@gmail.comWebsite: https://www.aloha-surgical.com/To get the latest Covid-19 information and its impact on the current real estate market, visit https://www.teamlally.com/covid19/

Adrienne Lally · Abdominal Care in Honolulu with Dr. Anand PatelThis week on the Team Lally Real Estate Radio Show, we interview Dr. Anand Patel. We’ll talk about the innovative and unique approach to care provided by his team at Aloha Surgical Care.We also have your favorite experts providing this week's tips on property management, mortgage loans, home inspection and home insurance!Who is Dr. Anand Patel?Dr. Anand Patel is a highly skilled and respected gastrointestinal and endoscopic surgeon practicing at Aloha Surgical Care located in Oahu, Hawaii. At his private practice, he offers innovative care for issues affecting the gastrointestinal tract and abdomen to improve the lives of his patients. In 2000, Dr. Patel earned his Doctor of Medicine at Ross University in Portsmouth, Dominica. He then went on to complete general surgery residencies at Western Reserve Care System and the Cleveland Clinic Health System, both located in Ohio. To reach Dr. Patel you may contact him in the following ways:Phone: (808) 207-5044Email: aloha.surgical@gmail.comWebsite: https://www.aloha-surgical.com/To get the latest Covid-19 information and its impact on the current real estate market, visit https://www.teamlally.com/covid19/

Do you ever feel like becoming a surgeon is impossible just because you went to a Caribbean medical school? Or maybe that your need for visa sponsorship for residency makes it unheard of? If you have any desire to become a surgeon ... then listen on. Dr. Okoye is à Canadian- American who graduated from Ross University. She categorizes herself as a student who struggled through undergraduate education. Yet, she vowed that she wasn't going to allow herself struggle through medical school. So what did she do? She knew as an IMG, she had to strive to stand out! She incorporated early planning, setting short term goals and being focused and determined on her track. In this episode you will learn: * How to study for examinations to match into surgery or other competitive surgical specialties * Who to get LOR's from when applying into residency training * How to get an acting internship or sub-internship * Why your medical school courses and exams matter a lot more than your anticipation for the USMLE's * How Dr. Okoye planned towards her application season * How to set reachable goals for general surgery training * The 5-year vs the 7-year track for general surgery * How much research do you need to match into surgery? To learn more, listen to the episodes at the links below. Apple: https://podcasts.apple.com/us/podcast/the-img-roadmap-podcast/id1490731292 Spotify: https://open.spotify.com/show/45NNJ7ewtqynqyssbwm1xz Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy9mOGMzY2EwL3BvZGNhc3QvcnNz Overcast: https://overcast.fm/itunes1490731292/the-img-roadmap-podcast RadioPublic: https://radiopublic.com/the-img-roadmap-podcast-GE0MMg Dr. Okoye mentioned using FREIDA to search through programs - here is the link to start your own search FREIDA™ ACGME Residency & Fellowship Programs Database --- Support this podcast: https://anchor.fm/ninalum/support

Dr. Jeelani is a Fellow of The American Congress of Obstetricians and Gynecologists. She is a well-known and highly-skilled reproductive endocrinologist and infertility specialist. Dr. Jeelani started her medical journey in the Caribbean's at the Ross University of Medicine. She finished her residency and fellowship at Wayne State University/Detroit Medical Center. She performed research on onco-fertility, where she explored the effects of toxins on reproductive function, chemotherapy and oocyte cryopreservation to give those facing cancer a better chance of seeing their dream of parenthood come true. Her research won her numerous awards and grants in reproductive medicine. She has authored a variety of publications and book chapters in well known journals highlighting cutting-edge REI advancements. In this episode, we explore the significance of scientific research for premed and medical students, the negative stigma around infertility, and the implications of going to a Caribbean medical school. You can find Dr. Jeelani on Instagram @roohijeelanimd or at viosfertility.com/roohijeelanimd. If you want to support Doctor's Inn, here are some easy ways: 1. Leave a rating! 2. Visit our website at www.doctorsinnpodcast.com and sign up for the email list-serv! 3. Follow our socials @doctorsinnpodcast

Dr. Colleen Smith got her DVM from Ross University in 2004. Prior to Veterinary School, she was a licensed veterinary technician and worked at the teaching hospital for the Virginia-Maryland College of Veterinary Medicine. After graduation, Dr. Smith worked with Dr. Michelle Tilghman at Loving Touch Animal Center near Atlanta, Georgia. She was certified in acupuncture by IVAS in 2006. She then moved to Chattanooga, Tennessee and and worked as an associate veterinarian before starting her own practice, Chattanooga Holistic Animal Institute, in 2012. The practice offers both conventional and integrative care along with rehabilitation services. Please enjoy this conversation with Dr. Smith as we discuss her vet school experience, becoming interested in holistic medicine, starting her own practice, volunteering in organized veterinary medicine, and her consulting role for a company that produces CBD products for pets.

Episode 32: VertigoThe sun rises over the San Joaquin Valley, California, today is October 20, 2020.It’s time to talk about vaccines again. The ACIP (Advisory Committee on Immunization Practices) posted new recommendations for meningococcal vaccinations on September 25, 2020. There are two kinds of meningococcal vaccines in the US: 1. Meningococcal conjugate or MenACWY vaccines (Menactra®, Menveo®, and MenQuadfi®)2. Serogroup B meningococcal or MenB vaccines (Bexsero® and Trumenba®). Let’s discuss how they are given.MenACWY: Menactra (MenACWY-D), Menveo (MenACWY-CRW), and MenQuadfi (MenACWY-TT) MenACWY routine: The meningococcal conjugate vaccine should be given to ALL PATIENTS at 11 to 12 years old, with a booster dose at age 16. Remember, it’s a two-dose series, the booster dose at age 16 is important to provide protection during the ages of highest risk of infection. So, that was easy. The hardest part is for patients younger than 10 years old because only patients who are at risk receive routine meningococcal conjugate vaccines before age 11. MenACWY in special groups: This vaccine is given to patients older than 2 months old only if they are at increased risk for meningitis (i.e., persistent complement component deficiencies; persons receiving a complement inhibitor such as eculizumab [Soliris] or ravulizumab [Ultomiris]); persons who have anatomic or functional asplenia; persons with HIV infection; microbiologists routinely exposed to Neisseria meningitidis; persons at increased risk in an outbreak; persons who travel to or live in hyperendemic or epidemic areas; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits.) I invite you to consult ACIP recommendations regarding vaccination in special groups. MenB: Trumenba (MenB-FHbp), Bexsero (MenB-4C)  MenB shared decision: MenB vaccination is not routinely recommended for all adolescents. It may be given to adolescents and young adults (16 through 23 years old, preferred age is 16-18 years old) on the basis of shared clinical decision. Those who decide to receive MenB vaccine, receive two doses 1-6 months apart depending on the brand name you use. MenB vaccines are not recommended before age 10 in any case. Adults older than 24 and older don’t need MenB unless they are at increased risk.MenB in special groups:Patients with certain medical conditions (persons with persistent complement component deficiencies; receiving a complement inhibitor; with anatomic or functional asplenia; microbiologists exposed to isolates of N. meningitidis; and persons at risk in outbreaks) should receive MenB vaccine. These recommendations will be included in the updated 2021 immunization schedules, and the AAFP will review changes to the schedules once they are available (1).This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program, from Bakersfield, California. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care since 1971.____________________________“A man is who he thinks about all day long” –Waldo Emerson.If you think you are not good enough, you may not reach your goals. So, think positive about yourself all day long, and you will become that person you think you are and will reach your goals.Hi, this is Dr Carranza, I’m a PGY3, and today I will interview a special guest.Question Number 1: Who are you? Hello, I’m Jagdeep Sandhu. I’m a 4th year medical student from Ross University, currently doing a sub-internship in family medicine. I’m originally from Seattle, Washington. I have an Indian ancestry, so I enjoy meditating and cooking Indian dishes.Question number 2: What did you learn this week? Lightheadedness vs VertigoThis week we learned about dizziness and its differentials. It is important to differentiate dizziness vs lightheaded because a lot of patients will say they are dizzy when they are truly lightheaded. To be honest dizziness (at least for me) is one of the toughest complaints to get from a patient as it is hard to pinpoint its etiology.Important questions to ask the patient are:Do you feel like you’re going to pass out? Do you experience a sense of darkness in front of your eyes? (points to syncope)Is the room spinning? Are you having nausea or vomiting? Ringing in your ears? (points to vertigo)  Peripheral VertigoPeripheral refers to vertigo originated from the ear structures, whereas central from the brainstem. Differentials of peripheral vertigo include:Benign paroxysmal positional vertigo: Transient episodes of vertigo caused by stimulation of vestibular sense organs, this is most commonly due to calcium debris within the posterior semicircular canal, known as canalithiasis. It affects middle-age and older patients; and twice as many women than men. Classically, patients describe a brief spinning sensation brought on when turning in bed or tilting the head backward to look up. The dizziness is quite brief, usually seconds, rarely minutes.The way to Evaluate/diagnose BPPV is with Dix-Hallpike maneuver (turn the patient’s head 45 degrees to one side, then you help you lie back quickly so their head hangs slightly over the edge of the table. If horizontal or rotation nystagmus is noted, the patient has BPPV) and can be cured with Epley’s maneuver.Vestibular neuritis: This is inflammation of the vestibular nerve, which is usually caused by a viral infection. It’s characterized by rapid onset of severe, persistent vertigo, nausea, vomiting, and gait instability. Hearing is preserved but if there is hearing loss(unilateral), then it is diagnosed as labrynthitis.  You can Evaluate/diagnose with a positive head impulse (or head thrust) test and gait instability but know that the patient is still able to ambulate. (lasts a few days and resolves spontaneously) Herpes zoster oticus: It is also known as Ramsay Hunt syndrome when it causes facial paralysis; it occurs due to latent VZV virus in the geniculate ganglion.  The patient will complain of ear pain and vertigo. On exam, you will find vesicles in the auditory canal and auricle along with ipsilateral facial palsy. You can treat with Acyclovir or Corticosteroids. Meniere disease: Itoccursdue to excess endolymphatic fluid pressure, which causes episodic inner ear dysfunctionresulting in the classic triad of vertigo lasting for minutes to hours, usually associated with unilateral tinnitus and hearing loss. Unfortunately, the hearing loss can sometimes be permanent. It usually affects one ear and although it can occur at any age, most cases start between young adults and middle age adults. Evaluate and diagnose clinical features, get an audiogram for hearing loss. Patients go into remission spontaneously but it can reoccur. Other causes of peripheral vertigo: Labyrinthine concussion (traumatic peripheral vestibular injury)Perilymphatic fistula (complication of head injury, barotrauma, or heavy lifting in which a fistula develops at the otic capsule)Aminoglycoside toxicityVestibular schwannoma (unilateral hearing loss associated with neurofibromatosis type 2) Central VertigoVestibular migraine: The mechanism is unknown, so you have to rely on the patient's history of vertigo associated with migraine headache and classic migraine symptoms such as visual aura, photophobia, or phonophobia.Brainstem ischemia: which is due to embolic, atherosclerotic occlusions of the vertebra-basilar arterial system. A few things fall under this category such as TIA, Wallenberg syndrome (lateral medullary infarction), Labyrinthine infarction (Anterior Inferior cerebellar artery) etc. Evaluate and diagnose with Imaging of the head and treat according to diagnosis.  Question number 3: Why is that knowledge important for you and your patients? It is important for when we are working at both the clinic and at the hospital as recognizing serious vertigo can help us plan for intervention. For example, if a patient presents with vertigo and on exam you find vesicles on their ear and facial paralysis then you can immediately begin therapy with a combination of Valacyclovir and Prednisone but if it is a severe case then the patient might need IV treatment.Also, if the patient has vascular risk factors then it is important to keep ischemia as part of your differential when your patient presents with acute sustained vertigo. Remember that for any stroke time of onset is KEY! CT should be done if MRI is not available but MRI is more sensitive for cerebellar infarctions.Question number 4: How did you get that knowledge? (learning habits)I did an ENT rotation in my 3rd yeard of medical school and learned from Dr Trang. I recommend that rotation to all medical students. I also searched in UpToDate, FP notebook app, AAFP and my attendings. See details below.____________________________Speaking Medical: Otolith by Gina Cha, MDStones are located in many unsuspected places in the body. Such is the case of otoliths. An otolith is a calcium carbonate structure in the saccule or utricle of the inner ear, specifically in the vestibular system of vertebrates. The saccule and utricle, in turn, together make the otolith organs. An otolith can cause great trouble if it’s out of its regular place. When otoliths are dislodged from their usual position within the utricle, and migrate into one of the semicircular canals (most commonly the posterior canal), moving the head causes movement of the heavier otolith debris in the affected canal causing abnormal endolymph fluid displacement and a resultant sensation of vertigo.____________________________Espanish Por Favor: Serenoby Claudia Carranza, MD, and Hector Arreaza, MDHi! This is Dr Carranza with our section “Espanish Por Favor”. The word of the week is SERENO (maybe we can have beach waves crushing in the background). SERENO is a state of mind, a peaceful feeling. To be SERENO means to be calm, peaceful, untroubled, tranquil. Sometimes when people are frustrated or too excited you can say: “Sereno, no te preocupes,” which you can loosely translate as “chill, don’t worry.”Sometimes you might ask someone how they are doing and they can say: “Sereno, sin preocupaciones,” which means “calm, without worries.” Nowadays not many people might actually feel that way but you can always remind them to lay back, relax, and take a deep breath “SERENO!”Another meanings of the word sereno includes “humidity on the atmosphere at night.” In some Latin American countries, sereno can make you sick if you, for example, shower and go outside at night, or you can get worse if you are sick and go outside. The sereno can also be used in folk medicine to “macerate” some herbal teas or remedies giving it a special property to cure illnesses. This may not be used in all countries but at least I know it’s true in Mexico and Venezuela.____________________________For your Sanity: Supermanby Tana Parker, MD Friend 1: Do you want to hear a really good Batman impression?Friend 2: Sure, go on. Friend 1: NOT THE KRYPTONITE!Friend 2: That’s Superman.Friend 1: Thanks, man, I've been practicing. “eBay is so useless. I tried to look up lighters and all they had was 13,749 matches.”“I just saw my wife trip and fall while carrying a laundry basket full of ironed clothes. I watched it all unfold.”I made a playlist for hiking. It has music from Peanuts , the Cranberries, and Eminem. I call it my trail mix._________________________Conclusion: Now we conclude our episode number 32 “Vertigo.” Dr Carranza and Jagdeep had an entertaining conversation about the differential diagnosis of peripheral and central vertigo. Don’t forget to practice the Dix-Hallpike and Epley’s maneuvers for BPPV. Otolith is a tiny stone located in the inner ear that can cause vertigo when it gets stuck in the semicircular canals. The word sereno (pronounced (say-RAY-noe) as an adjective is pretty much the same as the English serene, however, Dr Arreaza explained that sereno as a noun refers to the humidity on the air thought to be the “cause” of many ailments in some Latin cultures. Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Arianna Lundquist, Claudia Carranza, Jagdeep Sandhu, Gina Cha, and Tana Parker. Audio edition: Suraj Amrutia. See you next week!     _____________________References:Meningococcal vaccine updates: https://www.aafp.org/news/health-of-the-public/20201007meningococcalvacc.html. Review full article at: https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm?s_cid=rr6909a1_w Labuguen, Ronald H., M.D., University of Southern California, Los Angeles, California, Initial Evaluation of Vertigo, Am Fam Physician. 2006 Jan 15;73(2):244-251. https://www.aafp.org/afp/2006/0115/p244.html Furman, Joseph M, MD, PhD, and Jason JS Barton, MD, PhD, FRCPC, Evaluation of the patient with vertigo, UptoDate, last updated: Feb 11, 2020. https://www.uptodate.com/contents/causes-of-vertigo?search=vertigo§ionRank=1&usage_type=default&anchor=H5&source=machineLearning&selectedTitle=3~150&display_rank=3#H20 

Episode 24: Alcohol in Clinic[Music to start: Grieg’s Morning Mood (https://www.youtube.com/watch?v=-rh8gMvzPw0) The sun rises over the San Joaquin Valley, California, today is August 21, 2020. Fresh from the oven! The USPSTF issued the following recommendation on August 18, 2020: All sexually active adolescents and adults at increased risk should receive behavioral counseling to prevent Sexually Transmitted Infections (STIs).Counseling results in a moderate net benefit in prevention of STIs, a Grade B recommendation, which means the benefit is moderate to substantial, so offer this service to your patients.Some examples of patients who can benefit from counseling are those who have a current STI, do not use condoms, have multiple partners, belong to a sexual and gender minority, HIV patients, IV drug users, persons in correctional facilities, and others.Offering counseling in person for 30 minutes or less in a single session may be effective, but the strongest effect was found in group counseling for more than 120 minutes, delivered in several sessions. Other options include referring patients for counseling services or inform them about media-based interventions. Of note, there are about 20 million new STIs every year in the US (1). [Music mixes with country Chris Haugen - Cattleshire - Country & Folk https://www.youtube.com/watch?v=WiYqHkH4Tnc&list=PLYo1YtVKirP-LAZ3AjpIiJNW9KIe1MJLw&index=7]Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program, recorded weekly from Bakersfield, California, the land where growing is happening everywhere.The Rio Bravo Family Medicine Residency Program trains residents and students to prevent illnesses and bring health and hope to our community. Our mission: To Seek, Teach and Serve. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971. [Music continues and fades…] ____________________________[MUSIC][Quote]“The illiterate of the 21st century will not be those who cannot read and write but those who cannot learn, unlearn, and relearn” –Alvin Toffler.Sometimes there are things we need to unlearn. We see that frequently in Medicine. New guidelines, recommendations, tests, and treatments are updated regularly. We need to make sure we never stop learning, unlearning and relearning; and residency is just part of the beginning of a life-long commitment to learn. Today we have a dynamic intern. She started just one month ago her residency. I’m happy to welcome Ariana Lundquist today.     Question number 1: Who are you?Hi, my name is Ariana and I am a first-year resident at Rio Bravo Family Medicine Residency.  I am a California girl through and through from Orange County, California.I grew up surfing every weekend with my dad who also is a family physician.Early on I knew I wanted to be a doctor because I really loved being at my father's private practice. My mom had her private practice at my father's clinic, and so every day after school she would pick my sister and I up and take us to clinic.  We would run around and interact with every patient.  We truly grew up in the clinic and I cherish those memories as an adult.   I went to Canyon high school where I did water polo and swim.  For undergrad, I went to Cal State Long Beach where I majored in cell molecular biology with a minor in general chemistry and surfing.  I then went to the beautiful island of Dominica to attend medical school at Ross University.   My last 2 years of medical school were spent in Bakersfield.  As someone who loves the heat and sweet hospitality, Bakersfield was really fit for me.  I truly am excited to learn and grow as a physician here in Bakersfield with the Rio Bravo family medicine team.   For fun, I still try to surf whenever I get a chance, free dive, scuba dive, karaoke, and spend time with my family. Question number 2: What did you learn this week?This week I was working on my quality improvement project with my co-resident Dr. Civelli on alcohol withdrawals in a hospital setting.  During the research, I was wondering about how you would treat alcohol withdrawals in a clinic setting.  We encounter a lot of patients who, when they are willing to open up about it, admit to having alcohol dependency.   It is never a simple subject to talk about with patients because most people either feel that they have their alcoholism under control or that they are ashamed by the amount that they drink.  Once the patient is honest with you about the amount they drink and you realize that they are above the recommended daily intake, that is when you start to assess their willingness to quit.  That alone is another subject for a pod cast in the future, but if someone is willing to quit you have to consider if that patient is somebody who might have withdrawal symptoms.           Timing of alcohol withdrawal syndromesSyndrome Clinical findings Onset after last drink Minor withdrawalTremulousness, mild anxiety, headache, diaphoresis, palpitations, anorexia, gastrointestinal upset; normal mental status6 to 36 hoursSeizuresSingle or brief flurry of generalized tonic-clonic seizures, short postictal period; status epilepticus rare6 to 48 hoursAlcoholic hallucinosisVisual, auditory, and/or tactile hallucinations with intact orientation and normal vital signs12 to 48 hoursDelirium tremensDelirium, agitation, tachycardia, hypertension, fever, diaphoresis48 to 96 hours  Patient assessment 1) Substance use history questions include:-Duration of disorder?-When was your last drink?-How many drinks per day, and days per week?-History of withdrawal seizure or delirium tremens-Medical complications related to alcohol-Number of prior supervised withdrawal episodes?   2) General Physical Exam w/ vitals 3) Labs: CBC w/diff, blood glucose, electrolytes, calcium, magnesium, phosphorous, anion gap, renal and hepatic function 4) Withdrawal Symptoms  Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA): There are 10 areas to examine in this scale. Evaluate each area and assign a score (see details below):1. NAUSEA AND VOMITING: Ask "Do you feel sick to your stomach? Have you vomited?" Observation. 2. TACTILE DISTURBANCES: Ask "Do you have any itching, pins and needles sensations, burning sensations, numbness, or the feeling of bugs crawling on or under your skin?" Observation.3. TREMOR: Arms extended and fingers spread apart. Observation. 4. AUDITORY DISTURBANCES: Ask "Are you more aware of sounds around you? Are they harsh? Do they frighten you? Are you hearing anything that is disturbing to you? Are you hearing things you know are not there?" Observation. 5. Paroxysmal sweats. Observation. 6. VISUAL DISTURBANCES: Ask "Does the light appear to be too bright? Is its color different? Does it hurt your eyes? Are you seeing anything that is disturbing to you? Are you seeing things you know are not there?" Observation. 7. ANXIETY: Ask "Do you feel nervous?" Observation. 8. HEADACHE, FULLNESS IN HEAD: Ask "Does your head feel different? Does it feel as if there is a band around your head?" Do not rate for dizziness or lightheadedness. Otherwise, rate severity. 9. AGITATION: Observation. 10. ORIENTATION AND CLOUDING OF SENSORIUM: Ask "What day is this? Where are you? Who am I?" Count forward by three. Interpretation of CIWA score0 to 9 points:Very mild withdrawalOutpatient management10 to 15 points:Mild withdrawal 16 to 20 points:Modest withdrawalInpatient management21 to 67 points:Severe withdrawal    5) Co-morbidities  If patient shows no symptoms in first 24 hours and they are not at risk for major withdrawal, no medication is indicated as symptoms are unlikely to develop.Ambulatory Criteria:•A patient with mild symptoms of alcohol withdrawal (CIWA-Ar

Join BPI for this timely informational and sharing discussion. Dr. Marilyn K. Volker, Sexologist for the past thirty-two (32) years is a Diplomat of the American Board of Sexology and an Associate Fellow of The American Academy of Clinical Sexologists. She sits on the faculty of four South Florida universities— University of Miami, Florida International University, St. Thomas University, Barry University—as well as is Associate Professor at The Institute For Advanced Study of Human Sexuality, San Francisco, California, where she received her doctorate in 1991. Dr. Volker trains counselors to become sex therapists through the Florida Post-Graduate Sex Therapy Training Institute and The Joint Doctoral Program in Clinical Sexology for Sex Therapists. She has served as sexuality consultant for a variety of addiction treatment facilities state and nationwide and has written articles addressing sexuality issues in recovery. Dr. Volker teaches in the sexuality programs for two medical schools— University of Miami and Ross University and is a doctoral committee member for Union Institute. For more information on Dr. Marilyn Volker, go to:https://www.therapycertificationtraining.org/about-us/instructors/91-mar...

Episode 20: Baby BluesThe sun rises over the San Joaquin Valley, California, today is Jul 17, 2020.It feels good to talk about prevention when an effective and safe vaccine is actually available! This is the case for the Pneumococcal Conjugate Vaccine 13 (PCV13 or Prevnar 13®).  In November 2019, the CDC issued an update on PCV13 vaccination. PCV13 vaccination for ALL immunocompetent adults 65 years and older is NOT recommended. Instead, it is recommended to make a shared decision when these patients do NOT have an immunocompromising condition, CSF leak, or cochlear implant, and have not previously received PCV13. Some candidates for PCV13 include patients residing in areas with low pediatric PCV13 uptake; those traveling to settings with no pediatric PCV13 program; those with chronic heart, lung, and/or liver disease, diabetes, or alcoholism; and those who smoke. PCV13 is still recommended in a series with Pneumovax® (PPSV23) for all adults 19 years and older (including those 65 years and older) with immunocompromising conditions, CSF leaks, or cochlear implants. A single dose of Pneumovax® for ALL adults 65 years and older is still recommended (1,2).____________________________“Perfection is not attainable, but if we chase perfection we can catch excellence.” –Vince LombardiPerfection is a very complex concept. Have you seen a surgery that was performed perfectly? I have. Believe it or not, there are perfect surgeries. Some musicians can play a song perfectly. I think perfection in some areas may be attainable. Another example, I think a person can be perfectly punctual for a time. That’s perfection. However, in most cases, perfection may not be attainable, but we should at least aim for excellence. And today, we have a resident who is in her pursuit of excellence, she is doing very good in her residency. Her voice may be familiar to you because she has recorded many of our introductions, and people have loved her voice. Welcome Dr Der Mugrdechian. Question Number 1: Who are you?  My name is Alyssa Der Mugrdechian, I am a 2nd-year resident in the Rio Bravo Family Medicine Program here in Bakersfield. I am a native to the Central Valley having grown up in Fresno, California. I am of Armenian descent and my family settled in California after surviving the Armenian Genocide in 1915. Coming from a family of mostly educators, I am the first to pursue Medicine.  I went to UC Irvine for undergrad and majored in Biological Sciences, and my journey to becoming an MD took me to Ross University on the beautiful island of Dominica.  Though I have traveled a lot during my schooling, I am happy to have the opportunity to have returned to the Central Valley to complete my residency training in an underserved community close to my family and friends.  For fun, I like to draw/paint, I also enjoy cooking, traveling, going to the beach and going to any Disney park as often as possible. Question number 2: What did you learn this week? This month my rotation is Gynecology. I am generally seeing patients for gynecologic issues, OB follow ups and routine post-partum visits. During these appointments, a very important question that can often be overlooked is whether the patient is coping with post-partum depression. Furthermore, another important distinction to make is if it is in fact major depression vs. baby blues. Post-partum Depression (PPD) The post-partum period can encompass the first 12 months after giving birth, however there’s no set length that’s been agreed upon.  Major depression is not confined to the post-partum stage, it can also arise during pregnancy. Factors that increase risk of developing Post-Partum Depression (PPD):Antenatal depressive symptomsHistory of Major Depressive DisorderPrevious Post-Partum Depression Other factors to take into consideration are home life, socioeconomic factors, previous or current abusive relationships/situations.  Edinburgh Postnatal Depression scale The EPDS is a screening tool for postpartum depression. It consists of 10 questions. The test can usually be completed in less than 5 minutes. Responses are scored 0, 1, 2, or 3 according to increased severity of the symptom. Some items are reverse scored (i.e., 3, 2, 1, and 0). You add scores of each question to get a total score. Cut-off scores range from 9 to 13 points. It requires clinical judgment to determine the right timing for referral. For example, if a woman scores 9 or indicating any suicidal ideation, she most likely would benefit from immediate referral. “In women without a history of postpartum major depression, a score above 12 has a sensitivity of 86 percent and specificity of 78 percent for postpartum major depression. You can find the hand out at the end of this document.Other screening methods include PHQ-9, and diagnosis is based on DSM-5.      Distinguishing Between “Baby Blues” and Postpartum Major DepressionCHARACTERISTICBABY BLUESPOSTPARTUM MAJOR DEPRESSIONDurationLess than 10 daysMore than two weeksOnsetWithin two to three days postpartumOften within first month; may be up to one yearPrevalence80 percent5 to 7 percentSeverityMild dysfunctionModerate to severe dysfunctionSuicidal ideationNot presentMay be present Diagnosis and Treatment Labs can also be considered, including TSH to rule out other causes of depressive symptoms Treatment can include both pharmacologic and non-pharmacologic methods such as psychotherapy (interpersonal, cognitive behavioral therapy) Selective serotonin reuptake inhibitors — SSRIs are widely prescribed in lactating women. Breastfeeding should not be discouraged during treatment with SSRIs.DRUGSTARTING DOSAGEUSUAL TREATMENT DOSAGEMAXIMAL DOSAGEADVERSE EFFECTSSelective serotonin reuptake inhibitorsCitalopram (Celexa)10 mg20 to 40 mg60 mgHeadache, nausea, diarrhea, sedation, insomnia, tremor, nervousness, loss of libido, delayed orgasmEscitalopram (Lexapro)5 mg10 to 20 mg20 mgFluoxetine (Prozac)10 mg20 to 40 mg80 mgParoxetine (Paxil)10 mg20 to 40 mg50 mgSertraline (Zoloft)25 mg50 to 100 mg200 mgSerotonin-norepinephrine reuptake inhibitorsDesvenlafaxine, extended release (Pristiq)50 mg50 mg100 mgHeadache, nausea, diarrhea, sedation, insomnia, tremor, nervousness, loss of libido, delayed orgasm, sustained hypertensionDuloxetine (Cymbalta)20 mg30 to 60 mg60 mgSame as selective serotonin reuptake inhibitorsVenlafaxine, extended release (Effexor XR)37.5 mg75 to 300 mg300 mgSame as desvenlafaxine  Question number 3: Why is this knowledge important for you and your patients? Sometimes patients aren’t willing or open to discussing this topic. In other cases, it may not even be touched upon by providers following up with the patients. But especially with everything going on this year with the pandemic, mental health is vital to a patient’s overall well-being. It also affects maternal functioning, and ultimately the well-being of the child It can lead to lack of breastfeeding, lack of maternal-infant bonding, problems with abnormal child development, problems with infants sleeping properly and also receiving the proper vaccinations. Suicide can also occur, however this rate is very low in the post-partum period  Question number 4: How did you get that knowledge?I got interested in the topic because of the patients I have seen in clinic. I consulted reliable sources such as UpToDate, our day-to-day companion in clinic; American Academy of Family Physician; and the United States Preventive Services Task Force, which is our main source of preventive services offered in Family Medicine. Question number 5: Where did you get the information from?An article by Dr Viguera about Postpartum depression in UpToDate, updated on 11/20/2018. I also consulted an article about safe infant exposure to antidepressants in UpToDate. AAFP has a very good source of information about Postpartum depression. See details below. Edinburgh Postnatal Depression ScaleEdinburgh Postnatal Depression Scale. © 1987 The Royal College of Psychiatrists. The Edinbugh Postnatal Depression Scale may be photocopied by individual researchers or clinicians for their own use without seeking permission from the publishers. The scale must be copied in full and all copies must acknowledge the following source: Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–786. Written permission must be obtained from the Royal College of Psychiatrists for copying and distribution to others or for republication (in print, online or by any other medium). Translations of the scale, and guidance as to its use, may be found in Cox JL, Holden J. Perinatal Mental Health: A Guide to the Edinburgh Postnatal Depression Scale. London: Gaskell; 2003.  Speaking Medical: Borborygmusby Max Uschuk, MS4 We all have been in a silent exam and your stomach decides to demonstrate the sound of a humpback whale mating call. That’s borborygmus. What is borborygmus besides an interesting word to say? Technically speaking it is peristaltic movement of gas and fluid through the intestines causing an audible sound that is loud enough to be heard by the naked ear. When someone says their stomach is growling or rumbling, that is borborygmus or borborygmi (plural), not to be confused with bowel sound or peristaltic sounds which require a stethoscope to be heard. Is it medically pertinent? Many things can cause borborygmus. An empty stomach around 2 hours post prandial starts to signal the brain that it is fasting, it triggers peristaltic waves every 90-230 min, and contents are moved through the intestines and function to inhibit migration of bacteria from the large intestine to the small intestine. This movement can cause borborygmus. When someone swallows air while talking, eating or drinking it can increase borborygmus. Incomplete digestion of foods such as milk, gluten, fruits and vegetables, bean, legumes, and high fiber foods can increase borborygmus. Now, this can be normal but when paired with bloating, pain, diarrhea or constipation it can be indicative of a pathological process. Some pathologies such as celiac disease, colitis due to infection or necrotizing colitis, diverticulitis, irritable bowel syndrome, carcinoid syndrome or basically anything that really irritates the intestines can cause borborygmus. From the Practical Medicine Series; General Surgery, “the presence of stormy peristalsis or borborygmus in the absence of fever may be considered pathognomonic to intestinal obstruction as it never occurs in adynamic ileus” Thank you for listening and I hope you get to use the word borborygmus sometime soon. ____________________________Espanish Por Favor: Spanish Last Namesby Dr Claudia Carranza“Hola, me llamo Fernando Hernandez Guerrero Fernandez Guerrero.”That’s a fictional name from Fuller House, but sometimes that’s how Hispanic names sound like to English speakers. Hi, this is Dr Carranza in our section Espanish por favor, today instead of bringing you a word of the week I wanted to discuss a topic with everyone. It’s the topic of last names! In the States, people usually have one last name, unless once married they chose to hyphenate their last name. Well, in the Hispanic culture we usually have 2 last names. The last names we have are first, our father’s last name, and our second, our mother’s last name.  So, for example, my name is Claudia Carranza, but the name given to me at birth was: Claudia Roxana Carranza Guzman. I don’t think I have ever met anyone in Peru (where I’m from) that only had one last name. Dr Arreaza brought up an interesting point, which is what if people in Latin American cultures have one last name? I’ll let him expand on this topic. Dr Arreaza: Having only one last name may have a negative social connotation. When someone has one last name in Venezuela it usually means that you are a “natural son”, or illegitimate, or born from a single mother. Dr Carranza: In Peru, at least what I saw growing up, if a child only had one parent then they took the full first and second last name of that parent. So, guys when you meet a Hispanic patient with two last names, remember that their 1st last name is the one they will usually go by, not the second. So, for my name Claudia Roxana Carranza Guzman, you would call me: Claudia Carranza, not Claudia Guzman. Hope this helps when you are trying to figure out what last name to use when you see a patient or have a coworker with 2 last names!____________________________For your Sanity: by Steven Saito and Tana ParkerDoctor: I have bad news, and very bad news.Patient: What's the bad news?Doctor: You only have 24-hours to livePatient: And the really bad news?Doctor: I’ve been trying to contact you since yesterday._______________________________Now we conclude our episode number 20 “Baby Blues”. Dr Der Mugrdechian reminded us to screen for post-partum depression using the Edinburg Postnatal Depression Scale and make sure it is not “baby blues.” Max taught us the word borborygmus, just a fancy way to say “very loud stomach growling,” and Dr Carranza explained that the name you see at the end of a looooong Spanish name may not be the actual last name. The actual last name is the name before the last, I know it may be confusing, but it’s OK to ask your patients their preferred last name.     This is the end of Rio Bravo qWeek. We say good bye from Bakersfield, a special place in the beautiful Central Valley of California, United States, a land where growing is happening everywhere.If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. Our podcast team for this episode is Hector Arreaza, Alyssa Der Mugrdechian, Claudia Carranza, Lisa Manzanares, and Max Uschuk (pronounced Use-Chuck). Audio edition: Suraj Amrutia. See you soon! _____________________References:Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Updated Recommendations of the Advisory Committee on Immunization Practices, Weekly, November 22, 2019 / 68(46);1069–1075, https://www.cdc.gov/mmwr/volumes/68/wr/mm6846a5.htm#T1_downShared Decision-Making for Administering PCV13 in Older Adults, AMIT A. SHAH, MD; MARK R. WALLACE, MD; and HEATHER FIELDS, MD, Mayo Clinic, Scottsdale, Arizona, Am Fam Physician. 2020 Feb 1;101(3):134-135. https://www.aafp.org/afp/2020/0201/p134.html Viguera, Adele MD. “Postpartum unipolar major depression: Epidemiology, clinical features, assessment, and diagnosis” UptoDate. Last updated 11/20/2018. Mary C Kimmel, MD, Samantha Meltzer-Brody, MD, MPH, “Safety of infant exposure to antidepressants and benzodiazepines through breastfeeding” UptoDate. Last updated 11/10/2019. KATHRYN P. HIRST, MD, and CHRISTINE Y. MOUTIER, MD, University of California, San Diego, School of Medicine, La Jolla, California. “Postpartum Major Depression”, Am Fam Physician. 2010 Oct 15;82(8):926-933. https://www.aafp.org/afp/2010/1015/p926.html      

Episode eight of The Black Doctors Podcast features Dr. Curtis Okpara, an Internal Medicine Hospitalist. He is a Houston native and first-generation Nigerian-American. Dr. Okpara presents yet another view of life as an Internal Medicine Hospitalist. In this episode, Dr. Curtis gives details about his week-on/week-off schedule as a Hospitalist. He talks about his path through Baylor and on to Ross University, a medical school in the Caribbean. He provides much needed advice and encouragement to students considering this option. We talk about the significance of his Nigerian heritage and how his practice provides maximal family time. We wrap up by discussing his car collection and his new and wildly popular YouTube channel: The Life of Doctor Curtis O. Are you or someone you know interested in attending medical school in the Caribbean? Do you know any IMG students or graduates? Have you thought about pursuing a career in Internal Medicine? This episode is for you! Listen and share. Subscribe so you will be among the first to receive weekly episodes. If you like what you hear, please leave a rating or comment. TBDP is a volunteer passion project with the goal of inspiring all who listen. In-house music and audio production, so any ideas for improvements or suggestions for future guests are welcome. Thank you so much for listening. If you are thinking about starting your own podcast, check out my 30 Minutes To Podcast masterclass on my website www.StevenBradley,MD.com --- Send in a voice message: https://anchor.fm/blackdoctorspodcast/message Support this podcast: https://anchor.fm/blackdoctorspodcast/support

On today's episode, I am joined by Corey Boggs, who is a Doctor of Medicine Candidate from Ross University. On this episode, we address the racial disparities within the healthcare system and the toll it has taken on the physical and mental health of our community! This weeks "shout outs" go to Corey and all healthcare professionals of color who have made it their mission to combat racial disparities within the healthcare system! Follow Corey on Instagram: @_corey.diem_ The Cope For The Culture Podcast is geared towards discussing mental health as it relates to black and minority communities. On this show we have solo and interview based episodes with individuals from different walks of life who are dedicated to being the change within the culture as it relates to various topics and their effect on the world of mental health. The podcast is hosted by Tiana Renae who is a licensed mental health therapist. Thank you for listening and if you enjoyed this episode, please subscribe, leave a review and share with your tribe. Email: copefortheculturepodcast@gmail.com The hashtag for the podcast is #copefortheculturepodcast. Make sure to follow us on social media: Instagram: @copefortheculturepodcast Twitter: @cope4theculture --- Send in a voice message: https://anchor.fm/copefortheculture/message

In this episode, Dr. O’Connell and Dr. Salah discuss what sports medicine is and how it relates to the COVID-19 virus. Some topics covered include: - How exercise affects the immune system- How professional sports organizations avoid spreading infections like COVID-19 among themselves- What professional athletes do when they get ill- How athletes are staying in shape despite gyms being closed and seasons being on holdDr. Moin Salah is a sports medicine physician at Providence Medical Institute in the South Bay of Los Angeles where he practices urgent care and sports medicine. Dr. Salah earned his undergraduate degree from UCLA where he was a Division 1 track athlete. He received his medical degree from Ross University and completed his family medicine residency training at Kaiser Permanente Woodland Hills. Dr. Salah completed a sports medicine fellowship at the West Coast Sports Medicine Foundation through Harbor UCLA Medical Center and Kaiser Permanente. In addition, Dr. Salah completed an MBA in healthcare administration from the University of Massachusetts. Dr. Salah has a busy sports medicine schedule, including serving as the lead physician of the LA Wildcats of the XFL, the Mountain Dew Action Sports Tour, and the USA Olympic BMX team. In addition, Dr. Salah gives his time to the local community as the team doctor for Serra High School as well as other local high schools and colleges.Your host is Dr. Ted O’Connell, family physician, educator, and author of numerous textbooks and peer-reviewed articles. He holds academic appointments at UCSF, UC Davis, and Drexel University's medical schools and also founded the Kaiser Permanente Napa-Solano Community Medicine and Global Health Fellowship, the first program in the U.S. to formally combine both community medicine and global health. Follow Ted on Instagram (@tedoconnellmd) and Twitter (@tedoconnell)! Submit Your Questions for the PodcastSend an email to info@arslonga.media or check out covidpodcast.comWhat Can You Do? You can help spread commonsense about COVID-19 by supporting this podcast. Hit subscribe, leave a positive review, and share it with your friends especially on social media. We can each do our part to ensure that scientifically accurate information about the pandemic spreads faster than rumors or fears. Remember to be vigilant, but remain calm. For the most trusted and real time information on COVID-19 and the coronavirus pandemic, both the CDC and WHO have dedicated web pages to keep the public informed. The information presented in this podcast is intended for educational purposes only and should not be construed as medical advice. Producers: Madison Linden and Christopher Breitigan. Executive Producer: Patrick C. Beeman, MD

Anand Ravipati is a native of Huntsville, Alabama. He studied biotechnology at Penn State before pursing his medical degree at Ross University. After medical school, Anand has served as an advisor to many start ups while also being a venture capitalist investor. He currently serves as a product manager at Radical Motion, a start up focused on detecting and reconstructing 3D human motion from 2D content. In his free time, Anand helps organize the annual gala for the Tusk Foundation, is an avid tennis player, and tries his best to become a true seeker. 

  Let's talk about burnout amongst medical students... On this week's episode of the Lunch and Learn with Dr. Berry we follow up last week's discussion with Kessy Joseph with another fourth-year medical student, Aprylle Thompson, MS4. Aprylle was born in Jamaica and decided to pursue medicine after her aunt was diagnosed with the crippling disease of Creutzfeldt-Jakob Disease. Today she talks to us about how her experience with burnout has affected her as a medical student & offers tips not only for medical students but physician as well. Text LUNCHLEARNPOD to 44222 to join the mailing list. Remember to subscribe to the podcast and share the episode with a friend or family member. Listen on Apple Podcast, Google Play, Stitcher, Soundcloud, iHeartRadio, Spotify Sponsors: Lunch and Learn Community Online Store (code Empower10) Pierre Medical Consulting (If you are looking to expand your social reach and make your process automated then Pierre Medical Consulting is for you) Dr. Pierre's Resources - These are some of the tools I use to become successful using social media My Amazon Store - Check out all of the book recommendations you heard in the episode Links/Resources: Facebook Instagram Social Links: Join the lunch and learn community – https://www.drberrypierre.com/joinlunchlearnpod Follow the podcast on Facebook – http://www.facebook.com/lunchlearnpod Follow the podcast on twitter – http://www.twitter.com/lunchlearnpod – use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast For More Episodes of the Lunch and Learn with Dr. Berry Podcasts https://www.drberrypierre.com/lunchlearnpodcast/ If you are looking to help the show out Leave a Five Star Review on Apple Podcast because your ratings and reviews are what is going to make this show so much better Share a screenshot of the podcast episode on all of your favorite social media outlets & tag me or add the hashtag.#lunchlearnpod If you are looking to help the show out Leave a Five Star Review on Apple Podcast because your ratings and reviews are what is going to make this show so much better Share a screenshot of the podcast episode on all of your favorite social media outlets & tag me or add the hashtag.#lunchlearnpod Download Episode 126 Transcript Episode 126 Transcript... Introduction Dr. Berry: And welcome to another episode of the Lunch and Learn with Dr. Berry. I'm your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of drberrypierre.com as well as a CEO of Pierre Medical Consulting. Helping you empower yourself for better health with the number one podcast for patient advocacy, education and affirmation. This week we bring you an episode with student doctor Aprylle Thompson who's a fourth year medical student. She again continues this discussion that we have on Physician Burnout and really more aptly medical student burnout. And she was very poignant during her interview just talking about some of the trials and tribulations that she had to face as a medical student. Some of the expectations of a medical student that I think she will agree with me as well, is really at a line for what we shouldn't be expecting of medical students and she really asked the question, why don't we include medical students in this discussion of physician burnout. The discussion that is definitely had when we're talking about attendings that people who are in their career. About feeling signs of being down at a price where for some reason we don't have this discussion when we talk about the medical students and she really wants to make a point and what I love about her interview today is that please think about the medical students again and remember that we're all human. And if we're all human, understanding that not only are the distressors that the residents and the attendings are going to feel, you best believe the medical students have their own pervasive feelings of concern. So I want you to again, check out this week's episode with Aprylle Thompson, a fourth year medical student talking about medical student burnout. Let me know what you thinking. If you have not had a chance remember subscribe to the podcast. Leave us a five star review and tell one friend to tell a friend about this amazing discussion we're having here on the Lunch and Learn with Dr. Berry. Episode Dr. Berry: Alright Lunch and Learn community just heard another amazing introduction for a number two, so this is actually gonna be our second medical student on a topic at hand that is extremely important. That is extremely, I guess becoming very popular now with this discussion of Physician Burnout. And because of the matter at hand of how we started a series out, we really wanted to make sure we reached out and not only talked to just physician, but we wanted to talk to residency medical students. So I'm thankful that we got a chance to talk to Aprylle Thompson today, who is a fourth year medical student who's going to be gracing us today in helping us with our discussion. Aprylle, thank you. Aprylle Thompson: Glad. Thank you for having me. Dr. Berry: So Aprylle, I always did the introduction. I have a lot of people who love to skip right to this portion here. For someone who skipped through and they say you know what, who's this Aprylle Thompson? Tell a little bit about yourself that may not even be typically in your bio and always ask, especially since you're a medical student. Let's talk about your motivation for going to medical school, your career aspiration goals and all that good stuff. Aprylle Thompson: Well, I'm a fourth year medical student from Ross University School of Medicine, which located in Barbados. My interest in medicine started from my junior year in high school. The reason being was because my aunt was unfortunately diagnosed with Creutzfeldt–Jakob disease. So my family had to care for her around the clock and as she deteriorated she became more dependent on us. And we have to learn about the process and what to do. And because of that, my interest was piqued and I wanted to learn more about medicine and treat patients on a more intimate level. Dr. Berry: I love that. And it's so interesting, especially for a lot of us who get into the field that a lot of times our first experience of medicine is a family member who really makes us appreciate the system at hand and really helps put us in that situation where like, you know what, I can be like that doctor. I always tell people about Dr. Gaston who was my pediatrician growing up. And I just used remember thinking like, oh my God, one day I want to be like that Dr. Gaston because I just seen the hearts he was able to touch with just his interaction of being a physician. So we were talking today about Physician Burnout, which is again, especially for those who are in Lunch and Learn community. A topic that's getting much fanfare as of recently to the point where they're even classifying it as ICD 10 codes and all of these things there that are really trying to make it seem as popular as it is. And when we had Dr. Nicole on the podcast, she talked about how this phenomena isn't like a new issue. It's just gotten came out to light with that aspect of people were really being concerned about the onus of being quote unquote burnt out. And what I want to talk about today is really like how are not only physicians, but really how are people who are on the front lines, which our medical students. What's that onus like? What's their thought process? I like to start out just talking about as a medical student, what are some typical stressors that you face on a day to day, month to month basis just being a medical student? Aprylle Thompson: I believe the few stressors that we usually have, well number one is we have to impress everyone. By can go for the CEO of the hospital down to the garbage man. Not just that, as a medical student, sometimes we don't feel as if we know enough material to impress people. So we have that battle that we deal within ourselves. And then we have to also learn how to balance everything. Connect all the pieces together. So what I like to say is that we feel as if we really want to be at the table with everyone, but although we have the knowledge to get close enough, we're still not there yet. And then when you put in the hierarchy of medicine and what goes on in medicine, it just complicates everything altogether. Dr. Berry: And what was very interesting about that was, especially those who may infer, when we talk about the physician who is typically one who, again I say this all the time, that they're in a job where they're supposed to be correct 100% of the time. But a lot of times people, people don't realize too, to get to that point we face almost a daily struggle of I don't know enough. And I think and you said it right on the head, it's really bad in medical schools where we, I always say especially in on in a GME side, we train backwards, right? Where if you're a second year medical student, I start pimping you on stuff that the third year medical student knows. And if you're third year, I started pimping you on stuff for the fourth. For some reason, every time you get to a certain level, we expect you to know a level higher than you're actually at. Aprylle Thompson: Yeah, I've seen that. Dr. Berry: So question, as a medical student, and even when you're in the premed stage where some of the stresses that you've been facing, where they expected? Were you like, yeah, I'm probably going to have to deal with this type of stressors? Or was there anything like, whoa, I didn't realize medical students had it like that? Aprylle Thompson: Honestly, before I started medical school, I thought it would've been a walk in the park as ludicrous as that sounds. I thought it would like I would wake up every day. I'll go to the hospital. Helps sick patients. Get them back to their normal baseline and then go home happy. That's what I thought. I didn't understand that some days when it rains it will pour. And my thought process, what they're being sunshine and roses everywhere was obviously wrong. Dr. Berry: That’s so true. Do you have any family members in the health field prior to pursuing it? Aprylle Thompson: No. I was the first one. Dr. Berry: Same here. It's funny because most of my family, they all went like the business route and manager route. I was literally the only one who was even on the premed side. Didn't have any mentors on that side. I think it's so true that when you don't know what you supposed to know, sometimes kind of walking in the dark. I mean, a perfect example, I didn't realize until I was a, let's say a sophomore and somewhere undergrad. There was this test that you had to take before you went into medical school. I remember just walking into the career center and when Ms. Anderson, shout out to Ms. Anderson at Florida State. When she asked me, hey, what do you want to do? I want to go to medical school. Oh, have you been studying for MK? I'm like, what is that? Just to give people an idea that it's not uncommon for people who want to pursue a goal, but because they don't have the mentorship dare that they need to really be walking into, almost like the firing squad, but it kinda is. Especially in our system where we don't like to talk and we'll talk about that later too as far as how older physicians and people who have kind of been there, done that, don't really reach back enough to like say, hey, you know what you're going to get in medical school and you're going to have to deal with some of these issues that you may not be ready for. So we just want to give you a heads up. Aprylle Thompson: I think apart from that, with my id of the walk in the park, I think it's also the fact that TV shows don't do it justice either like Grey's anatomy. You think it's so happy and it is fun 24/7 but it's really not like that. Dr. Berry: Grey's anatomy, Scrub, ER, all of these. Yeah, trust me. Yeah. And they still funny. My wife can't stand watching those times shows with me because I'm like, I guess it was like I didn't need mumbling under my breath and I'm like, okay, alright. Sure that’s how it goes. For some of the stresses that you know that the typical medical student faces and then I asked especially because Ross University is an international medical school. What was that experience like? Not only going to medical school but going to medical school in an entire different country. Aprylle Thompson: It was honestly a great experience. But I think I have a little bit of leeway because I was born in Jamaica and my family is from Jamaica. So I felt like I was at home. I was in paradise. Dr. Berry: I love it because when you hear of the international medical graduate, I know a lot of times they're saying, well you're going to a medical school outside of the country, because we'd had even taken the fact that there are people weren't actually born in a country who are also going into that school as well too. So that definitely, I love that aspect of it. Now, as a medical student, what were some of the stresses that you typically faced? And just going from first year medical student all the way up in your last year now? Aprylle Thompson: Correct. My biggest stressor would have been balance. I mean, while I was in high school and college balance was a lot easier. But in medical school you have to learn that people will not spoon-feed you. You have to learn how to grow up and figure things out. And I had to learn how to balance my friends, my family, my social life and of course medicine. I believe that being a medical student or even a physician, it makes you realize that having just 24 hours in a day is not enough because everyone is pulling you in different directions and you're only one person. So you have to figure out how to break that up and split that up amongst everyone. Dr. Berry: I love about that. I think sometimes and it happens a lot, especially when you're a medical student, and I say, I always use a term like life be lifeing. Stuff is still happening, but you're in this, almost like this cocoon of being in medical school and having all of the pressures or responsibilities placed upon you. Sometimes you can't even really enjoy the typical experience of someone who normally would, you as a 21, 22, 23, 24 year old, in that range, especially in your 20s. I tell people my twenties were gone. My twenties were highlighted by me studying. And just what it is when you decide to embark on this journey. For sure, I think as a medical student, just having those pressures, not only the inside pressures that the school itself, places on this. But it's the outside pressures of friends and family and just life in general, that are still going on because unfortunately they don't pause while you're in it. Now would you say, especially with some of the stresses that you had to face and some of the stresses that medical students typically have to face, what would you say, from a preparation standpoint, what was the position of your school? And the reason why I ask that is because when we speaking with Dr. Nicole, she talked about the fact that as a physician, as an attending physician, the systems are in place for us to deal with physician burnout. So, now that we bring it all the way back to the medical student, I wonder what that situation is like as well too? How well would you say you were prepared for some of the stresses that you had to face over your time in school, by your school? Aprylle Thompson: I believe my school realized that burnout was increasing amongst physicians as well as medical students. So the clinical student affairs at my school, they promote something that was called a self-care day. And with that, that's what made the day, students are able to focus from their clinical rotations as well as within the classroom. They're able to take that day off and they can work on their mental health, emotional health, and even physical health. So that's one way my school did it. I know other schools love to incorporate therapy in which students are able to have maybe 30 to 45 minute sessions with a therapist and talk to them about what's bothering them and ways that they can plan to help improve burnout or whatever issues the student might be facing at that moment in time. Dr. Berry: I love that especially because it seems like it's coming from the top above where they're recognizing like, hey, our students are being affected by the pressures of burnout. And I talk about burnout a lot when we do this general discussion. When you say the Self-Care Day and you're able to decompress and you just get away from it. How was that one day like for you? Did you feel like it was enough? Do you feel like it was a start for things that come? How would you grade the actions of your school? Aprylle Thompson: I believe it was very beneficial because usually it comes in at the right time. Usually the day before I'm at the peak of my stress. And just knowing that the following day I can stay home, sleep in and relax or even just go to the gym. And I could just figure out ways how I can start my week or what I can do differently to help decrease rate at which I'm burning out. Dr. Berry: Now I got to ask, especially being in this stage of a graduate medical education director and really an attending in itself. Was there ever any time where your attendings either notice or even worse, probably didn't notice some of the burnout associated symptoms in the medical students? Was there something that essentially had to come from the top? Ross essentially had to say like, hey, give these guys a day off because you guys are at work. What would you say in that matter? Aprylle Thompson: I believe students spoke to Ross about it because sometimes attendance can be very oblivious because if faculty have to deal with their own issues and what's going on with their patients, sometimes medical students are overlooked. But luckily for me, my program at Ross University, they're able to identify the issues that we have and whenever we speak, they listen. So I've been very fortunate to be a part of this institute that really cares about their students to help fix the problem that's on arise. Dr. Berry: I love it. And we hedge that a lot. But when you hear the term physician burnout and understanding that you're a medical student. So you're, a few months is about to be a physician who I guess walking into this field where this aspect of physician burning out is very real. What do you think about it when you hear the term? Aprylle Thompson: I believe the term physician burnout, it's very synonymous to the word overworked. So when it happens, we don't perform our best and when we can't perform our best, we're not able to treat patients to the best of our ability, which will increase the rate at which medical error occurs. Dr. Berry: I love it and I think you really hit it on the head because again, like I said not I have a problem with the term physician burnout, but I do think it's something that's masking problems at hand. And sometimes I feel like, especially when you tie the phrase of physician burnout, you're putting the onus on the doc. But not putting the onus on all of the other factors that got the doctor to that point. It just like, oh well, Berry burnt out, that's holidays. Berry burnt out, not realizing, well Berry burnt out because the hours are too long. Very burnt out because he couldn't take care of his patients the way he wanted to take care of his patients. Very burnt out because the frustration of maybe not getting paid enough will continue to grow, all of these different reasons. But when it's titled Physician Burnout, all you hear is the physician is the onus and the physician is the responsible party associated with it. I'd definitely for sure love that definition because I think it's so true and it really cast light on a system that again, it has seemed to now trickle down and I'm not sure if it's was purposeful or I'm not sure if it was just a cumulative effect. But something that's kind of purpose all the way down to now the fact that you could be in training and still experiencing these symptoms of a burnout. Now as a medical student, I asked, you're a fourth year, you're about to be out of here. But was there ever times, especially in the mid before to self-care days and those things in that regard, there ever times you're like, yeah you know what? I'm feeling it right now. I guess this may be a little too much for me at the moment. Aprylle Thompson: I believe that time for me was while I was studying for my board examination specifically step 2 CK and while I was studying for my boards, I was also working in the ICU. So as you already know, the hours are very long. Dr. Berry: When you say ICS, oh alright. Aprylle Thompson: Yes, very long hours. So I had to balance trying to impress my attendance because as a medical student you want to be on the forefront. You want to show that you know your stuff. Apart from pressing my attendance after, make sure I impress my residents, whether that's just, I don't know, doing scutwork for them or being around the patient 24/7. Reporting back to them as soon as possible. I have to always be on my tip toes to make sure that I'm viewed in a positive light. Because as a medical student, your residents are usually they advocate for you. So if you impressed them, you can work your way up. And while trying to do that, I had to also learn as much as I can in the ICU. Because ICU is a whole another world, a different ballgame in medicine. And then when I left the hospital and I went home at about 8:00 or 9:00 PM, I had to still pull out my book to study until about one or two o'clock in the morning and then go out by four or 4:45 AM to get to the hospital by six o'clock and that cycle continued. And after a while I started to feel myself burning out and I couldn't really tell my resident or my attendant because as a medical student, we're not allowed to feel that way because we're not officially doctors yet. And while I was feeling burnout at that stage, I didn't even in the fact that I still had to eat, I still had to cook my meals for the week. I still have to go to the gym, do my laundry. But with everything like that, it's very tough to talk to people about it. Dr. Berry: And most importantly, you still got sleep. And especially Lunch and Learn community, I really want you to have to really pay attention to this story because it is not an uncommon story. First of all, again, I'm an internist. I'm a hospitalists. I take care of patients all day in a hospital. But I 100% agree when Aprylle talks about the fact that ICU is a, just a different ball game, a different beast, a different mindset that it takes to really take care of the sickest of the sickest patients. I can 100% agree with that. And just this understanding, and she touched on a couple points where she talked about one, the hierarchy aspect of it, where the attendings who are there, you have the residents who are there and then you have the medical student who is there and understanding that the work that you have to put in to impress not only the resident but also the attending, on top of juggling effect that this is I'm assuming this is your first time in ICU, right? Understanding that I'm having to learn on the fly while impressing all of the people who are above me. And because I may quote unquote medical, I've got to say quote unquote, but because I'm a medical student, no one recognizes that I can also be burnt out. Is definitely a quandary that a lot of our medical students I realize are facing, in this aspect of quote unquote training. And again, we shouldn't want to train our physicians to have to deal with that level of burden or stress. Because trust me in a light that when you're an attending, I could tell you wholeheartedly just so you can see some type of a light at the end of the tunnel. That level of work isn't there, but it's a different type of stress that you're going to be walking into. Aprylle Thompson: Yeah. You guys live the good life. Dr. Berry: Right. So it's one of those things where I'm becoming very keen now, especially with physician burnout, being discussed on a more and more aspect of it. Understanding that yes, as a physician. Because again, I used to be naive, I used saying, well when they talk about physician burnout, it was people who've been in the game, 10, 15 years and they were just tired. But then when I started walking around and I'm at a residency, let's see, five years now. So I'm five years out of residency and I'm seeing colleagues who are around my age exhibiting and talking about they're tired and done. So you can be five years out of training and already experiencing those symptoms definitely something needs to occur and change. When you're doing the ICU and you are recognizing like hey, I'm not sleeping. I'm not eating. I'm not, you're just probably not talking to friends. I'm not doing the things I needed to do to take care of my own. The support system that was there. Can you talk a little bit about it? Is this where the self-care day really came into play and really helped you or what was happening during that time? Aprylle Thompson: I believe I've been very blessed to have a big support system, specifically my family. From the moment I told you I wanted to go to medical school, they've been there with me from day one, whether if I had a bad day, if I had a happy day. For me, whenever I leave the hospital, the first set of people I call are actually my parents. We talk about my day, I try to replay how did they went. If it was good, they're happy. If it was bad, we talk about ways in which I can improve it tomorrow. And apart from talking to my parents, my fiancé has been a great support system as well. Whenever I've vent my frustration to him about what's going on in the hospital. He listens and he listens very closely and he helps me think about ways that I can distress ways that I can improve myself for tomorrow. So in that way, I don't bring the low from the previous day to the next day and it makes me feel 10 times better when I'm able to vent to my parents and my fiancé about what happened. Dr. Berry: Talk about this especially I want to hit you a follow up question. Is your fiancé in medicine or health or outside of it? Aprylle Thompson: It's funny you asked me that. A lot of people love to ask that. No, he's not. Dr. Berry: And the reason why I asked especially because you talked about how understanding he was is that sometimes a lot of our friends outside of our bubble don't really comprehend. The level of stress that we're dealing with. I definitely want to say you're very fortunate to have that person who can understand like hey, nope, she's on ICU this month. Yeah. I'm probably not gonna see her as much as I want this month. I'm not gonna make her feel guilty for not seeing her as much as I want this month. Those types of things that can build upon a relationship or hurt a relationship when there is that communication disconnect. And especially having parents as well too. Like I say, because having someone to say like, oh my God, today was crazy. And just to be able to talk about it is definitely something. Because one, our typical conversations. We just can't really have all willy-nilly. Unless you're in the field, no one's gonna really understand. I had to see 40 patients a day and being served for 10. Then I got really understand it. But if they're able to be sympathetic to the thoughts in feelings, it really helps you and really helps leave this stress that is usually there when you walk into that building. Whether it’s a clinic, whether it’s a hospital. But be able to go home and have that stress behind. Aprylle Thompson: Exactly and that's why I think it's great that he's not in the medical field as well because when I bent my frustration to him, I just vent. And then that's that. I don't have to bring work home every single day. Dr. Berry: I love it. We talked about just the system in general, of just our medical training. And again, I have some personal thoughts about just training and especially in only being, going through the process of being a medical student and a medical resident right now and attending, but also now being decided where I'm also training as physician, be attendings as a program director. What do you think about just our system in general? Is it our system that's really set up for people to burn out? And especially when we talk all the way down to the medical student, is it just set up so that people are gonna burn out just because the way we do our things? Aprylle Thompson: I believe so because in this system with medicine, not all position, but a lot of physicians, medical students are taught by intimidation and sometimes we're not allowed to feel tired or we're not allowed to know something. And if that happens, sometimes we can be scrutinized by physicians. And the culture of medicine with that, I hope it changes sooner than later and students overwork themselves because you want to impress everyone. So we sacrifice our mental health, our emotional health, and even our physical health just to prove a point that we are good enough and that we are equal to everyone else. Dr. Berry: I love that. I can tell you that's going to be a quote somewhere. We're going to definitely quote something up somewhere. I love the word intimidation because it is such a word that unfortunately does not stop. It's one of those things where I remember being a premed student and feeling like if I'm studying with this person next to me, this person may be able to take my spot in medical school. So I had to be fierce, be tougher to try to get that quote unquote last spot. And then it's the feeling that does not change when you get to medical school. Where not only are you feeling the intimidation from your colleagues and I always joke this because especially in medical, I used to think we're going to be colleagues, I'm not your like enemy. They still bring those kinds of same types of feelings into, that atmosphere. And then you walk into a system, especially for those who may know Lunch and Learn community, what typically occurs depending on the school, but some schools differ is that your first couple of years of medical school, you are essentially doing a lot of the bookwork, laying down the foundations from a basic science aspect. And then your last couple of years you're actually in the hospitals, in the clinics and awards, seeing patient direct patient care on a more, a full time basis. And for those who may not know Lunch and Learn community. But what happens is once you get into the latter years where you're a lot more direct patient care and then you're having to deal with residents or medical attendings who were either brought up differently or brought up in a certain way and don't really know how to get their point across without making you feel like you're lesser. This is a very common problem for a medical students. And again you talked about the pressures, not only the pressures of board exam, but the pressures of oh, if I don't perform and resident don’t liked me, they gave me a bad grade and they tell the attendant to give me a bad, all of these things here that they have to perform on a day to day basis, 24/7. And that's a pressure that I always tell people most career professionals do not have to deal with the pressure that the physician has to deal with. So just even make that micro and think about the pressures that the medical student has to deal with and understanding every single day they feel they're being graded and if one day right, they're human. Because I think that sometimes gets lost. If one day they're human and aren't as enthusiastic as they were the day before yesterday, they can be docked points for it. I think especially when it comes to physician burnout, because I think a lot of times I tell people when you have a physician who's burnt out and understand that they're not just gonna flat out quit, they're going to keep working. They’re going to keep seeing patients, they're not going to do it effectively. But they're going to keep on doing it. So when we talk about physician burnout and then what it can ultimately lead to, I think a very important topic and one that really I think probably should get much more fanfare than it is just the aspect of the physicians even committing suicide. And the fact that we don't have many people who are going into medicine as much as we did any more. Just this shortage that's around everywhere in that regards. What do you think about just those aspects of physician burnout, physician suicide, which is extremely high and as well as just the overall aspect that less people are going into medicine? Aprylle Thompson: Well, I believe in the rate at which physician suicides occurred. It's definitely at an all-time high. But I think for these people, it crosses the line of abuse. Reason being is because some people don't know how to distress. They don't know how to take what they're given, switch it up, and then find a way to relieve themselves. And that's because in the culture of medicine, we can't talk to each other because we're seeing as if we're less than or we're not able to keep up with the rest of the crowd. So because of that, we keep everything bottled up until we can't take it any more than fortunately some people they commit suicide because of that, because that's their way of getting away from all of the stress that they're dealing with within the workplace. Dr. Berry: Very poignant. I think you hit a home on another point. I mean, is sad is that physicians, we don't really talk to each other like that for that fear of being seen as less capable to do. And again, if you took the physician title away from us and someone just told you like, hey, I'm feeling down, I'm feeling bad about myself, I'm feeling depressed. People would automatically know, okay, this is the type of steps you need to do. But people wouldn't say that, okay, you're a less of a blank because of it. Well, for some reason when it comes to physicians and the feel that aspect of burning out, right? That automatically goes to the top of the head like oh, people are gonna think I'm less of a physician and I can't take care of the patients like I used to be able to take care of because of, I'm actually acknowledging this issues that I'm going through. Aprylle Thompson: It's funny you say that because I believe as physicians, sometimes we dub ourselves as being super human because even the burnout could just be from ourselves too. Because we actually look at one another as if we're greater than thou and we're not allowed to not know something. We're not allowed to feel tired. Because even sometimes the outside world, they don't see that. But we put it on ourselves and maybe if we can change that where it's okay to not feel fine, it's okay to let loose a little bit. Maybe that can help our culture a little bit. And the rate at which physician burnout occurs. Dr. Berry: Amazing. For the medical students, because again, you're almost added there. But if you could look back and say like, hey, if you want to, and I hate to say avoid it because it sounds like the system that we're in is going to be very difficult to avoid it. But if you want to be able to deal and manage some of the stressors and the symptoms of medical student burnout. Because I think that's the term that we need to really call it. What tips would you give to say like, hey, if you could do this and if you could do that, that could help you in the long run? Aprylle Thompson: Well I have a few tips. For one is, destress as much as possible, however you want to destress. If it's going to the movies or even a book, do what makes you happy. Secondly, I believe exercising is very important because as we all know, you'll have an increase in endorphins which will make you very happy and if you eat healthy, that can also change your health. And it can also make you feel better about yourself. Funny story is, I'm actually someone who loved burgers amongst other people. And after a while when you keep eating that you don't feel your best. But then whenever I changed my diet and I incorporate more fruits and vegetables, it's amazing how much clarity I have, how it improves, how I feel much happier. And I'm able to focus more. So if we're able to just exercise and maintain a healthy diet that can really help in the way that we react to burnout and how much we're able to tolerate before we get to that stage. Dr. Berry: Amazing tips. Before I let you go. Before we get you out of here, first of all, it has been absolutely amazing and your insight has definitely been something that I think is needed. Because I think is eye opening. I think as we continue to really highlight this phrase physician burnout, I think we need to make sure that we don't just start looking for problems once they become an attending and understand that a lot of these issues and a lot of the lack of support for these issues are happening as early as the second we start being a medical student. Before I let you go tell us about, especially because you're a medical student, so I love to hear about just your plans. What's about to happen? Where are you trying to match? Let's give all that stuff there so we can make sure we're on the lookout for you. Aprylle Thompson: So currently I'm applying for the 2020 match. Going through the hectic motion of getting my application done before September 15. I know a very big day. So I'm from Orlando, Florida. I hope to stay home, be with my family, but if I get matched anywhere else, I'll happily take a position there. So I love all aspects of medicine and as of right now, I'm loving internal medicine as well as general surgery. Dr. Berry: Okay. That's as interesting. I could tell you, I’m an internist right? You don't want me to know OR and I realized that very quickly that you want me nowhere near to OR. I just didn't have the mindset of a surgeon. I just knew it. One of the most important things that I tell anybody is just knowing yourself. Understanding like, oh, I like medicine, but that's not just have medicine I like to be. And so very interested that internal medicine or surgery still in the bread basket for you. So as a program director, I obviously definitely wanna wish you good luck on this upcoming match. I hope you get to whatever this by you're going to get. Like I say, it's a very different, internal medicine or surgery so hope you get to wherever you want to get to. But I want to thank you for sobbing vital podcast and really helping educate Lunch and Learn community on all your endeavors. From a social media standpoint, where can people find you, follow you, track your journey if they wanted to track your journey? Aprylle Thompson: So you can follow me on Facebook at just my name, Aprylle Thompson or on Instagram @cheecah_med. And you could also follow me on Twitter. I don't tweet as often as I should @ Aprylle Thompson. I don't have snapchat though. Dr. Berry: Sure. Okay. Alright. Appreciate it. Remember Lunch and Learn community, we always put all of these links in the show notes so you don't have to write anything now real quickly. We'll make sure it's in the show notes so that you can just click and then go right to Aprylle s page. Aprylle again, thank you for joining the podcast today and you have an amazing day. Aprylle Thompson: Thank you for having me. You have a wonderful day as well. 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  Let's Talk about Physician Burnout... On this week's episode of the Lunch and Learn with Dr. Berry I sat down with Kessy Joseph, a fourth-year medical student from Ross University School of Medicine. To continue last week's discussion on physician burnout with Dr. Nicole we are going to get the perspective of a medical student on their perspective of the important discussion. Kessy has career plans to pursue Internal Medicine, studied Health Education at the University of Florida and her research interests include the cultural views affecting health outcomes/decisions and food access in diabetes management. Kessy also discusses that in her free time she enjoys the sport of boxing and cooking. Text LUNCHLEARNPOD to 44222 to join the mailing list. Remember to subscribe to the podcast and share the episode with a friend or family member. Listen on Apple Podcast, Google Play, Stitcher, Soundcloud, iHeartRadio, Spotify Sponsors: Lunch and Learn Community Online Store (code Empower10) Pierre Medical Consulting (If you are looking to expand your social reach and make your process automated then Pierre Medical Consulting is for you) Dr. Pierre's Resources - These are some of the tools I use to become successful using social media My Amazon Store - Check out all of the book recommendations you heard in the episode Links/Resources: Instagram - www.instagram.com/la.kay.jo Social Links: Join the lunch and learn community – https://www.drberrypierre.com/joinlunchlearnpod Follow the podcast on Facebook – http://www.facebook.com/lunchlearnpod Follow the podcast on twitter – http://www.twitter.com/lunchlearnpod – use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast For More Episodes of the Lunch and Learn with Dr. Berry Podcasts https://www.drberrypierre.com/lunchlearnpodcast/ If you are looking to help the show out Leave a Five Star Review on Apple Podcast because your ratings and reviews are what is going to make this show so much better Share a screenshot of the podcast episode on all of your favorite social media outlets & tag me or add the hashtag.#lunchlearnpod Download Episode 125 Transcript Download the MP3 Audio file, listen to the episode however you like Episode 125 Transcript... Introduction Dr. Berry: And welcome to another episode of the Lunch and Learn with Dr. Berry. I'm your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of drberrypierre.com as well as a CEO of Pierre Medical Consulting. Helping you empower yourself for better health with the number one podcast for patient advocacy, education and affirmation. This week we bring you a guest medical student. She's actually our second medical student on the podcast who talk about physician burnout. Maybe you've not had a chance, please check out last week episode with Dr. Nicole Washington, Board Certified Psychiatrist who really breaks down the foundation of what Physician Burnout is. She helps explain that it isn't something that just happened within the past year, even though the news may make it seem that way and we really lay out the groundwork of what these next series of episodes is going to be like here on the Lunch and Learn with Dr. Berry. So we are going to have a chance to talk with not only other physicians, but we're talking to resident physicians, those who just got out of medical school but aren't official attending status yet. And now we're even going to be talking to medical students because we realized after our discussion with the physician burnout that this isn't something that happens right when we're done at a residency. No, like we're getting hit over the head very early. As early as in our medical school days. So we have Ms. Joseph here who's in fourth year medical student. She’s at a Ross School Medicine and she's going to give her encounter on what physician burnout means to her. She's going to talk about some of the instance that she faced personally, how she was able to get over it. So I'm very excited for you guys to get ready for another amazing episode and listen to her words. Again, whether you're a medical student, physician or whether you're a patient. And again, you're not going to be a doctor. Understand, and I talked about this last week, that if you don't think physician brand now affects you because you're not a physician, you are going to be sadly mistaken. Because physicians who are burning out aren't just quitting on a spot. No, they're working for a years on in within a depressed state, in the least effective state that they can be. And they're having to take care of your relatives and you don't want that to occur. So you want to know if your physician's experiencing some signs of burnout. That way they can make sure that they're taking care of you correctly. So like always, if you have not had a chance to make sure to subscribe to the podcast, leave us a five star review. Whether you're on Apple podcast, Castbox, Google play. I think Stitcher lets you do comments as well. So wherever you can leave comments and if for some reason a podcast app you listen to a podcast doesn't allow you to leave a comment, go ahead and come to the website LunchandLearnpod.com and leave a comment there. Just let us know how we're doing on the podcast. Remember to rate five stars and let's get ready for another amazing episode here on Lunch and Learn with Dr. Berry. Episode Dr. Berry: Alright Lunch and Learn community just heard another amazing introduction. And this is a topic and again, if you caught last week's episode with Dr. Nicole, we are going to be starting a series of a serious topic, especially for not only you guys, the patients, the one who gets taken care of. Because this is really affecting the people who got to take care of you, which we kind of alluded last week. Again when we talk about Physician Burnout, it's not something that the physicians feel it and then they just go away. No, they still keep taking care of people, which means taking care of you, taking care of your mom, taking care of grandma. But with the energy that we got from last week's episode, I excited to expand it and really talk to all different kinds of stages of the physician. And this week we have a guest who's a medical student. And it's so funny because again it wasn't too long ago that I was a medical student but I was surprised just by talking with Dr. Nicole the fact that now we have medical students are starting to feel that pinch, starting to feel that burned and those symptoms that really is a problem. Because if they're feeling it early what happens? I mean they want to quit early. So again Kessy thank you for joining today's podcast here on the Lunch and Learn community. Kessy Joseph: Yes, thank you Dr. Berry for having me. I'm really excited to be here. Dr. Berry: So I gave them a little bit introduction of your bio in the beginning portion. But tell them, just to listeners, because I got listeners who love to skip, go right into the main talking points where I tell them something about yourself they should know by now. Your motivation, even let's say you are regular now. Why are you going to medical school? All that good stuff there. Because I think that really ties home the fact when we talk about Physician Burnout. Kessy Joseph: So essentially just give a little of my background. I'm Canadian born, patient breed, Florida raised. There was a lot of different influences that happened throughout my life, but the most prevalent influence was definitely medicine because of my family background and just like the people I was raised around. But I didn't really want to go to med school until I hit about grad school. That's where I really started working in the whole clinics and seeing all the different populations and the management of different chronic diseases and I really piqued my interest and I was like, whoa, I think I want to be a doctor. I want to be the person that they come to help with their health conditions because I feel like once they start getting referred to like diabetes educator or the nutritionist, they is kind of get lost in the system. They don't really follow through, so why can't I be that person that can do all of that for them? As long as their primary care physician. Dr. Berry: I always ask my doctor friends, but especially medical students, if it wasn't medical school, what would you be doing? Because me, I always tell people my plan B, I probably would did something like on a computer side and you know, some engineer, something. It would just, it was either physician or I'm going in this direction here. Would you have still stayed in the health realm or what was the..? Kessy Joseph: I was thinking, at that time I was really into the whole health education behavior, like diet, nutrition, like community health realm. So that's really what I was interested in. But at the same time I also want to go to culinary school at the same time. So I don't know where I would've been right now. Dr. Berry: Okay, cool. I like that. Okay. We had Dr. Lauren on here who's culinary physician as well too. So I love that aspect of it. As I stress especially for physicians, I think a lot of times when we go in this route, sometimes we forget about our second and third passion because we think we can only focus on physicians. So definitely we want to make sure we still encourage, especially if you still like culinary and food and stuff like that, that we still go in that direction. Kessy Joseph: Right. For sure. I definitely agree. We'll get into it later, but that's definitely something I use for my therapy. Dr. Berry: I love it. Okay. Alright. So let's talk about it. Because I think when we speaking with Dr. Nicole last week, she talked about the aspect of the fact that medical students are facing a lot of stresses. And again, I'm act like I didn't, it's about eight years now. So it's been eight years since I've been in medical school. And I knew there were some stresses there. But let's talk about some of the common stresses that typical medical students are facing these days. Kessy Joseph: I would say there's definitely different stressors depending on the type of medical student you are. For me particularly, I'm considered an international medical student because I went to Ross University. So there are some stressors that aren't as prevalent as in the U S med students. But I think it still can be understood and related to. For everyone, I definitely think one of the main stressors is workload for sure. We have to commit so much time and energy this making sure we have this large breadth of knowledge. And then not only that, a lot of this knowledge is put on us on our own. We have to teach it to ourselves so that can result a lot of sleepless nights. A lot of… Dr. Berry: I remember those, we used to camp out in the library for hours. Even when I think about it now, I'm like, wow, I used to really stay in a library for like 12, 14 hours. Kessy Joseph: I just remember sleep, staying up all night before an exam the next morning. It's rough. It's definitely rough. And then is this like the succession of exams that we have every two weeks, every month, it's like never ending. And not only that, the step one and then the shelf exams and then the step two, step 2 CK, step 2 CS, it's like it never ends. Dr. Berry: And you talked about it because especially, I got a lot of friends who went to international medical school, especially Ross as well. What are some of that extra that being an international medical student, it weighs on you as well? Kessy Joseph: Wow, there's so many. Firsthand, just the fact that we had to go to school in a different country. We had to relocate our entire life to a country that's not as industrialized as the United States. So we had to pretty much adapt to sometimes not having access to water or electricity for a couple of days. Dr. Berry: Wow. Okay. Alright. That's definitely a stressor. Kessy Joseph: Yeah. And then also it's in the Eastern Caribbean. So hurricane season, definitely a tough one for us to the point where in 2017 our entire school was relocated to another island because it was damaged to that extent. So that's just some of the stresses. Is this the fact that after we do leave the island for clinical rotations we have to relocate from state to state, go into different hospitals just to complete all of our clinical requirements. Dr. Berry: Very interesting. I'm definitely glad you touched on it because I especially I love that the Lunch and Learn community understand that when your physician is standing in front of you, most times they have went through a lot of trials and tribulations just to get there. So we really need to, and again, I think sometimes of course I think I'm biased, right? I think sometimes the physicians don't get the amount of respect and credibility that they deserve. Because I don't think a lot of people, and it could be partly our fault because a lot of times we don't really tell our story. But I don't think a lot of people understand like, hey, during school I went out without water. That's a story that if my physician tells me that I'm definitely gonna make sure I listen to exactly what they're saying because clearly they did what they needed to do to get here. Definitely, thank you for that aspect there. Now let me ask you, before you started, I know when you made that transition, I want to go to medical school and before you actually got there, were some of the stressors expected where they're any new ones that you're like, oh I didn't realize it was going to be like this significant. Was there something that threw you for a loop? Kessy Joseph: Well, I definitely knew about the whole workload. I went to grad school. I knew a little bit about that already. But I was expecting having to be up all night studying this, studying that. So that was okay. But ' Very hard to the point where you let yourself go. You stop caring about your personal grooming. You don't eat. I just remember being on the Island, I lost probably like 20 pounds because I just didn't care. I'll just see you whenever I can. Dr. Berry: And again, Lunch and Learn community I'm telling you this is not a unique story. Because again, we're really not exaggerating. You’re spending majority of, if you're not sleeping, the majority of the day is spent studying something. So when you think about those extra maybe an hour or two or three that you have outside to not be studying or not be sleeping. Social life really doesn't shoot up to the top because lifestyle happens, family. So there's a lot of things I still got to occur. Again, I'm nodding my head because I'm like, yap, she is hitting it right on the head. Kessy Joseph: Yeah. I missed so many weddings, so many birthday parties, so many events. And it's hard because people just don't understand when you tell them, Oh I can't make it because school are like what? You weren't at University of Florida, you can make things, why can't you make things now? I don't understand. Dr. Berry: It’s a different type of pressure. And what was funny is, especially when you're talking to other physicians, you definitely don't even have to explain us. If I'm talking to another physician, they're like, yeah, I can't do it. Okay. Alright. I understand. Usually the people on the outside who don't really have the insight in, for them it is perplexing. You don't have time. Yes, I actually don't have time. I'm being dead honest with you. Kessy Joseph: Right. To the point where they think you're just lying. No, I would love to be there. Dr. Berry: I wish I could be there. Dr. Nicole says something about that last week where we sometimes even demonize our medical students sometimes when they ask for like, hey, is it okay if I get off early? Is it okay if I take off to go? There are attendings out there, my colleagues and I get on them all the time for it who are like demonized students for wanting life to still be happening while they're a medical student. Because again, it's one of those, oh, when I was your age, I had a walk in the snow backwards. BS, do you think that that school prepared you to face some of the stressors that you did ultimately face? Kessy Joseph: Not at all. They have their little lectures where there's this like, Oh, you know, if you ever need help or you're ever feeling any mental, like mental instability, we have resources for you. The whole spill. I feel like it's more to cover them. They never really tell you how to prophylactically prevent burnout from happening or what to do to make sure this burnout doesn't happen. Or is this like, oh, once you reached the edge of the cliff and you feel like you're about to fall off, reach us, contact us, we're here for you. So I feel like that's a little too late. Dr. Berry: Yes. And it's so interesting because your story isn't unique. I wish we could say it too. Even unfortunately, again, I'm in graduate medical education and we have these same things or like, yeah, we've got wellness programs and we offer this, we offer that. But again, I sometimes feel like it's window dressing as well. We're offering it so someone can't say we didn't offer it more than the active approach. Actively making sure our students' wellness and wellbeing and mental health and self-care. We don't do any of that. And especially when I was in school we have to do it. There was like a month break and then after that we did a test every single week. It was midterm, final, midterm, final. Every single week, which is crazy when I look back at it. It's crazy that that's the system that medical school has really enacted and unfortunately I think it's a big reason why the trickledown effect is starting to occur. Because when I talk about burnout, when we talk about burnout just in general, I used to be naive. I used to think it was something that only happened to, you know, docs who've been around for 10, 20, 30 years. But as I got out and realized this was happening much sooner, much more of my friends, I'm like, okay, this is weird. Why are they starting to experiencing things and now we can see where some of the groundwork is being laid. And now the medical students, y'all can't even get out of school before it starts hitting y'all over the head. Knowing all that, how do you typically deal with just stress in general? Because I know medical school stresses a heap, but just stress in general. Kessy Joseph: I think really what helps me personally is because of my background in health education and behavior. So I do understand the different facets of overall health. The social, the mental, the physical. You have to make sure every single corner is pretty much covered. And for me, I just like to do things that make me happy. So I enjoy cooking. I enjoy baking. But right now I try to stay away from that because I usually results negatively for me as in weight gain. So I change it to a little bit of exercise. I started boxing. It's really fun. (Oh wow. Okay. But what got you into boxing?) I actually always wanted to box since I was a teenager because my dad would always watch boxing and I thought it was a really cool. I see boxing as an art. You gotta be really skillful and it's really cool sport in my opinion. And I'm also really into gardening. I think watching something grow from nothing is the most beautiful thing. So this producing fruits and vegetables from this water and sun and soil is so relaxing. It's like making I guess your own little children. And I'm always so happy with the products that I produce. So it definitely makes me happy. And then just traveling and exploring and doing outdoor activities, being involved in my community. So this really getting myself outdoors and involved in things outside of medicine because I feel like people in the medicine field always are focusing on medicine and sometimes you just need to step away from that and clear your mind and see other things. It's not always medicine. There's other things in the world. Dr. Berry: I love that you said that because I think it is definitely something that I know a few of my colleagues really have problems with getting away from medicine. Because Lunch and Learn community I just alluded earlier, medicine is busy enough that you can't really consume a lot of your life if you let it. So I'm definitely glad that you're able to experience some of those outlets. And is that something that you had to learn to expose yourself outside of medicine? Was there something that you tried to incorporate even in your early stages of being a medical student? Kessy Joseph: I think this was subconsciously instilled in me by my mother because she always used to say like, don't stress yourself out because you know what, if something were to happen to you today, they'll find someone else to replace you. Dr. Berry: That's so true. The reason why it hit me is because I remember vividly, when I became an attending and there was a doc out of that hospital, he had been there for maybe like 10, 20 years. And he passed away. And I remember he got two emails, like literally just two emails, one email say, Hey, this person passed away. And another to say, hey, this is where the funeral was at. And that was it. You didn't hear anything about, and this is a doc who really put his time and effort to that hospital. And I remember just two emails was all that he got. Didn’t get a party. Didn't get anything. So it's so true that if you don't expose yourself outside of medicine, because of the way the system is, they'll just plug someone in behind you and act like you didn't put in all of the amount of amazing effort that you did. Kessy Joseph: Exactly. So that's why I always feel you've got to put yourself first before you can put any patient first. (I love it). You are just as important as this patient. If you're not functioning at your prime, at your 100%, you can't serve your community. It's important for you to just realize that. Dr. Berry: Very great point. Especially because I think sometimes we as a physician, we get in trouble because we think that, at the patient, yes, Lunch and Learn community, the patients, we understand that. But if the person who's trying to take care of you, isn't that their best? They can't effectively do it. So you have to take care of yourself for it. Just like when you're in an airplane and they tell you, you gotta put your own oxygen mask on first. It's the same premise. If you yourself isn't taking care of, to the ability you need to be taken care of, how do you expect to take care of others and in the most efficient way? When you, especially as a medical student, when you hear the term physician burnout, as a medical student, how do feel about that? How do you feel especially because nowadays where I think has become such a popular term for some reason now and a lot of people, more people are bringing it up. A lot more articles are being published. When you hear the term physician burnout and you're about to walk and especially because it's not like you're on the outside looking in. You're on the inside. You are medical student, graduated, about to become one of physicians and you hear this term burnout. What does some of the thoughts that go through you? Kessy Joseph: I mainly think of it as this physician can no longer perform at their best abilities and this results in them jeopardizing the patient care. So essentially this physician no longer cares about what they're doing and there just there to be present because it's compulsory. So it was just like I'm here because I have to be here, but my mind's not physically here and I have no desire being here. Dr. Berry: And as a medical student, was there especially because when you talked about some of the stressors and you definitely had a lot of stressors to deal with as a medical student. Was there ever any times that you felt that you were at that point? Kessy Joseph: Almost definitely. Dr. Berry: Felt like, oh, is this hitting me too? Kessy Joseph: I was hit real hard during surgery. My surgery rotation, for those of you who don't know, surgery rotation surgeons in general is a very tough field. They wake up at ridiculous hours and they leave the hospital at ridiculous hours. They basically live at the hospital. I just remember it was the middle of my surgery rotation. I just moved to New York. So already that's a stressor in itself because New York is a crazy city and I was waking up at 3:30 AM every morning to get to the hospital at five and I would be in the OR all day just standing there, because medical students don't really do much in the OR. So just imagine standing in the OR for hours and hours and hours and then I wouldn't get to leave to go home until six to 8:00 PM. So I get home at eight to nine. So do the math. If I get home at nine and I have to wake up at 3:30 I typically would what like go to bed at like 10-ish. So I would get like four or five hours of sleep every day. So that went on for three weeks straight. And most days I didn't eat. I remember one time I stopped to think about something and I realized, oh my gosh, I haven't eaten an actual meal in 36 hours. (Wow). That's insane. I'm literally running on a banana and Graham crackers from the patient pantry room. What is this? This is not okay. So that went off for three weeks straight and then right from there I went into an emergency medicine rotation and those shifts are 12 hours long. Four consecutive nights or days. And after my first week in the ED of four consecutive 12 hour shifts, I was done. I started feeling like I had no motivation. I had no interest of going to the hospital. I just couldn't. I was rethinking the whole medicine thing. Dr. Berry: Right then and there. Yeah. Lunch and Learn community, the two specialists that you just named are two of the specialties that suffer a lot from burnout. So again, she was a medical student. She wasn't even, it's like, so just to understand just how deep and pervasive that the feeling and association is. Kessy Joseph: It's rough. Very rough. And I just remember telling myself, whoa, what am I? No, I can't do this. I cannot do this. I literally wrote an email to the coordinator and said, I'm taking a week off. I can't do this. My mental health, I can't see myself going back next week and continuing to do this or I'm just gonna like slowly degrade and crumble into pieces. So I took a week off for myself, for my mental health. Dr. Berry: Now how was it? I guess the question is what was the initial response from your email? Kessy Joseph: She was actually very supportive because I have a good relationship with her. And also my school recently at that time was this launching a new initiative for mental health. So I guess it worked in my favor as well. So she was accepting. She's like, okay, that's fine. No worries. I'm happy you're actually taking the initiative to take care of yourself, your mental health, and I'll let the attendings know that you would like to change your schedule around and it was fine. Dr. Berry: What I love about that is she recognized that you are human. And I think that sometimes gets lost in the training of our medical professional that we're humans who are stepping into a field. And I tell everyone who listened to me that we want in a few fields that we're required to be correct 100% of the time because if we're only correct 99% of the time, that could mean your grandma does not come home. That could mean your dad does not come home. So when you're dealing with that level of pressure on a day to day basis and it's not being recognized that you're dealing with that much pressure on a day to day basis, you can definitely will. So I definitely give props to, it was an advisor? Who that was? (The coordinator). Coordinator, yeah so definitely props to who recognize like, hey, what we need to recognize like, yes, the mental health is going to be important if we want her to actually succeed. So definitely shout out to her for sure. And then during that week, what did you do? Was it just like you just disconnected or what was the? Kessy Joseph: So I had a ball. So I called, I had my boyfriend come down in New York. We traveled to Canada. Went to go see my family. We went to the zoo. We went to museums. We went out to restaurants. It was great. Like I just decompressed, enjoyed life basically. It was nice. It was definitely like me hitting the reset button and it was definitely needed. Dr. Berry: I love it. When you came back and the button was reset, were you completely like, I'm ready to go now. Was still some lingering effects? What was that feeling back that first day? Kessy Joseph: It was weird. I actually felt like I wanted to do medicine. Like, yeah, okay, I'm ready. Let's go. Let's start at least seeing these patients. I'm happy to be here. Let's save some lives. That's the attitude I had. It was great. I was really excited to be there versus a week ago where I didn't even want to get out of my bed and go. Dr. Berry: That’s amazing. Amazing to hear because again and that's what we want. That's the scenario that we want to see when our colleagues. Because again this is something that I have to tell my attending colleagues all the time like, hey, you didn't realize this is going gonna be a colleague and like a couple of years. Sometimes I think we get so hierarchy and the way we look at medicine is that we don't recognize like, hey buddy, you are actually a medical student. Whatever years ago you were like there's no way you could become a doctor without becoming a model student. So understanding like yes, this person needs to breed. This person needs to relax. They need to be able to have some mental clarity. It's definitely an important so definitely love the fact that you were able to reset. One, you're able to recognize you needed to reset. And then the opportunity was there and it was given to you. So definitely thankful for that aspect of it. Kessy Joseph: I'm just very lucky the fact I had the support system and the faculty that actually supports us taking care of our mental health. Because I feel like if I had attendings who were like, Oh, suck it up, just keep coming. No, you can't have a day off. Then you do realize most medical students won't finish medical school. So you have to be supportive. You have to show that you care about our sanity essentially. So you want us to become these great physicians, so you have to support us in taking care of ourselves to be great physicians. So I'm happy that I have attendings like that, but I know everyone's not as fortunate. Dr. Berry: Now a question that was post by Dr. Nicole was the aspect of the burnout we're experiencing. Is it a rite of passage? Is it a form of abuse? What's actually happening on such a level that when you tell your story from Ross University, I can relate your story from Nova, Southeastern University. From a systemic standpoint, why do you think so many students are really just experiencing these signs of burnout? Kessy Joseph: I feel it's difficult to say because I know for some students, they do get the whole abuse aspect of being in medical school while they're in clinical rotations where attendings are like pimping them from left to right, degrading them saying, oh really? That's the answer you're giving me. You're wrong. Go look it up. Blah, blah, blah. But personally, I've never experienced that. But I would say systemically it's really the fact that a lot of people who do go to medical school or kind of type A perfectionist. So whenever we do make a little mistake or whenever we do forget a fact or not know something, we beat ourselves up and forget that this is a learning process. We can't know everything. We were expected to make mistakes. So we can't just keep degrading ourselves and not being confidence within ourselves while we're on this journey to becoming a physician. And I think that's really one factor in this whole process of physician burnout. Dr. Berry: That's so huge and so key because it may hit it right on head the fact that a lot of us are such perfectionists. I always equate it to when like athletes go to college sports and in their homes, in their home towns, they were the man. They were that elite person. And then you get, go to college and then you're in a room full of other elite people. And you realize like, wow, my eliteness isn't as elite as I thought it was. And again, sometimes you get a reality check. You get that bad grade on that physics exam. You get bad grade on anatomy physics. You started getting Bio-Chem and all these things are happening. And you're like, your armor that you've been able to build up because you've been the elite of the lead as an undergrad, medical students just begins to get chipped away. And a lot of us have not been prepared to deal with that. We just have not been prepared to deal with the strife that comes with not being a hundred percent perfect. So I definitely think that's, I mean that's really hitting right on the head. Why I think some of them are medical students are really starting to feel some of that burn. Again, and it does worry me because especially, I know you're a medical student, but I can tell you as a resident you're going to feel different levels of pressure. As an attending, you're gonna feel different levels of pressure and stresses. So I'm glad that you had that opportunity that I kind of face a little bit in, in your medical student career, in NOLA. Hey, these are ways that I can work my way through it because unfortunately, and I'll let the cat out the bag. You're going to experience more. You're gonna experience not to say it, it's going to be worse. It's just going to be different. So having the tools to cope with it now are extremely important. So that definitely, I think you're doing an amazing job. Like I said, it's one of those things where sometimes you do have to go through it to see yourself on the other side and you already done that. But if you had look back, especially you're a spokesman now. You're at in your last year and you're looking to get out, what tips would you give to help students behind you either avoid if they can or I say deal with, I probably mean the better manage the medical students burnout? Kessy Joseph: I think as a medical student you need to manage your time and prioritize your time. Yes, you can take all the hours in the day to study. But trust me, those two hours that you decide not to study and do something else for yourself won't change your grade. You won't learn any much more. Dr. Berry: Yes. Talk about it. Lunch and Learn community I know it sounds like crazy, but trust me, I've got colleagues right now who are attendings right now who never could learn that concept. They felt that if they weren't studying to the last second to the last T they were going to miss the one question I was going to make them pass or fail the exam. Because that's just the thought process that was there. So again, even though we say like it's real real how some of the medical students feel. Kessy Joseph: I have yet to this point studied at the last minute and actually been questioned on any materials that I read the last 24 hours. It's only things that you know from months and months and months of studying that you're assessed on. So that I just really think people need to prioritize their time and also learn yourself. Learn when you're starting to not be yourself anymore. If you're always, if you're typically known as the happy go lucky, like really friendly person, always wanting to go to work, always wanting to see the first patient of the day and then all of a sudden you realize, oh, it's hard to get out of bed. You just want to sit in the clinic, not see any patients. There's something wrong with you. You're not yourself. Maybe you need to step back and take some time for yourself and reassess everything. See what can change in your daily routine to make you feel better essentially. So that for sure is how to just to manage the burnout. And avoiding the burnout, I don't know any prophylactic measures you can take, but maybe integrate some exerciser activity or hobby you can do every week or spend some time with friends or family every week. Don't isolate yourself. I feel a lot of medical students isolate themselves. They just go to the hospital and then go home, sleep, go to the hospital, go home, sleep. Forget, they don't do laundry. They don't cook. They don't take care of themselves. Try to do something for yourself. I think it's important. Try to still humanize yourself. Dr. Berry: I love it. Before I let you go, I always ask my guests, especially because you're doctor now, right? You're my colleague. How can what you do really help empower others really just really take better control of their health. Right? Especially us the medical students, who really need to hear your work. Kessy Joseph: Wow, that's a good question. I've never really thought of how I can empower others, but I just think my words, seeking support and help from other people that's been through what you're going through. Really that's pretty much it. Find people you can relate to. Dr. Berry: Amazing. And where can others find you? This is actually a nice little side question. Because I think in this day and age where social media is extremely prevalent, this is just from a general social aspect. Because we talked about making sure we don't disconnect from people. As a medical student, understand that you're about to be a, you're a physician in a few months and understanding that your words, even though it may not seem like it now or are extremely powerful and people are going to want to hear or see or reads this kind of stuff that you do or follow. Are you on social media? And when I say on social media especially, I mean in your moniker of as a medical student about to be a physician. Kessy Joseph: Not necessarily, but I do. I mean if you want to see how I live life to be my stressors, I am on Instagram. Look at my great traveling pictures and all that great stuff. Dr. Berry: What's your Instagram so we can follow you, what’s the Instagram? Kessy Joseph: Its la.kay.jo Dr. Berry: Okay. Alright. Lunch and Learn community that will be in the show notes that you can follow the soon to be Dr. Joseph. And again, I joke because I always talk about as, I remember when I was doing my blogging as a medical student, social media wasn't really the thing that people did. So it was always very weird because I've been calling myself Dr. Berry Pierre since a medical student because I was like oh that's a foregone conclusion. So sure. So I had already skipped the student doctor moniker because I didn't need that attached to me anyways. One because I didn't want to have to switch all my stuff out when it came around to it. But I was always talking about health and always and people follow me for again almost like eight to 10 years now under that moniker. So I always encourage my medical students to get out there and show yourself and let people know who you are because especially in this day and age where as a physician, you need to do things that help you stand out amongst the crowd. Because I always encourage all my medical students get a social media page, obviously one that you liked, right? If you like Facebook, get your Facebook. If you like Instagram, get your Instagram. If you like Twitter, whatever you like and understand that you're about to, you're a role model now as a medical student. Because I'm pretty sure you already getting those medical questions like, hey, how you do this. So I've already shared the questions already happened. It's like I say you might as well just go ahead and establish yourself and establish who you are as a brand as well. Kessy Joseph: You have a good point. And it's interesting because to be honest, as a medical student, I really haven't done as much social media because of time. There's really, I don't like to use my free time on the computer or on social media because I rather experience the outdoors. Dr. Berry: But take the picture of outdoors so we can see what you're doing. I want to see the cooking. I want to see where you traveling. I want to see all of that. Kessy Joseph: Okay. I'm gonna take your advice because I have more free time now. I think I'm gonna rev up my social media footprints. Is that what we call it? Dr. Berry: Oh yes it is. Yes it is. So again, first of all, I want to thank you. You are actually my second medical student on the podcast. So definitely shout out to you, especially because the journey that you're about to commence, because in fact we got time now, let's because you're in the process of the match, right? Let's give people a little inside look of what it means to go from medical student to resident. How are you, as far as that's concerned, where are you at? Just so people can know that they look out for you whenever that time comes around. Kessy Joseph: Alright. So my primary specialty of choice for this upcoming match is internal medicine. Dr. Berry: Yes. Ladies and gentlemen obviously I'm biased, right? Because I'm internist as well too. So I love when the medical students want to be an internist. Kessy Joseph: And obviously, like I said, I'm South Florida race so I'm looking to go back home. (Perfect). Really, moving forward I really want to focus on like conducting and doing research on community health and especially focusing on certain populations, different cultural beliefs and how that affects their health outcomes. That's definitely some of my career interests, but I'm all about primary care and that's the goal for me. And hopefully this upcoming match season goes in my favor. Dr. Berry: Especially as a Program Director, I know you've plan on applying towards Ontario region. Again, we would definitely love to see you there. So again, we're putting those positive affirmations out there and again, I always tell even if you don't want Wellington, at least as long as you match and get to where you get to. I'm happy because again, I love the journey of the medical student. I love the journey as a physician in general and I wish more people knew about the journey and knew what the journey took. Because I think it would really give people a lot more appreciation of just how hard it is to become a doctor. Kessy Joseph: It is hard. Very hard. Dr. Berry: So again, Lunch and Learn community again, we want to thank MS4, soon to be Dr. Joseph for blessing us, really with educating us on what the burnout process is for a medical student. We appreciate your kind words. We're sending nothing but prayers and wishes on your journey up in this up and coming match and make sure you lane at the destination that God puts you in. Kessy Joseph: Wow. Thank you Dr. Berry. Thank you so much for having me. Thank you so much for your kind words and your blessings and everything and positive energy. I love it. I thoroughly enjoyed speaking to you and being on your show. I hope to see you again. (Yes). Possibly. (Yes. Alright). It was definitely a pleasure.

Dr. LaTonzia Adams-Sheeley began working for the Veterans Affairs Portland Health Care System in 2016, as Medical Director of Microbiology and Molecular Microbiology. In 2017, she became director of the departments of Chemistry and Support Services. In addition, she is the Co-Pathology Residency Director at the VA and Assistant Professor at Oregon Health & Science University where she teaches Microbiology to the pathology residents and medical students. Dr. Adams-Sheeley is board certified in Clinical Pathology. In 2002, she earned her bachelor’s degree in Biology with minors in Chemistry & French from Indiana University. In 2004, she earned her Master’s Degree in Biomedical Sciences from Midwestern University. In 2010, she graduated from Ross University School of Medicine. Afterwards, she completed an anatomic and clinical pathology residency at the University of Illinois at Chicago in 2014, followed by completion of a Research & Clinical Fellowship in Medical Microbiology at The Johns Hopkins University School of Medicine. Dr. Dan Taramasco grew up in Western, NY. and currently resides in Rochester, NY. He received his B.S. in Biology, Rochester Institute Of Technology in 2005 and his M.D. at Ross University of School of Medicine in 2010. His training consisted of internship and residency at Rochester General Hospital in Rochester, NY where he was Chief Resident and he is board certified in Internal Medicine. His current position, Academic Hospitalist, Rochester General Hospital / Rochester Regional Health. His professional interests are metabolic syndrome / diabetes / thyroid disease. In this episode, learn: Why they became doctors What they love about practicing medicine The challenges and tribulations of medical practice Would they do it again? Would they advise others to become doctors? What a potential doctor should know. Interesting Tidbits: This is an excellent and helpful article if you want to stop being so reactive to your phone and learn to focus on deep work and thought provoking material - https://medium.com/better-humans/how-to-set-up-your-iphone-for-productivity-focus-and-your-own-longevity-bb27a68cc3d8

In this episode Scott Becker interviews Dr. Zeyad Baker. Zeyad Baker, MD is President and Chief Executive Officer of ProHEALTH Care, the largest, independent, physician-run healthcare organization in the Northeast. Dr. Baker previously served as Co-President of Riverside Medical Group, where from 2010 until 2018, he built the practice to almost 300 providers with 100 locations. Under Dr. Baker’s leadership, Riverside Medical Group was recognized as the best deliverer of value-best care in the state of New Jersey, winning extensive awards and commendations for quality of care, patient access and measurable improvements in the health of the patient population.  Riverside Medical Group became an Optum Partner in 2016. Prior to joining the Riverside Medical Group, Dr. Baker was an attending physician in Pediatrics at Hackensack University Medical Center. Coupled with his responsibilities as a physician, Dr. Baker was the Clinical Assistant Professor of Pediatrics at the University of Medicine and Dentistry of New Jersey (UMDNJ), teaching medical students and pediatric residents. In addition to his teaching role at Hackensack University Medical Center, he has also held teaching positions as the Associate Professor of Pediatrics at Rutgers Medical School and Columbia University.  Dr. Baker has taught over 1,000 medical students and residents in primary care. After graduating from Georgetown University, Dr. Baker attended medical school at Ross University. He completed his residency in pediatrics at UMDNJ, receiving the highest honors and recognition given to pediatricians in residency training through the Arnold P. Gold Foundation Award for Humanism and Excellence in Teaching, and twice receiving the prestigious Golden Apple Award, an honor bestowed by a medical school’s student body upon the doctors most recognized for their excellence in teaching. Dr. Baker has been asked to present at numerous prestigious speaking engagements including the Harvard Club at “The Future of Healthcare Transformation”. He is also the youngest physician to be appointed to the highest governing board in New Jersey, The New Jersey State Board of Medical Examiners. Dr. Baker has received multiple awards while a practicing physician including the New Jersey Top Doc award, the Compassionate Doctor Award, and the Patient Choice Award. Throughout his career, Dr. Zeyad Baker has managed over 1,000 physicians and has brought together a rare combination of clinical, academic and operational experience to successfully lead two substantial organizations, where the patient is the top priority. Since taking the helm of ProHEALTH Care in July, 2018, as the new President and CEO, Dr. Baker has launched a bold agenda of patient-centered reforms destined to transform the healthcare system.  In his first year, he has brought forward plans, which include a forward-thinking schedule of key initiatives designed to dramatically improve patient care, create an entirely new paradigm for the healthcare and patient experience, and make healthcare significantly more accessible than ever before.  Some of these innovations already launched include: - Creating the longest hours open for primary care services in the northeast through the Extended Hours Center, which along with ProHEALTH Care’s primary care services, provide continual access to medical care 365 days a year, 7 days a week - Creating the Care Coordination Center, a telemedicine approach that will provide patients with access to their providers on critical matters such as appointments, referrals, prescription refills, and medical questions answered 7 days/week, 24 hours a day. - Launching The Parenting Lounge, the first health system integrated, free prenatal and post-natal series of family educational programs in the Northeast dedicated to providing all families with the critical knowledge to support their children’s healthy beginnings.

Lauren Smith, DVM, is a small animal veterinarian from New York who has taken her passion for vet med to the depths of the internet writing various blogs for sites such as Dr. Andy Roark, and her own site, The Vetitude. Now in the process of transitioning from clinic work to her own relief business, Lauren is here to talk about everything from entrepreneurship to empathy and how to deal with haters in your comments section.  A self-described ambivert who found a safe haven in academics, Lauren has a wide range of stories and life experience to share with you today. Learn how ROSS University of Vet School helped equip her to deal with what life and the Universe throw at you, ways to work through the anxiety that may be stopping you from achieving your dream, and how to have more empathy and less compassion fatigue with your peers and clients. If you struggle to understand things from a clients perspective, want to increase your charisma in the exam room, or are having a hard time narrowing in on the core values you need in a workplace, Lauren is here to help guide you in the right direction.  Are you ready to build up your empathy muscle and come to terms with the reality that nobody is perfect? Share what you learned most from Lauren’s perspective in the comments on the episode page.    In This Episode Tools to understand a clients perspective in a non-judgemental and empathetic way How to have more empathy for yourself, your teammates and your clients  What to do when a client asks you what you would do in their position Understanding how the way you dress can convey power and charisma  Fostering open communication through self-care and identifying your core values   Quotes “I definitely like the puzzle of putting together the diagnostics and figuring out what is going on with animals. Dealing with a complex DKA or an IMHA, I'm really in my element with those.” (19:33) “More than anything, those core values, finding a place that matches your core values is going to be the most important thing in finding a job where you are happy. Because if you are surrounded by people who are doing things that don't fit your value set, you are never going to be happy.” (27:03) “We need to have more empathy for ourselves, for our teammates and for our clients. And I think those are the three things I really try to emphasize in what I try to tackle with the vetitude.” (33:58) “Empathy is a self-renewing resource, the more we practice it the more we have. And actually the less compassion fatigue we get because we are building up that empathy muscle.” (37:43)   Links The Vetitude Website The Vetitude Instagram The Vetitude Facebook Lauren Smith DVM Website Dr. Andy Roark Website The Real Reason Your Wait At The Vet's Office Is So Long by Lauren Smith These Are My Thoughts When I Lose A Patient by Lauren Smith Thank You for Not Judging Me by Lauren Smith   Enjoying these stories? Consider supporting Podcast A Vet on Patreon & check out our awesome patron-only perk Find the full show notes here  Keep up with everything Podcast A Vet Follow Podcast A Vet on Facebook | Twitter | Instagram Join our free community of dedicated vet professionals looking to improve their practices and lives in our free Facebook community! We'd love it (and you) if you would take 1 minute and leave us a review on iTunes!

Dr. Dan Taramasco grew up in Western, NY. and currently resides in Rochester, NY. He received his B.S. in Biology, Rochester Institute Of Technology in 2005 and his M.D. at Ross University of School of Medicine in 2010. His training consisted of internship and residency at Rochester General Hospital in Rochester, NY where he was Chief Resident and he is board certified in Internal Medicine. His current position, Academic Hospitalist, Rochester General Hospital / Rochester Regional Health. His professional interests are metabolic syndrome / diabetes / thyroid disease.He has lost over 100lbs, naturally.Resources:https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968https://www.cdc.gov/features/osteoporosis/https://www.bones.nih.gov/health-info/bone/osteoporosis/overviewhttps://my.clevelandclinic.org/health/diseases/13017-osteomalacia

Dr. Rahi is a medical doctor specializing in hormones, integrative medicine and aesthestics. She went to Medical school at Ross University, Residency in Internal Medicine at University of Southern California (USC) and Fellowship in Integrative Medicine from the University of Arizona. She is based in Santa Monica, California. Her vision for health and wellness is beauty and health from the inside out. Website: http://www.doctorrahi.com Instagram: http://instagram.com/doctorrahimd Twitter: http://twitter.com/doctorrahimd Facebook: https://www.facebook.com/doctorrahi/

Of all the causes of infertility, a male factor is responsible for 40%. Yet the focus of infertility treatment traditionally has mainly been on the female. Recent research has indicated that males now produce less than half as many sperm and of lower quality compared with the early 1970s. So, what do you need to know about advances in male infertility treatment options with sperm blockages or severely low sperm counts?In this episode, Zamip Patel, M.D., a board-certified urologist, fellowship-trained in andrology, and chief of staff at Florida Hospital East Orlando, joins host Mark P. Trolice, M.D., to discuss the role of male infertility and the latest advances in male infertility treatment. Listen in as he shares insights on everything from low sperm count treatment, sperm retrieval surgery, and ICSI, to vasectomy reversal, hormone treatment, and sperm freezing.Tune in to discover:The importance of the male factor in treating infertilityWhen males should consider the use of assisted reproductive technologies like IVFThe genetic factors involved in treating azoospermia (zero sperm)Why a thorough anatomic, environmental, genetic and hormonal evaluation by an experienced fertility specialist is critical before deciding on a treatment planThe latest areas of advances in male infertilityAbout Zamip Patel, MDZamip Patel, MD is a board-certified urologist and one of the few physicians in the Orlando area with fellowship training in andrology, which is the study of the male reproductive system including male infertility. As a member of the highly credentialed medical team at Florida Urology Associates, he sees patients at the practice’s east Orlando and Oviedo locations and performs both inpatient and outpatient procedures at Florida Hospital East Orlando. Dr. Patel received his advanced sub-specialty training in andrology at the University of Illinois in Chicago after earning his medical degree at Ross University in the West Indies and completing his urology residency at Mount Sinai School of Medicine in New York.Dr. Patel conducted his urology residency at the Mount Sinai School of Medicine, New York, and his andrology fellowship at the University of Illinois Chicago, a region known to establish standards for assisted reproduction. He is one of a handful of Urologists with specialty training in male reproduction in the Southeast. As one of the urologists at East Orlando Urology, Dr. Patel provides both inpatient and outpatient procedures at Florida Hospital East Orlando, offering patients quality and convenient urological health care options. Specialties include treating the following urological conditions: disorders of the urinary tract, bladder, prostate and kidneys; cancers of the kidney, bladder, prostate, adrenal glands and testes; and male infertility, erectile dysfunction, vasectomy and vasectomy reversal.https://www.floridahospital.com/doctor/zamip-prakash-patel-md-1437318326About Mark P. Trolice, M.D.Mark P. Trolice, M.D., FACOG, FACS, FACE is Director of Fertility CARE: The IVF Center in Winter Park, Florida and Associate Professor of Obstetrics & Gynecology (OB/GYN) at the University of Central Florida College of Medicine in Orlando responsible for the medical education of OB/GYN residents and medical students as well as Medical Endocrinology fellows. He is past President of the Florida Society of Reproductive Endocrinology & Infertility (REI) and past Division Director of REI at Winnie Palmer Hospital, part of Orlando Health.He is double Board-certified in REI and OB/GYN, maintains annual recertification, and has been awarded the American Medical Associatio

08/08/2018 - A healthy discussion on ROSS University, Dominica and more with former mayor of Portsmouth Mr. Washway Douglas and a concerned Dominican citizen.

In this episode, Roger Welton, DVM talks to us about your pet's health and fitness. Why it's important to feed your pets the right food. Which pets are good companions for someone who wants to incorporate more movement and activity? And how your pets mirror your good or bad habits. Dr. Roger Welton is the president as well as an attending veterinarian of Maybeck Animal Hospital. Dr. Welton is a 2002 graduate of Ross University, School of Veterinary Medicine. Dr. Welton has completed advanced postdoctoral training in reconstructive surgery of the knee, diagnostic ultrasound, and rehabilitation (stem cell and PRP therapy, cold laser therapy, acupuncture, nutritional and nutraceutical therapy). www.maybeckvet.com Blog: http://web-dvm.net/ Podcast: http://www.blogtalkradio.com/rwdvm

Links from today’s Podcast: Jeremy Scott MSII Instagram  |  Contributor Description: Today, I could not be more excited to bring you an interview with Jeremy Scott, a second-year medical student at Ross University. Jeremy is a non-traditional medical student. After college, he received a Master’s degree and worked in retail for 5 years. He then…

Listen NowResearch published by the Association of American Medical Colleges (AAMC) this past April estimated the US could see a shortage of up to 120,000 physicians by 2030.  AAMC estimates the shortage would be particularly acute in primary care, i.e., upwards of 50,000 primary care physicians would be needed.   The primary care shortage is already acute.  The federal Health Research and Services Administration (HRSA) estimates there are currently over 5,900 Primary Care Shortage Areas (PCSAs) in the US.  The current and future physician shortage would be dramatically worse if not for the approximately 250,000 foreign-trained physicians currently practicing in the US, a disproportionate percent of whom are primary care practitioners and work in under-served communities.  Despite the critical role these physicians play (and the quality of care they provide), foreign-trained medical school graduates face substantial barriers, particularly under the current administration, in obtaining residencies, qualifying academically to train and practice in the US, and in obtaining requisite visas.    During this 25 minute conversation Mr. Simon discusses, in part, AUA's programming and student demographics, the contribution foreign-trained students make in the US health care market, again, particularly in primary care and in under-served areas, and the barriers foreign-trained students, moreover foreign-trained and non-US citizens, face in obtaining medical residencies and licensing, moreover in obtaining visas,  in order to train and practice in the US. Mr. Neal Simon is the President and C0-Founder of American University of Antigua (AUA) College of Medicine.  After graduating from New York School of Law in 1978 Mr. Simon worked as Assistant Counsel at the New York Department of Education and worked as well in private practice specializing in medical licensure.  He taught at the Ross University College of Medicine in the 1990s and served as President of the Ross University from 1992 to 2003.  Mr. Simon has been recognized for his work in medical education by the American Association of Physicians of Indian Origin and by Sungshin Women's University.  Mr. Simon has served as Ambassador at Large for Antigua and Barbuda and is presently serving on the advisory board at Florida International University and at Manipal University.For information on AUA's College of Medicine go to: https://www.auamed.org/.The report by the American Immigration Council's "Foreign-Trained Doctors Are Critical to Serving Many US Communities," noted during this podcast is at: https://www.americanimmigrationcouncil.org/research/foreign-trained-doctors-are-critical-serving-many-us-communities.   This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Unis's Son is missing. He is at Ross University in Dominica, but she hasn't been able to reach him. Please listen and if you have any way of helping, she would greatly appreciate it.

0:00:00Some thoughts on Homeopathic Vaccination by Dr Karl Kruszelnicki0:01:08     IntroductionRichard Saunders0:05:00     HM Queen Elizabeth II opens the UK ParliamentDr Simon Singh comments on hopeful libel reform0:10:30     An interview with Julie Lada - Quackery at the VetFrom her blog we discover that.... "I am a Purdue University Animal Science graduate embarking on an adventure to obtain my DVM at Ross University on the tropical island of St. Kitts in the Caribbean."Julie tells us that ducks are not the only quacks in the vet business!0:27:40     Reality Bites... with Joanne BenhamuJo comments on International Nurses Day, Saturday, 12 May 20120:31:40     Festival of Mind Body Spirit in SydneyOur small but merry band of reporters head for the Mind Body Spirit to sniff out quackery. Will Richard Saunders, Dr Rachael Dunlop and Maynard make it out in one piece?0:42:30     Maynard's Spooky Action...Tubas.... need we say more?

Kevin Eva, Editor in Chief of Medical Education, talks to Kalman Winston (Assistant Professor of Academic Success, Ross University, Dominica) about remediation, one of the next frontiers for Medical Education and the medical education research community. Kal Winston is co-author of the paper ‘At-risk medical students: implications of students’ voice for the theory and practice of remediation’ (Volume 44, Issue 10, Medical Education) which discusses how to identify and help students who are in difficulty during their health professional training.

Kevin Eva, Editor in Chief of Medical Education, talks to Kalman Winston (Assistant Professor of Academic Success, Ross University, Dominica) about remediation, one of the next frontiers for Medical Education and the medical education research community. Kal Winston is co-author of the paper ‘At-risk medical students: implications of students’ voice for the theory and practice of remediation’ (Volume 44, Issue 10, Medical Education) which discusses how to identify and help students who are in difficulty during their health professional training.