Clinical Conversations: Recent Episodes
Royal College of Physicians of Edinburgh
In this episode, Dr Marilena Giannoudi hears about a case that changed the practice of Professor James Dear.They discuss the challenges of caring for a patient without a diagnosis, who to talk to if you are feeling uncertain in how to treat a patient, and how you can own up to and move on from mistakes you may make.Professor James Dear is a Consultant in Clinical Pharmacology at the Royal Infirmary of Edinburgh and Personal Chair of Clinical Pharmacology at the Centre for Cardiovascular Science at the University of Edinburgh.Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members & Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.Recording date: 9 June 2025-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://www.rcpe.ac.uk/events-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode, Dr Kat Ralston hears about a case that changed the practice of Dr Chris Tiplady. They discuss the importance of recognising when a patient may be entering the last phase of life, what we owe to patients and families in understanding what matters to them, and how we can navigate managing uncertainty and being wrong as clinicians.Dr Chris Tiplady has been a Consultant Haematologist in Northumbria since 2001 and has held a number of roles in postgraduate and undergraduate medical education over the years. He has been a Director of Medical Education in two trusts and now leads the Master of Medical Education course at Sunderland University. He also has a regular blog published by the Royal College of Pathologists, discussing professionalism in medicine.Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC).Recording date: 14 April 2025-- Useful Links --NHS England, Last 1000 days - https://www.youtube.com/watch?v=HynytVepxZcREDMAP toolkit for future care planning conversations - https://www.spict.org.uk/red-map/The King's Fund, Patients' preferences matter: stop the silent misdiagnosis (May 2012) - https://www.kingsfund.org.uk/insight-and-analysis/reports/patients-preferences-matter-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://www.rcpe.ac.uk/events-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode of Clinical Conversations, Dr Aoife Duignan chats with Dr Claire Steel and Dr Shelagh O'Riordan about Hospital at Home. They explore what Hospital at Home is, and the evidence base behind it, thinking through which patients may benefit from it. They also consider how technology can enable patients to receive care in their own homes and what a day in the life might look like. Finally they consider some top tips for becoming involved with Hospital at Home. Dr Claire Steel is a consultant physician in older people’s medicine in NHS Lanarkshire. She is the President of the UK Hospital at Home Society and clinical lead for Hospital at Home in NHS Lanarkshire. She works closely with Healthcare Improvement Scotland to support the growth and development of H@H in Scotland.Dr Shelagh O'Riordan is a consultant physician and lead for the Hospital at Home service in East Kent. She is President Elect of the UK Hospital at Home Society and National Clinical Lead for Hospital at Home/Virtual Wards for NHS England. Dr Aoife Duignan is a geriatric medicine registrar in Edinburgh. She is also the Representation Co-Vice Chair for the RCPE Trainees and Members' Committee (T&MC). Recording date: 16 April 2025-- Useful links --Hospital at Home Society Health Improvement Scotland Toolkit - https://www.ihub.scot/project-toolkits/hospital-at-home-toolkit/hospital-at-home-toolkit/Hospital at Home RCT - https://pubmed.ncbi.nlm.nih.gov/35129936/PPL South East Region Virtual Wards Evaluation - https://ppl.org.uk/what-we-do/virtual-wards-consultancy/Cochrane Review - https://www.cochrane.org/CD007491/EPOC_hospital-home-services-avoid-admission-hospitalUK Hospital at Home Society - https://www.hospitalathome.org.uk/NHS England Virtual wards operational framework - https://www.england.nhs.uk/long-read/virtual-wards-operational-framework/-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://www.rcpe.ac.uk/events-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode Dr Emma Spencer discusses decompensated cirrhosis with Dr Michael Williams. This discussion includes the definition of a decompensation event, how to recognise these events on the medical take and the importance of doing so. They also discuss key steps in investigating causes of decompensations of cirrhosis and how to manage these unwell patients.Dr Michael Williams is a consultant hepatologist, working on the Scottish Liver Transplant Unit in Edinburgh. His clinical interests are liver transplantation and autoimmune liver disease.Dr Emma Spencer is an IMT3 doctor in the South East of Scotland and a member of the RCPE's Trainees & Members' Committee (T&MC).Recording date: 13 March 2025-- Useful Links --BSG/BASL Decomp Cirrhosis Care Bundle - https://www.bsg.org.uk/clinical-resource/bsg-basl-decompensated-cirrhosis-first-24-hours-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://www.rcpe.ac.uk/events-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode of clinical conversations, Dr Kat Ralston chats with consultant toxicologist Dr Emma Morrison about poisoning in the older adult. They explore why we need to think differently about deliberate self-harm in the older adult and talk through common toxicology cases, including decision-making around escalation. Finally, they consider a common sense approach to what we can do differently as clinicians to reduce the risk of self-harm and suicide in this patient group.Dr Morrison trained in medicine at the University of Glasgow, with an intercalated BSc in Physiology. She also completed a PhD investigating to role of short RNAs as biomarkers and mediators in toxic injury. In 2020, Emma become a Consultant Physician at the Royal Infirmary of Edinburgh.Emma’s NHS work continues to support her passion of ensuring transparent and equitable decision making in prescribing, supporting the central tenets of value-based medicine. Her roles within medicines governance include Chairing Lothian’s Area Drug and Therapeutics Committee and is a committee member of the SMC.Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC).--Useful Link--TOXBASE - https://www.toxbase.org/Recording date: 19 December 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://www.rcpe.ac.uk/events-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode, Dr Kat Ralston chats with Prof Miriam Johnson about palliative care in heart failure. They discuss the evidence supporting specialist palliative care input in this patient group and explore how to develop effective integrated services. They chat about holistic, needs based assessment and share top tips on the approach to the debilitating symptom of breathlessness. Professor Miriam Johnson is Professor of Palliative Medicine at Hull York Medical School, Associate Director of the Wolfson Palliative Care Research Centre at the University of Hull. She is Adjunct Professor of Palliative Medicine at the University Technology Sydney, Sydney, Australia. For twenty years (2000 to 2020), she also provided consultant palliative physician services to Scarborough General Hospital and Saint Catherine's Hospice, Scarborough where she set up one of the UK’s first integrated palliative care services for people with heart failure.Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC).Recording date: 5 December 2024-- Useful Links --Abel et al (2024), Hospital admissions in the last year of life of patients with heart failure, https://doi.org/10.1093/ehjqcco/qcad047.Balata et al (Oct 2024), Early integration of palliative care versus standard cardiac care for patients with heart failure (EPCHF): a multicentre, parallel, two-arm, open-label, randomised controlled trial, https://doi.org/10.1016/j.lanhl.2024.08.006.Barnes-Harris et al, Barriers and facilitators for cardiopulmonary resuscitation discussions with people with heart failure, https://doi.org/10.1371/journal.pone.0314631.Campbell et al (2018), Which patients with heart failure should receive specialist palliative care?, https://doi.org/10.1002/ejhf.1240.Date et al, Modified-release morphine or placebo for chronic breathlessness: the MABEL trial protocol, https://doi.org/10.1183/23120541.00167-2023.Ekström et al, Effect of regular low-dose extended-release morphine on chronic breathlessness in chronic obstructive pulmonary disease: the BEAMS randomized clinical trial, http://doi.org/10.1001/jama.2022.20206. Ferreira et al, The effect of regular, low-dose, sustained-release morphine on routine physical activity in people with persistent breathlessness– a hypothesis-generating study, https://doi.org/10.1183/13993003.01484-2022.Johnson et al (2024), Benefits of specialist palliative care by identifying active ingredients of service composition, structure, and delivery model: A systematic review with meta-analysis and meta-regression, https://doi.org/10.1371/journal.pmed.1004436.Jordan et al (2020), Duration of palliative care before death in international routine practice: a systematic review and meta-analysis, https://doi.org/10.1186/s12916-020-01829-x.King et al (2022), Concurrent Validity and Prognostic Utility of the Needs Assessment Tool: Progressive Disease Heart Failure, https://doi.org/10.1016/j.jpainsymman.2022.01.014.McConnell et al (2023), Integrating palliative care and heart failure: a systematic realist synthesis (PalliatHeartSynthesis), https://doi.org/10.1136/openhrt-2023-002438.Roch et al (2020), Utility of the integrated palliative care outcome scale (IPOS): a cross-sectional study in hospitalised patients with heart failure, https://doi.org/10.1177/1474515120919386.Breathing, Thinking Functioning Model - https://www.btf.phpc.cam.ac.uk/Caring Together - https://www.mariecurie.org.uk/professionals/working-in-partnership/caring-togetherScottish Palliative Care Guidelines - https://rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://www.rcpe.ac.uk/events-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode, Dr Marilena Giannoudi discusses Type 1 diabetes with Dr Sam Pearson. Topics include diagnosing T1 diabetes, recognising the impact of a new diagnosis of diabetes on patients and possible treatments, including technological interventions. Dr Sam Pearson is a diabetes consultant at St James hospital in Leeds. They help look after patients with all types of diabetes mellitus but have a particular interest in helping younger adults with type 1 diabetes and how technology may help them. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.Recording date: 14 November 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://www.rcpe.ac.uk/events-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode, Dr Kat Ralston chats with Dr Imogen Smith about palliative care in hospital inpatients. They discuss what is different about the older adult when considering palliative care, including thinking about trajectories, communicating uncertainty, and parallel planning. They explore symptom control including a practical approach to syringe drivers (continuous subcutanous infusions) for the non-specialist.Dr Imogen Smith was appointed as Consultant in General Internal Medicine and Medicine for the Elderly at St John’s Hospital, Livingston, in April 2020. Her clinical interests are in Hospital at Home, and Hospital Based Complex Clinical Care/Palliative Care. She is an educational and clinical supervisor and also clinically supervises and educates Advanced Nurse Practitioners in HBCCC/H@H contexts. During training, she was appointed to the first cohort of NHS Lothian Chief Registrars (2018-2019). And she sat on the RCPE Trainees and Members Committee (2018-2020).Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC).Recording date: 20 November 2024--Useful Links--Scottish Palliative Care Guidelines - https://rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/Patterns of Functional Decline at the End of Life - https://jamanetwork.com/journals/jama/fullarticle/196538REDMAP Framework for Future Care Planning Conversations - https://www.spict.org.uk/red-map/-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://events.rcpe.ac.uk/-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode, Dr Kat Ralston chats with Dr Nik Rae about infective endocarditis. They discuss the complexities of clinical presentation in this condition and share tips to help you in your diagnostic journey. They explore a pragmatic approach to management, including individualised decision making and the emerging evidence base for use of oral agents. Dr Nikolas Rae is a Consultant Physician in Infectious Diseases and Acute Medicine with a range of clinical interests including infections in people who inject drugs, blood borne viruses, mycobacterial and fungal infections.Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC). Recording date: 7 November 2024-- Useful Links --Oral vs IV antibiotics systematic review - https://pmc.ncbi.nlm.nih.gov/articles/PMC8901545/European Society of Cardiology (ESC) Endocarditis Guidelines - https://academic.oup.com/eurheartj/article/44/39/3948/7243107WikiGuidelines Endocarditis Consensus Statement - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807791Scottish Antimicrobial Prescribing Group (SAPG) penicillin allergy de-labelling guidance - https://www.sapg.scot/guidance-qi-tools/quality-improvement-tools/penicillin-allergy-de-labelling/-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://events.rcpe.ac.uk/-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
This is a co-release with our sister podcast, Career Conversations. In this episode, Dr Marilena Giannoudi speaks with Dr Neil Shepherd about remote and rural medicine. Dr Shepherd highlights the benefits as well as the challenges of working in remote and rural areas and some of the professional support in place for this career path.Dr Neil Shepherd considers himself to be a rural generalist. He completed his GP training in 2014 and acute care rural GP fellowship in 2018. He currently works as a rural emergency physician in Caithness General Hospital, a Locum GP in Orkney and as training programme director for broad based training with NHS Education for Scotland. He is also a Fellow of the Royal College of Physicians of Edinburgh. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.Recording date: 5 November 2024--Useful Links--BASICS Scotland - https://basicsscotland.org.uk/Broad Based Training Information - https://www.scotmt.scot.nhs.uk/recruitment/broad-based-training.aspxRural and Remote Health Credential - https://www.nes.scot.nhs.uk/news/rural-and-remote-health-credential-unscheduled-and-urgent-care/GP Fellowships - https://www.scotlanddeanery.nhs.scot/your-development/gp-fellowships/UCLan's National Centre for Remote and Rural Medicine - https://www.uclan.ac.uk/centres/ncrrmDisclaimer: Please always refer to official recruitment websites for the latest guidance as application dates and processes may differ to those described in this episode.-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://events.rcpe.ac.uk/-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode of Clinical Conversations, Dr Kat Ralston chats with Dr Alan Japp about heart failure with reduced ejection fraction. They discuss an approach to clinical assessment, share top tips for diuresis and explore the four pillars of heart failure therapy.Dr Alan Japp is a Consultant Cardiologist at the Edinburgh Royal Infirmary and St John's Hospital, Livingston. He is also the Clinical Lead for Heart Failure in NHS Lothian and the Local Principal Investigator for DAPA HF and IRONMAN clinical trials. Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC).Recording date: 16 October 2024-- Useful links --European Society of Cardiology Heart Failure Guidelines (2023 focused update) : https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://events.rcpe.ac.uk/-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode, Dr Marilena Giannoudi speaks with Dr Sarah Schoeman about the genitourinary medicine (GUM) clinic. Dr Schoeman discusses the prevalence of sexually transmitted infections, provides non-GUM specialists tips on how to ask a patient's sexual health and describes some interesting cases from her clinical experience.Dr Sarah Schoeman is a GUM Consultant in Leeds based at the Leeds Teaching Hospitals Trust. She is also Clinical Lead for the Leeds Teaching Hospitals Trust HIV service. She is currently co-Chair of the GUM SAC alongside Dr Andy Williams and together they represent the GUM SAC on the BASHH board. In addition Sarah is a current clinical member of the HIV CRG, Clinical Lead for the West Yorkshire HIV Network, Clinical Lead for the Leeds Fast Tack Cities project, a BASHH Sexual Health Dermatology SIG member and BSSVD council member.Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee (T&MC), a Fellow of the Higher Education Academy, and is currently undertaking a PhD.Recording Date: 3 October 2024-- Useful Links --LoveGUM - https://lovegum.bashh.orgGet involved in GUM - https://padlet.com/stashh1/get-involved-in-gum-kz9569d4dbswatyz-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://events.rcpe.ac.uk/-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
For Sepsis Awareness Month, Dr Marilena Giannoudi speaks with Dr Ron Daniels about sepsis. They discuss the causes, investigation, management, and prevention of sepsis. Topics include the Sepsis 6 and escalation of care, use of blood cultures, septic shock, and post-sepsis syndrome.Dr Ron Daniels is an NHS Consultant in Intensive Care, based at University Hospitals Birmingham, U.K. He’s also Founder and Chief Executive of the UK Sepsis Trust and Vice-President of the Global Sepsis Alliance. In 2016 he was awarded the British Empire Medal for services to patients. Ron’s expertise lies in translational medicine and leadership. He leads the team driving dissemination of the Sepsis 6 treatment pathway and is part of the team responsible for much of the policy and media engagement around sepsis in the U.K. and elsewhere, including as a core member of the team securing the adoption of the 2017 Resolution on Sepsis by the World Health Organization (WHO). At home, Ron’s worked with the NHS over the last 9 years to ensure that by 2019, in England, more than 80% of patients presenting with suspected sepsis were receiving appropriate antimicrobials rapidly. He is now leading a team working with His Majesty’s Government to once again drive sepsis improvement work in the post pandemic era. He’s ever mindful of the perceived conflict, and the synergies and need for collaboration, with the antimicrobial stewardship agenda.Dr Marilena Giannoudi is a clinical academic trainee in cardiology in the Yorkshire and Humber region. Her current interests include heart failure, endothelial dysfunction, and medical education. She is a Fellow of the Higher Education Academy and is currently pursuing a PhD. Dr Giannoudi is passionate about ensuring that trainees' voices are heard and that educational opportunities are available to foster confidence and independence throughout their training. She has developed core medical training (now IMT) teaching programs in hospitals across her deanery. Additionally, she uses her position on the local junior doctor body to advocate for and implement necessary changes.-- Links --The UK Sepsis Trust's Clinical Tools - https://sepsistrust.org/healthcare-professionals/clinical-tools/NICE guidelines on suspected sepsis - https://www.nice.org.uk/guidance/NG51Global Sepsis Alliance - https://globalsepsisalliance.org/-- Choose RCPE as your College of Entry for PACES --We encourage you to sit PACES with our College. We have a friendly and experienced examinations team who expertly support candidates, and we deliver PACES at centres across the UK. Select RCPE as your College of Entry when applying online through your My MRCP(UK) online account.Recording date: 11 September 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE events --https://events.rcpe.ac.uk/-- Become an RCPE Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In this episode, Professor Eylem Levelt and Dr Marilena Giannoudi discuss the early stages of cardiometabolic disease, its asymptomatic challenges, and key risk factors. They cover how junior doctors can protect at-risk patients and the prevalence of diabetes and weight issues among those diagnosed. Reflecting on trends over the past decades, they share insights into improving patient outcomes. Looking ahead, they discuss reducing heart failure and managing conditions like obesity-related heart disease. Prof Levelt offers practical advice for junior doctors on identifying and managing at-risk patients.Prof Eylem Levelt is an academic cardiologist with a specialist interest in cardiovascular imaging and diabetic heart disease.Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.--Links--For clinicians: European Society of Cardiology (ESC) Clinical Practice Guidelines: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-GuidelinesAmerican College of Cardiology (ACC) Guidelines: https://www.acc.org/GuidelinesFor patients: British Heart Foundation (BHF): https://www.bhf.org.uk --Related listening-- Inherited Cardiac Conditions, Clinical Conversations https://podcasts.rcpe.ac.uk/show/clinical-conversations/inherited-cardiac-conditions-3-june-2024/Women in Cardiology [Re-release], Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/women-in-cardiology-re-release-8-march-2024/Medical Specialties - Clinical Genetics, Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/medical-specialties-clinical-genetics-07-jun-2023/Demystifying PACES - Cardiovascular [Station 3], Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/demystifying-paces-cardiovascular-station-3-29-jan-2024/Movement Medicine, Career Conversations https://podcasts.rcpe.ac.uk/show/clinical-conversations/movement-medicine-03-apr-2023/Follow Professor Levelt on X @EylemLeveltRecording date: 25 June 2024-- Follow us --www.instagram.com/rcpedintraineestwitter.com/RCPEdinTrainees-- Upcoming RCPE Events --events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week Dr Ben Warner interviews Professor Tom Fardon on the topic of asthma. Through a case study, Prof Fardon discusses how to assess and treat a severe exacerbation of asthma and what needs to be considered when discharging patients. Tom and Ben also discuss diagnosing asthma and the treatments available to patients. Professor Fardon is a Consultant Respiratory Physician at NHS Tayside and Honorary Professor at the University of Dundee. They are also Clinical Lead for the Scottish Government's Respiratory Specialty Delivery Group. Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals with the University of Glasgow.--Useful Links-- Current NICE guideline on Asthma: Diagnosis, monitoring and chronic asthma management - https://www.nice.org.uk/guidance/ng80Current BTS/SIGN British Guideline on the Management of Asthma - https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/Upcoming SIGN updates - https://www.sign.ac.uk/our-guidelines/british-guideline-on-the-management-of-asthma/BTS Clinical Statement on the medical management of inpatients with tobacco dependency - https://thorax.bmj.com/content/79/Suppl_1/3Treatable traits approach in asthma - https://treatabletraits.org.au/wp-content/uploads/2022/02/MJA-TT-Case-Final.pdf Environmental impact of inhalers toolkit produced by ‘Greener Practice' - https://www.greenerpractice.co.uk/high-quality-and-low-carbon-asthma-care/ Greener Practice guide on reducing the carbon footprint of inhalers - https://s40639.pcdn.co/wp-content/uploads/Reducing-Carbon-Footprint-of-Inhaler-Prescribing-v3.3.2.pdfNational Review of Asthma Deaths (NRAD) - https://www.hqip.org.uk/resource/asthma-deaths-nrad-report-2014/British Thoracic Society asthma attack care bundle - https://www.brit-thoracic.org.uk/quality-improvement/clinical-resources/asthma/bts-asthma-care-bundles/ Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial - https://doi.org/10.1016/S0140-6736(02)11679-5 Clinical remission in severe asthma with biologic therapy: an analysis from the UK Severe Asthma Registry - https://erj.ersjournals.com/content/62/6/2300819 Low Dose Inhaled Budesonide and Formoterol in Mild Persistent Asthma - https://doi.org/10.1164/ajrccm.164.8.2104102 Recording date: 22 May 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this brief episode, Dr Marilena Giannoudi, Co-Chair of the Trainees and Members’ Committee, gives an overview of the Royal College of Physicians of Edinburgh's podcasts relevant to doctors-in-training. These include: this podcast, 'Clinical Conversations'; 'Career Conversations' including the new 'Demystifying PACES' series; and the Recently Appointed Consultants' Committee's podcast, 'Consultant Conversations', relevant to senior trainees.All RCPE podcasts can be found at https://podcasts.rcpe.ac.uk/The 'Demystifying PACES' podcast series can be found at https://podcasts.rcpe.ac.uk/show/career-conversations/category/paces/ Recording date: 23 January 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/-- Become a Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
What happens at the Inherited Cardiac Conditions clinic?In this episode, Dr Marilena Giannoudi and Dr Anshu Sengupta discuss Inherited Cardiac Conditions (ICCs) and the ICC clinic, including who makes up this multi-disciplinary team. They discuss the approach to patients with ICCs covering investigations and management including guideline-led treatment, monitoring, risk assessment and exercise advice.Dr Anshu Sengupta is a Consultant Cardiologist in the Yorkshire Heart Centre, specialising in investigating and managing patients and families with ICCs. He has a specialist interest and training in heart failure and cardiac magnetic resonance imaging.Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.-- Useful links --For clinicians:- European Society of Cardiology (ESC) Cardiomyopathy Guidelines: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiomyopathy-Guidelines- American College of Cardiology (ACC) Guidelines: https://www.acc.org/GuidelinesFor patients:- British Heart Foundation (BHF): https://www.bhf.org.uk- Cardiomyopathy UK: https://www.cardiomyopathy.org/- Arrhythmia Alliance: https://heartrhythmalliance.org/aa/uk/-- Related listening --Women in Cardiology [Re-release], Career Conversationshttps://podcasts.rcpe.ac.uk/show/career-conversations/women-in-cardiology-re-release-8-march-2024/Medical Specialties - Clinical Genetics, Career Conversationshttps://podcasts.rcpe.ac.uk/show/career-conversations/medical-specialties-clinical-genetics-07-jun-2023/Demystifying PACES - Cardiovascular [Station 3], Career Conversationshttps://podcasts.rcpe.ac.uk/show/career-conversations/demystifying-paces-cardiovascular-station-3-29-jan-2024/Movement Medicine, Career Conversationshttps://podcasts.rcpe.ac.uk/show/clinical-conversations/movement-medicine-03-apr-2023/Recording date: 22 May 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Kat Ralston chats to Dr Matt Lambert about hyperacute stroke. They discuss a targeted approach to first assessment, including how to utilise your team effectively in a time-pressured environment. They explore the evidence behind different treatment options and share practical tips on thrombolysis and thrombectomy.Dr Lambert is a consultant in Stroke and Medicine for the Elderly in NHS Tayside and was clinical lead for stroke in Tayside from 2016 until 2023. During this time they led a significant reorganisation of stroke services which led to significant improvements in the delivery of stroke care as measured by the Scottish Stroke Care Audit and laid the foundations for introducing a mechanical thrombectomy service for acute stroke in Tayside. They have an interest in quality improvement and completed the Scottish Quality and Safety Fellowship. Since late 2023 Dr Lambert has been the Stroke Specialty Advisor to the CMO and National Clinical lead for Stroke in Scotland.Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.-- Useful Links --NIHSS training - https://www.ninds.nih.gov/health-information/public-education/know-stroke/health-professionals National Clinical Guideline for Stroke for the UK and Ireland - https://www.strokeguideline.org/Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials - https://doi.org/10.1016/s0140-6736(16)00163-xRecording Date: 11 March 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode Dr Ben Warner discusses multimorbidity, also known as multiple long-term conditions, with Professor Frances Mair. They discuss what multimorbidity is, how the concept differs from frailty and how the burden of treatment and health inequalities impact patients with multiple long-term conditions. Professor Frances Mair is the Norie Miller Professor of General Practice, Head of General Practice and Primary Care, and Director of a Wellcome funded Multimorbidity PhD Programme for Health Professionals at the University of Glasgow.She co-leads the NHS Research Scotland Primary Care Network, promoting research activity in primary care and is a member of the MRC Clinical Academic Research Partnerships Panel. Professor Mair is also an International Advisor to the Norwegian Primary Care Research Network and the Australian Translating Research Outcomes into the Primary Health Interface (TROPHI) Scientific Advisory Group as well as acting as a Visiting Professor at the University of Melbourne, Australia. Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health, having completed the LSHTM’s East African Diploma in Tropical Medicine and then worked for 18 months in rural South Africa. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals with the University of Glasgow.Recording date: 20 February 2024-- Useful Links --https://www.bmj.com/content/339/bmj.b2803https://www.nice.org.uk/guidance/ng56 https://doi.org/10.1016/S0140-6736(12)60240-2https://www.gla.ac.uk/colleges/mvls/graduateschool/multimorbidity/ https://www.gla.ac.uk/schools/healthwellbeing/staff/francesmair/ -- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Marilena Giannoudi and Dr Vidhya Nair discuss orthogeriatrics, including frailty and fragility fractures, osteoporosis, and falls risk assessment, and the importance of a multi-disciplinary (MDT) team throughout patient care.Dr Vidhya Nair graduated from Newcastle University in 2002 and moved down to Leeds in 2003. Dr Nair became a Consultant in Elderly Medicine specialising in Orthogeriatrics in 2011 and worked in Pinderfields General Hospital on a dedicated hip fracture unit. Since 2015 Dr Nair has worked as a Consultant in Leeds Teaching Hospitals. Dr Nair's current role is as the Clinical Lead for Orthogeriatrics based at Leeds General Infirmary, providing orthogeriatric input onto orthopaedic wards and the Major Trauma Unit.Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.-- Useful links --Frailty for the Non-Specialist - 'Clinical Conversations' podcasthttps://podcasts.rcpe.ac.uk/show/clinical-conversations/frailty-for-the-non-specialist-11-mar-2024/National Osteoporosis Guideline Group (NOGG)https://www.nogg.org.ukFRAX® tool - Fracture Risk Assessment Tool https://frax.shef.ac.uk/FRAX/ (and see https://www.fraxplus.org/)Recording date: 15 February 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Kat Ralston chats with Dr Emma Phillips about clinical debriefing. They talk about what clinical debriefing is (and isn’t) and why we should be incorporating this into our everyday work. They explore when and how to facilitate a clinical debrief and share tips on how we can embed clinical debriefing into our practice.Dr Phillips is an Anaesthetic Registrar working in South-East Scotland. She completed a simulation fellowship at Scottish Simulation Center in 2018 and maintains active role in simulation based education. Dr Phillips completed a Master's in 2022 with a dissertation examining attributes and evidence for use of clinical debriefing tools. She has also published and presented on a number of topics including non-technical skills in simulation, clinical debriefing, educational innovations and airway management. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.-- Useful Links --Kolbe M, Schmutz S, Seelandt J C, Eppich W J, Schmutz J B. Team debriefings in healthcare: aligning intention and impact BMJ 2021; 374 :n2042 - https://doi.org/10.1136/bmj.n2042 Phillips EC, Smith SE, Tallentire V, et al. Systematic review of clinical debriefing tools: attributes and evidence for use BMJ Quality & Safety Published Online First: 28 March 2023. - https://doi.org/10.1136/bmjqs-2022-015464Petrosoniak A, Gabriel J, Purdy E. Stop asking if it works, start making it happen: exploring barriers to clinical event debriefing in the ED. CJEM. 2022;24(7):673-674. - https://doi.org/10.1007/s43678-022-00396-9Walker CA, McGregor L, Taylor C, Robinson S. STOP5: a hot debrief model for resuscitation cases in the emergency department. Clin Exp Emerg Med. 2020;7(4):259-266. - https://doi.org/10.15441/ceem.19.086Wolfe et al. (2014) Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes - https://doi.org/10.1097/CCM.0000000000000327 Rose & Cheng (2018) Charge nurse facilitated clinical debriefing in the emergency department - https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/charge-nurse-facilitated-clinical-debriefing-in-the-emergency-department/CC224433937ACBA849491A66EBC9593D Ralston et al. (2024) Overcoming barriers to clinical event debriefing through simulation - https://doi.org/10.1111/medu.15359 Recording Date: 16 February 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, released to coincide with World TB Day 2024, Dr Ben Warner discusses pulmonary tuberculosis (TB) with Dr David Connell.Dr David Connell first explains his personal interest in TB. They then discuss pulmonary TB in depth, including: epidemiology; pathogenesis, immune response, and transmission (a 'lymphatic disease with respiratory spread'); how TB presents and differential diagnoses; latent TB infection and reactivation; and management including the importance of the multidisciplinary team (MDT) and the role of public health in contact tracing and the end goal of elimination.Dr David Connell completed higher specialist training in Respiratory and General Internal Medicine in North-West London including at St.Mary’s Hospital, where he completed a PhD in the immunology of Tuberculosis, before becoming a Consultant at Ninewells Hospital in 2017 where he has a specialist interest in Complex Pulmonary Infections and TB. He is Co-Chair of the Scottish Health Protection Tuberculosis Network and is a Clinical Service Advisor to the BTS MDR-TB Advice Service.Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health, having completed the LSHTM’s East African Diploma in Tropical Medicine and then worked for 18 months in rural South Africa, where he encountered the sharp end of the global TB pandemic. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals fellow with the University of Glasgow.Recording date: 1 March 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week Dr Marilena Giannoudi focuses on the topic of Frailty with Dr Sean Ninan. They discuss recognising frailty, the different ways to measure the severity of frailty and the importance of adapting treatment for frail patients. Dr Sean Ninan is a Consultant Geriatrician and Clinical Lead for Dementia and Delirium at Leeds Teaching Hospitals NHS Trust. Dr Ninan is also Course Director of Leeds Frailty Education. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.Recording Date: 04 December 2023-- Useful Links -- CGA Toolkit - https://www.cgakit.com/frailtyCGA in Primary Care Settings - https://www.bgs.org.uk/cgatoolkit GIRFT Geriatric Medicine - https://gettingitrightfirsttime.co.uk/medical_specialties/geriatric-medicine/ Rapid Delirium Test - https://www.the4at.comClinical Frailty Scale - https://www.dal.ca/sites/gmr/our-tools/clinical-frailty-scale.html-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week, Dr Kat Ralston takes a fresh look at the geriatric giants with Dr Clare Bostock. They explore frailty syndromes using the “5M’s” approach (matters most, mind, mobility, medications, and multi-complexity) and discuss the importance of a detective mindset to make the diagnosis. They share practical tips on the assessment and management of patients with frailty at the front door. Clare Bostock is a consultant geriatrician at NHS Grampian. Her areas of special interest include acute assessment, polypharmacy, falls, and quality improvement. She works in the geriatric assessment unit at Aberdeen Royal Infirmary. The geriatric medicine team at ARI started daily reviews of older people with frailty in the Acute Medical Admissions area in July 2022. She spent nearly 3 years working in the hospital at home team alongside acute work at ARI, and now works in ARI and at an intermediate care facility at Rosewell House. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.--Useful Links--Managing multiple medicines- https://rightdecisions.scot.nhs.uk/polypharmacy-guidance/British Geriatrics Society Frailty module - https://www.bgs.org.uk/elearning/2023-frailty-identification-and-interventions Clinical Frailty Scale - https://www.bgs.org.uk/sites/default/files/content/attachment/2018-07-05/rockwood_cfs.pdf Think Delirium Toolkit-https://learn.nes.nhs.scot/2442/rrheal/education-networks/rural-teams-education-network/think-delirium-improving-the-care-for-older-people-delirium-toolkit The Geriatric 5M’s - https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.14979 Silver Book II – Geriatric Syndromes (British Geriatrics Society) - https://www.bgs.org.uk/resources/silver-book-ii-geriatric-syndromesACB Calculator - https://www.acbcalc.com/ Managing Multiple Medicines: Anticholinergics Recommendations - https://rightdecisions.scot.nhs.uk/polypharmacy-guidance/hot-topics/anticholinergics/Top Tips for Clinical Frailty Scale - https://www.dal.ca/sites/gmr/our-tools/clinical-frailty-scale/cfs-guidance.html-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Kat Ralston talks to Dr Sam Hopkins about growth mindset. They talk about what growth and fixed mindsets are, and why thinking about your mindset is critical to successful learning and development as doctors. They discuss practical tips on ways to influence your mindset and the mindset of others around you, including effective ways to seek and give feedback and the power of role-modelling that failure is not only normal but an essential part of growth as a doctor.Sam Hopkins is a Specialty Trainee in Medical Oncology at the Edinburgh Cancer Centre and a Senior Medical Education Fellow for the Medical Education Directorate, NHS Lothian. She is also an Honorary Clinical Fellow at the University of Edinburgh.Her research interests are growth mindset, specifically how to increase trainee adoption of a growth mindset in the clinical learning environment, and innovative simulation methodology, such as her novel table top simulation board game. She is Canadian of origin and her passions include cooking, positive psychology and yoga.Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.-- Useful Links --Carol Dweck TED talk "Developing a Growth Mindset" - https://www.youtube.com/watch?v=hiiEeMN7vbQHopkins SR, Rae VI, Smith SE, Meldrum S, Tallentire VR. From safety net to trampoline: elevating learning with growth mindset in healthcare simulation. Advances in Simulation. 2023 Nov 10;8(1):26. - https://link.springer.com/article/10.1186/s41077-023-00264-1Hopkins SR, Rae VI, Smith SE, Mutch CP, Oliver N, Tallentire VR. Growing a growth mindset: a tabletop simulation board game. International Journal of Healthcare Simulation. 2023 Jul 10(null):1-3. - https://www.ijohs.com/article/doi/10.54531/cjfe6207?q=Dweck CS, Leggett EL. A social-cognitive approach to motivation and personality. Psychological review. 1988 Apr;95(2):256. - https://psycnet.apa.org/record/1988-29536-001Yeager DS, Dweck CS. What can be learned from growth mindset controversies?. American psychologist. 2020 Dec;75(9):1269. - https://psycnet.apa.org/record/2020-99903-019Wolcott MD, McLaughlin JE, Hann A, Miklavec A, Beck Dallaghan GL, Rhoney DH, Zomorodi M. A review to characterise and map the growth mindset theory in health professions education. Medical Education. 2021 Apr;55(4):430-40. - https://asmepublications.onlinelibrary.wiley.com/doi/abs/10.1111/medu.14381Recording date: 23 November 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this brief episode, Dr Marilena Giannoudi, Co-Chair of the Trainees and Members’ Committee, gives an overview of the Royal College of Physicians of Edinburgh's podcasts relevant to doctors-in-training. These include: this podcast, 'Clinical Conversations'; 'Career Conversations' including the new 'Demystifying PACES' series; and the Recently Appointed Consultants' Committee's podcast, 'Consultant Conversations', relevant to senior trainees.All RCPE podcasts can be found at https://podcasts.rcpe.ac.uk/The 'Demystifying PACES' podcast series can be found at https://podcasts.rcpe.ac.uk/show/career-conversations/category/paces/ Recording date: 23 January 2024-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/-- Become a Member --https://www.rcpe.ac.uk/membership/join-collegeFeedback: cme@rcpe.ac.uk
In the second of two episodes on Long COVID, Dr Hannah Preston discusses Long COVID and ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) with Dr Binita Kane.Long COVID, also known as Post-Covid Syndrome, is further explored. Dr Preston and Kane discuss Postural Tachycardia Syndrome (PoTS), immune dysregulation, Mast Cell Activation Syndrome (MCAS), the impact of Long COVID on women's and men's health, investigations, emerging research and treatments, and the importance of listening to your patient.Dr Binita Kane is a Consultant respiratory physician in Manchester. She has worked on the frontline of the pandemic since 2020 and set up the first COVID virtual ward model in the UK and has advised nationally on the role of virtual wards across England.In January 2021, Dr Kane’s 10 year old daughter developed COVID and subsequently Long COVID. This has led her on an international search for answers, culminating in her becoming a campaigner, researcher, patient advocate, champion for the Long COVID Kids charity and now a specialist Long COVID physician.Dr Kane is a member of the World Health Network Long COVID Executive Committee, Independent SAGE and a campaigner for clean air.Dr Hannah Preston is a Renal Registrar in Edinburgh and RCPE Trainees and Members' Committee (T&MC) Co-Chair.Listen to Part 1: https://podcasts.rcpe.ac.uk/show/clinical-conversations/long-covid-part-1-27-nov-2023/-- Links --PoTS UK:https://www.potsuk.orgStanding up to PoTS:https://www.standinguptopots.org/videos-about-potsVisible app - Visible Healthhttps://www.makevisible.comBMJ Long COVID - an update for primary care (2022):https://www.bmj.com/content/378/bmj-2022-072117Nature review article: Long COVID, major findings, mechanisms and recommendations:https://www.nature.com/articles/s41579-022-00846-2Review article: Long COVID pathophysiological factors and abnormalities of coagulationhttps://pubmed.ncbi.nlm.nih.gov/37080828/Dr Kane's YouTube channel 'The Long COVID Clinic - What you CAN do' in partnership with The Long COVID Support Charity:https://www.youtube.com/@LCCWYCDGez Medinger YouTube channel - interviews with the world's leading Long COVID researchers and more:https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXwThe World Health Network - Long COVID resources, bringing together knowledge from across the world:https://whn.global/long-covid/Long COVID Kids Charity - resources for children and families affected by Long COVID:https://www.longcovidkids.orgWorld Physio Long COVID resources - international repository of resources regarding safe rehabilitation approaches:https://world.physio/covid-19-information-hub/long-covid-- Related RCPE content --For RCPE's COVID-19 content, see https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=COVID-19&ta=2&excl=1Recording date: 26 November 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In the first of two episodes on Long COVID, Dr Hannah Preston discusses Long COVID and ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) with Dr Binita Kane.Long COVID, also known as Post-Covid Syndrome, is explored in depth, including prevalence, risk factors, symptoms and impact, pathophysiology, and management. Dr Kane also busts some common myths about Long COVID.Dr Binita Kane is a Consultant respiratory physician in Manchester. She has worked on the frontline of the pandemic since 2020 and set up the first COVID virtual ward model in the UK and has advised nationally on the role of virtual wards across England.In January 2021, Dr Kane’s 10 year old daughter developed COVID and subsequently Long COVID. This has led her on an international search for answers, culminating in her becoming a campaigner, researcher, patient advocate, champion for the Long COVID Kids charity and now a specialist Long COVID physician.Dr Kane is a member of the World Health Network Long COVID Executive Committee, Independent SAGE and a campaigner for clean air.Dr Hannah Preston is a Renal Registrar in Edinburgh and RCPE Trainees and Members' Committee (T&MC) Co-Chair.-- Links --BMJ Long COVID - an update for primary care (2022):https://www.bmj.com/content/378/bmj-2022-072117Nature review article: Long COVID, major findings, mechanisms and recommendations:https://www.nature.com/articles/s41579-022-00846-2Review article: Long COVID pathophysiological factors and abnormalities of coagulationhttps://pubmed.ncbi.nlm.nih.gov/37080828/Dr Kane's YouTube channel 'The Long COVID Clinic - What you CAN do' in partnership with The Long COVID Support Charity:https://www.youtube.com/@LCCWYCDGez Medinger YouTube channel - interviews with the world's leading Long COVID researchers and more:https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXwThe World Health Network - Long COVID resources, bringing together knowledge from across the world:https://whn.global/long-covid/Long COVID Kids Charity - resources for children and families affected by Long COVID:https://www.longcovidkids.orgWorld Physio Long COVID resources - international repository of resources regarding safe rehabilitation approaches:https://world.physio/covid-19-information-hub/long-covid-- Related RCPE content --For RCPE's COVID-19 content, see https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=COVID-19&ta=2&excl=1Recording date: 16 October 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
Dr Kat Ralston and Dr Sarah Bartlett discuss free e-learning on the '10 things a doctor can do to combat climate change' initiative from the Royal College of Physicians of Edinburgh's College Advisory Forum on the Environment (CAFE).This initiative has featured in The BMJ, the College's journal JRCPE and in Scotland's Chief Medical Officer's Annual Report.Dr Sarah Bartlett is Co-Chair of RCPE's CAFE with Dr Marion Slater, and Registrar in Geriatric Medicine, General Internal Medicine and Stroke in Edinburgh.Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.-- Links --CAFE '10 things...' e-learninghttps://learning.rcpe.ac.uk/10thingsLast podcast episode: Sustainability - be lazy to save the planethttps://podcasts.rcpe.ac.uk/show/clinical-conversations/sustainability-be-lazy-to-save-the-planet-30-oct-2023/CAFE '10 things...' in The BMJhttps://doi.org/10.1136/bmj.o2650CAFE '10 things...' in JRCPEhttps://doi.org/10.1177/14782715231158878CAFE '10 things...' in CMO Annual Report (page 56)https://www.gov.scot/publications/realistic-medicine-doing-right-thing-cmo-annual-report-2022-2023/-- Related content --RCPE Fellows & Members can explore planetary health content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Planetary%20Health&ta=2&excl=1Recording dates: 23 August 2023 (Dr Bartlett) and 3 November 2023 (Dr Ralston)-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week Dr Kat Ralston discusses sustainability in healthcare with Dr Shauna Golden. They explore why striving for individual perfection isn't the answer, and discuss the importance of using your sphere of influence to drive change. They share practical tips on how you can improve sustainability where you work, including projects that are 'win-win' - saving the planet, saving money and improving staff and patient experience.Dr Shauna Golden has a background in Emergency Medicine and was the first Medical Education Fellow in Sustainability in NHS Lothian. She studied and trained in Ireland, became interested in the climate crisis while working in Australia, and thereafter completed a Masters in Global Health Policy at The University of Edinburgh.Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.-- Links --Sustainable QIhttps://www.susqi.org/ Sustainable QI specialtieshttps://sustainablehealthcare.org.uk/what-we-do/sustainable-specialties Mary Robinson podcasthttps://www.mothersofinvention.online/ NHS Scotland Strategyhttps://www.gov.scot/publications/nhs-scotland-climate-emergency-sustainability-strategy-2022-2026/NHS Lothian Climate Challenge Grantshttps://nhslothiancharity.org/apply-for-funding/climate-challenge-grants/Charing Cross Quality Improvement projecthttps://www.england.nhs.uk/greenernhs/whats-already-happening/reducing-unnecessary-cannulation-at-charing-cross-hospital/ Centre of sustainable healthcarehttps://sustainablehealthcare.org.uk-- Related content --RCPE Fellows & Members can explore planetary health content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Planetary%20Health&ta=2&excl=1Recording date: 6 July 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week Dr Jonathan Bardgett discusses how to manage patients with a red hot painful swollen foot with Dr Callum Mutch. Jonathan and Callum discuss diagnostics, treatment and examples of different case presentations. Dr Mutch is an infection doctor working in Edinburgh with his time split between the microbiology lab and the infectious diseases ward. He has recently undertaken a medical education fellowship focusing on Simulation Based Mastery Learning and Digital Education. Outside of work he is the co-host of the Infectious Diseases Insight of Two Specialists (ID:IOTS) podcast. Disclaimer: Please always refer to the most up-to-date local antimicrobial guidelines-- Useful Links--NICE guideline [NG141]: Cellulitis and erysipelas: antimicrobial prescribing - https://www.nice.org.uk/guidance/NG141 Sullivan T, de Barra E. Diagnosis and management of cellulitis. Clin Med (Lond). 2018 Mar;18(2):160-163. - doi: https://doi.org/10.7861/clinmedicine.18-2-160 MicroGuide App: https://apps.apple.com/gb/app/microguide/id447171786 / https://play.google.com/store/apps/details?id=com.xancu.utreat&pli=1 NHS Scotland Antimicrobial Companion app: https://www.antimicrobialcompanion.scot/Shorter is better - https://www.bradspellberg.com/shorter-is-better NG141 Summary of the Evidence on Antibiotic prophylaxis for the prevention of recurrent cellulitis and erysipelas - https://www.nice.org.uk/guidance/ng141/chapter/Summary-of-the-evidence#antibiotic-prophylaxis-for-the-prevention-of-recurrent-cellulitis-and-erysipelas Differentials: Lipodermatosclerosis - https://cks.nice.org.uk/topics/venous-eczema-lipodermatosclerosis/, DVT NICE guideline NG158 - https://www.nice.org.uk/guidance/NG158 Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, Inaba K, Perry JJ. Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis. Ann Surg. 2019 Jan;269(1):58-65. - doi: https://doi.org/10.1097/sla.0000000000002774 Infectious diseases tag on Education Portal - https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Infectious%20Diseases ID:IOTS podcast - https://idiotspodcasting.buzzsprout.com/ (https://idiotspodcasting.buzzsprout.com/1782416/9227705-6-skin-and-soft-tissue-infection and https://idiotspodcasting.buzzsprout.com/1782416/9227743-7-necrotising-fasciitis)Recording Date: 28 June 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode Dr Marilena Giannoudi discusses the approach to patients with peripheral neuropathy with Dr Louise Davidson. Dr Davidson first covers the basic anatomy and function of the peripheral nervous system and describes lower motor neurone signs. They discuss different peripheral neuropathy presentations and types. Dr Davidson emphasises the importance of a thorough history before moving on to examination, testing/investigations, and management.Dr Louise Davidson is a Consultant Neurologist based in Edinburgh. Dr Davidson works full time for the National Health Service with interests in epilepsy, general neurology and botulinum toxin for dystonia. Dr Davidson was awarded an MD degree following her research into the diagnostics of Sporadic Creutzfeldt-Jakob Disease. During her general neurology practice, Dr Davidson has managed a number of different cases of peripheral neuropathy and has previously discussed the topic at college meetings and at general medical grand round meetings. Dr Davidson is also actively involved in medical education and is the current local programme lead for neurology training.Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is a member of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.-- Related content --RCPE Fellows & Members can explore neurology content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=NeurologyRecording date: 26 June 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode Drs Dáire O'Shea and Sarah Clifford discuss what the acute medic needs to know about HIV (human immunodeficiency virus) with Dr Jonny Bardgett, including the patient journey following diagnosis, opportunistic infections, advances in diagnosis and management, treatment side effects, and use of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) to reduce transmission and acquisition of HIV.Dr Sarah Clifford recently completed training in Infectious Diseases and General Medicine, and is currently working as an acting consultant in the Regional Infectious Diseases Unit at the Western General Hospital in Edinburgh. Clinical interests include HIV medicine and tropical medicine. Dr Clifford is a graduate of the Liverpool School of Tropical Medicine & Hygiene, and the Gorgas Course in Tropical Medicine (Lima, Peru).Dr Dáire O'Shea is a Consultant Physician in Infectious Disease at the Regional Infectious Diseases Unit Edinburgh and Honorary Clinical Senior Lecturer at University of Edinburgh. He is a graduate of Trinity College Dublin, Ireland and undertook Internal Medicine and specialist Infectious Diseases Training in Ireland. In 2011 Dr O'Shea was awarded a Transplant Infectious Diseases fellowship with the Alberta Transplant Institute in Canada continuing to take on a position with the Infectious Diseases Academic Faculty of the University of Alberta. In 2014 he took up his current position in Edinburgh. Subspecialist interests include infection in immunocompromised hosts, in particular infection post transplantation; HIV medicine, and Viral hepatitis. Research interests focus on immunopathogenesis and immune determinants of infection outcomes.-- Link --HIV drug interactions https://www.hiv-druginteractions.org/Recording date: 31 May 2023Sound issues: We apologise for some lower quality audio in this episode.-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Libby Sampey interviews Dr Catriona Kyle about adrenal insufficiency and steroid replacement. They discuss the different types of adrenal insufficiency and relevant physiology before exploring recognition, investigations and diagnosis, and links to other autoimmune diseases. They go on to discuss management including ‘sick day rules’, and patient follow-up. Dr Catriona Kyle is a Consultant Endocrinologist at the Western General Hospital in Edinburgh, and has a PhD in steroid physiology from the University of Edinburgh.Dr Libby Sampey is a member of RCPE’s Trainees and Members’ Committee podcast team and a Foundation Year Doctor.-- Links --Society for Endocrinology - Adrenal Crisis Informationhttps://www.endocrinology.org/clinical-practice/clinical-guidance/adrenal-crisis/Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (Bornstein et al., 2016)https://doi.org/10.1210/jc.2015-1710Society for Endocrinologyhttps://www.endocrinology.org/Recording date: 8 June 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
Today Dr Marilena Giannoudi discusses treating diabetic patients on the wards with Dr Evgenia Foteinopoulou. Dr Evgenia Foteinopoulou is a Consultant in Endocrinology & Diabetes at NHS Lothian with a special interest in Diabetic Nephropathy and Diabetes classification. Dr Foteinopoulou is also involved in Undergraduate and Postgraduate medical teaching. Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications, and a clinical academic trainee in cardiology in Yorkshire and Humber.Recording Date: 21 April 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week Dr Marilena Giannoudi interviews Professor Mahmood Adil on data, how it can be used in healthcare and what opportunities are available for healthcare workers interested in medical data.
Professor Adil has over 25 years of medical, public health, executive management and policy experience and delivered on key senior positions in the UK & USA including; Medical Director (Public Health Scotland), National Quality & Efficiency Advisor (Department of Health, England), Visiting Faculty (Yale School of Public Health). He has been responsible for national health intelligence and health protection functions and helped to improve quality/patient outcomes, reduce cost and innovate health care services for populations in the UK and internationally.
Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications, and a clinical academic trainee in cardiology in Yorkshire and Humber.
Recording Date: 24 February 2023
-- Useful Links -- TOPOL - https://topol.hee.nhs.uk/ TOPOL Digital Fellowships - https://topol.hee.nhs.uk/digital-fellowships/ FCI - https://fci.org.uk/ FutureLearn Course: Data for Health & Care - https://www.futurelearn.com/courses/data-for-health-and-care Florence Nightingale Foundation Digital Fellowships - https://florence-nightingale-foundation.org.uk/academy/digital-fellowships/ NHSE elfh Hub - https://portal.e-lfh.org.uk/ EDRIS - https://www.isdscotland.org/products-and-services/edris/ NHS Digital - https://digital.nhs.uk/data
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This week, Dr Libby Sampey interviews Ian Lee on impromptu teaching on the medical ward. Ian discusses the importance in facilitating teaching on the wards and how to recognise and overcome challenges, as both educators and learners, to provide good quality training in a clinical setting.
Ian Lee is a Lecturer in Medical Education and Senior Fellow of the Higher Education Academy who works mainly on the University of Edinburgh's Clinical Educator Programme. With a background in nursing, Ian's past clinical teaching includes; teaching resuscitation and clinical skills; ALS instruction; roles in simulation based education and of course supporting medical and nursing students on clinical placement in patient facing clinical settings which is what forms the basis of today's Clinical Conversation. Now in full time academia, Ian continues to share his experiences of working with learners in clinical settings and augments this with evidence from the literature as well as insights developed from hosting workshops on similar topics.
Recording Date: 31 March 2023
--Useful Links-- Clinical Educator Programme website - https://www.clinicaleducator.org/en-gb/
A five-step "microskills" model of clinical teaching, by Neher et al. (1992) - https://pubmed.ncbi.nlm.nih.gov/1496899/
Teaching That Counts: The One-Minute Preceptor Model from CanadiEM - https://canadiem.org/teaching-that-counts-the-one-minute-preceptor-model/
SNAPPS: a learner-centered model for outpatient education, by Wolpaw, Wolpaw & Papp (2003) - https://doi.org/10.1097/00001888-200309000-00010
Learning and teaching in the clinical environment, by Spencer (2003) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125480/
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In this episode Dr Sampey discusses with Dr Gurney what QI is. Why it is beneficial in a healthcare setting. How it affects patient outcomes and helps to deliver patient centred care.
Dr Gurney is Lecturer on MSc Clinical Education at the University of Edinburgh & Co-leader of a 40 credit course on Quality Improvement in relation to Clinical Education within the MSc. Additionally she clinically works in medicine of the elderly and acute medicine.
Recording Date: 23 Feb 2023
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This week Dr Kat Ralston discusses the concept of civility with Dr Catherine Stretton. They reflect on their own personal experiences and explore the evidence on the impact incivility has on our ability to do our jobs effectively. They discuss recognising the factors that can lead to incivility, explore strategies to challenge incivility with compassion and consider how we can influence our workplace culture to improve patient safety.
Kat is a Specialist Trainee in Geriatric and General Medicine and a Medical Education Fellow, currently working in Edinburgh.
Cath is a Consultant Anaesthetist in St. John's Hospital, Livingston. Alongside her clinical work, she is very interested in staff experience and how this translates into to the quality of healthcare that our teams deliver to our patients. She is also interested in utilising Quality Improvement science to achieve excellence in these two areas, so both patients and staff get the best possible experience from our healthcare system.
--Useful Links-- Civility saves lives website - https://www.civilitysaveslives.com/ The Price of Incivility by Christine Porath and Christine Pearson (2013) in Harvard Business Review - https://hbr.org/2013/01/the-price-of-incivility The Impact of Rudeness on Medical Team Performance: A Randomized Trial – Riskin, Erez et al. (2015) - https://doi.org/10.1542/peds.2015-1385 Exposure to incivility hinders clinical performance in a simulated operative crisis – Katz et al. (2019) - http://dx.doi.org/10.1136/bmjqs-2019-009598 Paul Stretton’s Twitter - (@psquantumsafety) The ‘just culture’: why it is not just, and how it could be – Stretton (2020) - https://doi.org/10.12968/bjhc.2020.0058
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In this episode Dr Jonathan Bardgett interviews Dr Ganesh Arunagirinathan about hyponatraemia. They discuss the importance of recognising hyponatraemia and how to manage patients presenting at the front door.
Dr Arunagirinathan is a Consultant Physician in Diabetes & Endocrinology in Edinburgh.
Recording Date: 12 December 2022
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In this episode, Edward Foo discusses spontaneous bleeding presentations and their identification and management with Dr Andrew Page.Dr Andrew Page is a Consultant Haematologist with a special interest in bleeding and thrombotic disorders at the Royal Infirmary of Edinburgh, and Director of the Edinburgh Haemophilia Centre. Before training as a medic, he worked in basic scientific research in the field of genetics. This continues to inform his clinical interests, and Dr Page is also the Clinical Lead of the Scottish Bleeding and Platelet Disorders Genetic Diagnostic Service.Edward Foo is a medical student at the University of Edinburgh and Student Observer of the RCPE Trainees and Members' Committee (T&MC).--- Notes for the listener ---At c. 10.55, Dr Page discusses European licensing for gene therapy in haemophilia B. The situation has changed since recording (13/12/2022), and gene therapy in haemophilia B now has conditional authorisation in Europe: https://www.ema.europa.eu/en/news/first-gene-therapy-treat-haemophilia-bAt c. 24.23, Dr Page discusses reversal of warfarin. Dr Page mentions Beriplex, which is the brand of prothrombin complex concentrate (PCC) used in NHS Lothian, where Dr Page works. However, it should be noted that other brands are available and Beriplex is just being given as an example. Other brands can be found in the BNF: https://bnf.nice.org.uk/drugs/dried-prothrombin-complex/medicinal-forms/--- Link ---The ISTH Bleeding Assessment Tool is available from:https://www.isth.org/page/reference_toolsRecording date: 13 December 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Marilena Giannoudi discusses the role of the 'first fit' clinic and seizure diagnosis and management with Dr Richard Davenport.Dr Richard Davenport has been a Consultant Neurologist since 1999. While very much a general neurologist, he undertakes NHS first seizure, movement disorder and MND clinics, and has particular interests in education and training. Dr Davenport became President of the Association of British Neurologists (ABN) in May 2023. Outside of neurology, Dr Davenport enjoys cycling.Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications.-- Link --https://www.gov.uk/epilepsy-and-drivingRecording date: 24 January 2023-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week Dr Jonny Bardgett discusses Guillain–Barré syndrome (GBS) with Dr Gavin Langlands. Topics include; what GBS is, when to suspect GBS and diagnose, when to start treatment and escalate and the prognosis and rehabilitation of patients. Dr Gavin Langlands is in their penultimate year of neurology Registrar training at the Institute of Neurological Sciences, Glasgow in the West of Scotland, with a developing interest in neuromuscular disorders.Recording Date: 07 December 2022-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
Dr Jonathan Bardgett talks with Dr Zoë Fritz about treatment escalation plans and the ReSPECT process, contextualised with patient case vignettes. Dr Zoë Fritz is a Wellcome fellow in Society and Ethics, and a Consultant Physician in Acute Medicine at Addenbrooke’s Hospital, Cambridge. Her research is focused on identifying areas of clinical practice that raise ethical questions and applying rigorous empirical and ethical analysis to explore the issues and find effective solutions. This applied clinical ethics research allows her to translate ethical analysis into improving healthcare experience and outcomes.-- Links --ReSPECT - https://www.resus.org.uk/respectREDMAP - https://www.spict.org.uk/red-map/Recording date: 26 October 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode Dr Hannah Preston interviews Dr Emma Lunan about physical activity, what advice to give patients about moving more and how doctors can get involved in the interesting field of Sports & Exercise Medicine. Dr Lunan (@emma_lunan) is a GP Partner and Consultant in Sports & Exercise Medicine and Chair of Movement for Health. --Useful Links--Moving Medicine - https://scotland.movingmedicine.ac.uk/ Movement for Health - https://www.movementforhealth.scot/ British Association of Sports & Exercise Medicine (BASEM) - https://basem.co.uk/Recording Date: 26 September 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Amy Prideaux interviews Professor Patrick Kiely about giant cell arteritis (GCA; a.k.a. temporal arteritis), covering diagnosis and management of this rheumatology emergency.Professor Patrick Kiely is a consultant rheumatologist and Professor of Practice in Clinical Rheumatology.-- Links --British Society for Rheumatology guideline on diagnosis and treatment of giant cell arteritishttps://doi.org/10.1093/rheumatology/kez672Trial of Tocilizumab in Giant-Cell Arteritishttps://doi.org/10.1056/NEJMoa1613849Tocilizumab for treating giant cell arteritis – NICE Technology appraisal guidance [TA518]https://www.nice.org.uk/guidance/ta518 Sound issues: We apologise for the audio disturbances in this episode.Recording date: 24 August 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week Dr Jonny Bardgett and Dr Jonny Guckian discuss abnormal skin lesions and how medics should approach them during the acute medical take. Dr Jonny Guckian is a dermatology registrar in Leeds. He is Co-Chair of the RCPE Trainees and Members' Committee, Director for Social Media and Communications for ASME and Podcast Associate Editor for the British Journal of Dermatology.--Useful Links--https://dermnetnz.org/topics/seborrhoeic-keratosis - Seb Khttps://dermnetnz.org/topics/cutaneous-squamous-cell-carcinoma - SCChttps://dermnetnz.org/topics/basal-cell-carcinoma - BCChttps://dermnetnz.org/topics/melanoma - Melanomahttps://dermnetnz.org/topics/abcdes-of-melanoma - ABCD https://www.royalmarsden.nhs.uk/information-gps/gp-resources/skin-cancer/skin-cancer-diagnosis - Glasgow 7 point checklisthttps://www.aad.org/media/stats-indoor-tanning - sunbed stats https://www.blackandbrownskin.co.uk/ and https://www.blackandbrownskin.co.uk/mindthegap - clinical signs on black and brown skinRecording Date: 21 July 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
Dr Marilena Giannoudi talks with Victoria Watson about the role of the rapid access chest pain clinic (RACPC).Victoria Watson is an Advanced Clinical Practitioner in Cardiology at Bradford Teaching Hospitals and leads the chest pain service. Victoria has been qualified for 23 years always having worked in Cardiology.Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications, and a clinical academic trainee in cardiology in Yorkshire and Humber.Recording date: 26 September 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode Lynsey Alexander gives us a valuable insight into the role, involvement and contribution of Occupational Therapists working in the Acute Medical Unit, as an essential part of the Multi-Disciplinary Team.Lynsey Alexander is an Occupational Therapist within the Medical assessment Unit. She also has a keen interest in quality improvement.Recording date: 9 August 2022-- Follow us --www.instagram.com/rcpedintraineestwitter.com/RCPEdinTrainees-- Upcoming RCPE Events --events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
Dr Hannah Preston discusses toxidromes with Dr Euan Sandilands. In this episode of Clinical Conversations, Dr Hannah Preston discusses toxidromes (different poisoning presentations) and their management in the acute medical unit (AMU) with Dr Euan Sandilands, with a focus on hyperthermic toxidromes.Dr Euan Sandilands is Consultant Physician at the Royal Infirmary of Edinburgh, Honorary Senior Clinical Lecturer at the University of Edinburgh, and Director of the National Poisons Information Service - Edinburgh unit.Dr Hannah Preston is a Renal Registrar in Edinburgh and Co-Chair of RCPE's Trainees and Members' Committee (T&MC).-- Link --TOXBASE: https://www.toxbase.org/Recording date: 1 August 2022 -- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week on Clinical Conversations we have two episodes on clinical skills.In the second episode, Dr Jonathan Bardgett talks with Dr Sarbjit Clare about Point of Care Ultrasound (PoCUS) and its use in clinical practice.Dr Sarb Clare MBE is the Deputy Medical Director and Acute Medical Consultant at Sandwell and West Birmingham NHS Trust. She is the NHSEI Midlands Regional Advisor for AIM. She was the first appointed Acute Physician at City Hospital in 2008 where she set up Acute Medicine from infancy and she has been pivotal in developing acute medicine regionally and nationally. She is a national pioneer in Point of Care Ultrasound (POCUS) which she lectures and teaches on nationally. She runs a yearly course “Ultrasound at the Front Door” and has created many free online learning tools and released her first medical book “Ultrasound For the Generalist – A Guide to Point of Care Imaging” with Cambridge University Press in 2021.Recording date: 11 August 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
This week on Clinical Conversations we have two episodes on clinical skills.In the first episode, Dr Jonathan Bardgett and Dr Anda Bularga talk with Professor Andrew Elder about clinical skills in postgraduate medicine. They discuss how medical education has changed over the years internationally.Professor Andrew Elder is the President of the Royal College of Physicians of Edinburgh (RCPE) and an NHS Consultant in Medicine for Older People. Since 2013 he has built collaborations with a number of centres in North America, most notably Stanford and Johns Hopkins, serving as a Visiting Scholar and Fellow at the former, where he has supported teaching and assessment of core bedside skills and co-founded the Society of Bedside Medicine to promote those skills.Recording date: 19 July 2022-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
Dr Marilena Giannoudi discusses pericardial disease with Professor Abdallah Al-Mohammad. In this episode of Clinical Conversations, Dr Marilena Giannoudi discusses pericardial disease with Professor Abdallah Al-Mohammad. Professor Al-Mohammad provides a detailed overview of pericardial disease and offers helpful insights, especially highlighting the importance of gaining detailed histories and requesting targeted investigations when receiving these patients at the front door. Professor Al-Mohammad is a Consultant Cardiologist and Professor of Cardiology for Sheffield Teaching Hospital. Their interests are in heart failure, infective endocarditis and cardiac imaging. -- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode, Dr Kate McLaren shares her experiences with Dr Hannah Preston of non-invasive ventilation (NIV), also discussing who needs to be involved in the process.Dr Kate McLaren is a Consultant in Respiratory Medicine with a particular interest in the integrated management of chronic lung disease.Recording date: 28 June 2022.
This week on Clinical Conversations Dr Jonathan Bardgett talks with Mr James Milburn and Dr Umesh Basavaraju about jaundice and patients presenting with or without accompanying pain. By discussing cases and highlighting the surgical and gastroenterological focus, both speakers offer helpful advice and advocate for the multidisciplinary approach when treating jaundiced patients. Mr Milburn is a Consultant General & Hepatobiliary Surgeon at Aberdeen Royal Infirmary.Dr Basavaraju is a Consultant Gastroenterologist at Aberdeen Royal Infirmary. Their main interest is interventional endoscopy in biliary and pancreatic conditions. Recording date: 21 June 2022.-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
In this episode of Clinical Conversations Dr Jonathan Bardgett interviews Dr Gourab Choudhury on Chronic Obstructive Pulmonary Disease (COPD). Drs Bardgett and Choudhury discuss what COPD is, why it is important to recognise its symptoms and talk through a case to give advice on how to manage a COPD exacerbation in the Acute Medical Unit. Dr Choudhury is a Respiratory Consultant at the Royal Infirmary of Edinburgh and the Respiratory Managed Clinical Network Lead in NHS Lothian.Recording date: 28 June 2022.-- Follow us --https://www.instagram.com/rcpedintraineeshttps://twitter.com/RCPEdinTrainees-- Upcoming RCPE Events --https://events.rcpe.ac.uk/Feedback: cme@rcpe.ac.uk
Drs Bardgett and Guckian in conversation about recruitment.
This week, Drs Jonny Bardgett and Jonny Guckian share their experiences of medical recruitment, discuss the application points system and give advice on how to utilise your skills and experience in application and interview.
--Useful Links-- Oriel - https://www.oriel.nhs.uk/Web/ IMT Recruitment - https://www.imtrecruitment.org.uk/recruitment-process/applying/application-scoring HST Recruitment - https://phstrecruitment.org.uk/recruitment-process/applying/application-scoring
Recording date: 21 July 2022.
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Dr Marilena Giannoudi discusses with Drs Jivendra Gosai and Louise Mundy, their experience of taking part in Out of Programme Opportunities, the variety of opportunities available and how to get the most out of these opportunities.
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In this episode of Clinical Conversations, Dr Hannah Preston interviews Professor Tony Heagerty on the clinical management of hypertension, including lifestyle changes to lower blood pressure.
Professor Tony Heagerty is Head of the School of Medical Sciences in The University of Manchester and Honorary Consultant Physician/Professor of Medicine at Manchester Foundation Trust. He is Past President of the British Hypertension Society, European Society of Hypertension and International Society of Hypertension. His research interests are in hypertension management, diabetes and obesity.
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In this episode Dr Gatenby discusses with Dr Giannoudi the various aspects of this fascinating specialty and describes her journey so far.
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In this episode Drs Guckian and Bardgett discuss the variety and severity of dermatological conditions presenting in Acute Medicine.
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In this episode of Clinical Conversations Dr Jonathan Bardgett interviews Dr Damian Fogarty on why Acute Kidney Injury and Chronic Kidney Disease is so important and talk through cases to give tips on managing a patient in the acute take.
Dr Fogarty is a Consultant Nephrologist in the Belfast Trust. His current post, in a tertiary referral centre, manages patients with Acute Kidney Injury and Chronic Kidney Disease including those requiring dialysis or transplantation.
https://twitter.com/DamianFog
--Useful Information-- This podcast although pre-recorded is a spontaneous conversation & as such recommendations and advice need taken in context with written and proof-read reviews such as within these references:
Acute kidney injury: prevention, detection and management NICE guideline Published: 18 December 2019 www.nice.org.uk/guidance/ng148 PDF at https://www.nice.org.uk/guidance/ng148/resources/acute-kidney-injury-prevention-detection-and-management-pdf-66141786535621
BMJ Quality Improvement Programme Acute Kidney Injury: It’s as easy as ABCDE Caroline Forde, Jennifer McCaughan, Niall Leonard https://bmjopenquality.bmj.com/content/1/1/u200370.w326 BMJ Quality Improvement Reports 2013; 2, No. 1 u200370.w326 doi: 10.1136/bmjquality.u200370.w326 The 'ABCDE' checklist (Address drugs, Boost blood pressure, Calculate fluid balance, Dip urine, Exclude obstruction) was introduced to prompt AKI management.
In NHS England there is a mandated AKI programme under the umbrella term of ‘Think Kidneys’ (https://www.thinkkidneys.nhs.uk/). As part of this there is a national audit with data collection using laboratory AKI e-alerts and managed by the UK Renal Registry-UK Kidney Association in association with NHS England. This service estimates that one in five emergency admissions into hospital are associated with acute kidney injury and potentially up to 100,000 deaths in secondary care are associated with acute kidney injury with perhaps 25-30% potentially preventable. (National Confidential Enquiry into Patient Outcome and Death (NCEPOD) Adding Insult to Injury 2009)https://www.ncepod.org.uk/2009aki.html.
AKIN stages: An increase of more than 26μmol/l above baseline (within a 48hr period) OR An increase of more than or equal to 1.5 to 2 fold from baseline An increase of more than or equal to 2 to 3 fold from baseline An increase of more than 3 fold from baseline OR Serum creatinine ≥355μmol/l with an acute rise of at least 45μmol/l OR Initiation of RRT
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This week, TMC members Jonathan Bardgett and Anda Bularga interview Drs Matthew Watto and Paul Williams, founding members of the US Internal Medicine podcast ‘The Curbsiders’. The group compare the similarities and differences in medical training pathways within the United States and United Kingdom and discuss their experiences of creating a medical podcast series.
--Useful Links-- Curbsiders Podcast - https://thecurbsiders.com/
https://twitter.com/thecurbsiders https://twitter.com/DoctorWatto https://twitter.com/PaulNWilliamz
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In today's episode of Clinical Conversations Dr Hussun-Ara Shah interviews Dr Phil Crosbie about the Lung Health Check Pilot, the new national lung health checks and supporting patients with smoking cessation.
Dr Crosbie is a Senior Lecturer and Honorary Consultant in Respiratory Medicine at the University of Manchester. His main clinical and research interest is lung cancer with a specific focus on early detection and screening. Phil is research lead for the Manchester Lung Health Check Service and co-chief investigator of the Yorkshire Cancer Research funded Yorkshire Lung Screening Trial. He is also member of the national Targeted Lung Health Check Expert Advisory Group and Early Detection lead for Cancer Research UK’s Lung Cancer Centre of Excellence.
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In this episode of Clinical Conversations Dr Anda Bularga interviews Dr Eoin O'Sullivan about cognitive bias and how it impacts on clinical decision making.
Dr Eoin O'Sullivan is a Kidney Research UK Research Fellow at the University of Edinburgh and a Renal Registrar at the Department of Renal Medicine at the Royal Infirmary of Edinburgh.
-- Useful Links -- https://twitter.com/eoinrenal Society to Improve Diagnosis in Medicine - https://www.improvediagnosis.org/
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In today's episode of Clinical Conversations, Dr Jonathan Bardgett interviews Dr Gill Aitken, Programme Director of Clinical Education postgraduate study at the University of Edinburgh.
Gill and Jonathan discuss the difference between Medical Education and Clinical Education, mentorship and tips on creating helpful teaching sessions.
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In this episode of Clinical Conversations Dr Jim Parry talks to Dr Ashling Lillis about Acute Oncology and Oncology in the AMU.
Dr Ashling Lillis is a consultant and Clinical Lead for Acute Medicine at Whittington Hospital in London and is also a National Clinical Advisor for Macmillan Cancer Support.
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In this episode of Clinical Conversations Dr Hannah Preston interviews Professor James Dear on paracetamol overdose in the Acute Medical Unit, the role of NAC and the new SNAP regime.
Professor Dear is Professor of Clinical Pharmacology at the University of Edinburgh and Consultant Clinical Toxicologist in NHS Lothian and for the National Poisons Information Service.
-- Useful Links --
https://www.toxbase.org/
https://toxandhound.com/
https://twitter.com/EdinClinTox
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In this episode Dr Kiely discusses with Dr Prideaux the advances made in his career in rheumatology, what this has meant to patients, and why this is such a fascinating specialty.
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In this episode of Clinical Conversations Dr James Parry talks to Dr Anna Olsson-Brown about Immuno-oncology and managing patients on immunotherapies during the acute take.
Dr Olsson-Brown is a consultant medical oncologist at the Clatterbridge Cancer Centre. Throughout her clinical work she has been involved with the use of oncological immunotherapies, their uses and toxicities.
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In this episode Dr Anda Bularga discusses with Dr Meghan Perry, the variety and complexity of cases which present with pyrexia of unknown origin, and how experience, clinical skill and detective work contribute in this fascinating area of medicine.
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In this podcast Dr Bardgett asks Drs Koch and Weidanz about their ongoing experiences of the COVID pandemic.
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In this episode of Clinical Conversations, Dr Rachel Sutherland talks to Dr Jon Miles about the importance of good management of ambulatory care patients in a same day emergency care setting.
Dr Miles is a recently retired Consultant in Acute & General Medicine with particular interest in Same Day Emergency Care. Dr Rachel Sutherland is Consultant in Acute Medicine specialising in Same Day Emergency Care.
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In this episode of Clinical Conversations, Dr Jonathan Bardgett interviews Dr Gillian Bain about managing Inflammatory Bowel Disease.
Dr Bain is a consultant gastroenterologist at Aberdeen Royal Infirmary and is Trainee Programme Director for Gastroenterology in the north of Scotland.
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In this first episode of 2022 Dr Jonathan Bardgett interviews Dr Rob Hallifax about Pneumothoraces.
Dr Hallifax is an NIHR Academic Clinical Lecturer the University of Oxford. He studied an MSc in Natural Sciences in Cambridge before training in medicine at the University of Oxford. He won an MRC Clinical Training Fellowship for his DPhil: "Understanding Pneumothorax: epidemiology, physiology and outcomes". Dr Hallifax was the trial coordinator for RAMPP (Randomised Ambulatory Management of Primary Pneumothorax) - the largest primary pneumothorax trial in Europe. He has recently published on pneumothorax in JAMA and Lancet.
== Recent publications == Management of primary spontaneous pneumothorax: less is more - http://doi.org/10.1016/s0140-6736(20)32676-3
Trends in the Incidence and Recurrence of Inpatient-Treated Spontaneous Pneumothorax, 1968-2016 - http://doi.org/10.1001/jama.2018.14299
Conservative versus Interventional Treatment for Spontaneous Pneumothorax - http://doi.org/10.1056/NEJMoa1910775
Ambulatory management of primary spontaneous pneumothorax: an open-label, randomised controlled trial - https://doi.org/10.1016/S0140-6736(20)31043-6
https://www.ndm.ox.ac.uk/team/robert-hallifax
In this podcast Dr Bularga discusses medical training and delivery of healthcare in Malawi with Dr Isaac Chirwa, Consultant Endocrinologist in Lilogwe and Dr Michael MacKenzie, Consultant in Infectious Diseases in Lilogwe. Both Dr Chirwa and Dr MacKenzie have experience of undergraduate and postgraduate medical training in the UK and Malawi.
In this podcast Dr Bularga discusses the effects of the COVID-19 pandemic in Malawi and its impact on the country's healthcare system. Dr Isaac Chirwa and Dr Michael MacKenzie share their experience over the past 18 months including the set up of the vaccination programme.
We also give a timely update on the Omicron variant and its impact on the healthcare system in Malawi and other parts of Africa so far.
Dr Jonathan Bardgett interviews Dr David Breen about Parkinson's Disease. How PD is diagnosed, and discussion of different therapies used to treat, therapies to avoid, and side-effects of medications.
Dr Breen is a Senior Clinical Research Fellow at the University of Edinburgh and Honorary Consultant Neurologist at NHS Lothian.
He completed neurology and research training in Cambridge and London, before moving to Toronto as a post-CCT Movement Disorders Fellow.
He specialises in the assessment and treatment of people with all types of movement disorders.
Dr Jonathan Bardgett interviews Dr Ollie Lloyd about the types and causes of meningitis and the approach to identifying when the patient presents, management and when to carry out a lumbar puncture and what to look for.
Dr Lloyd is a registrar (ST5) in Infectious Diseases at RIDU, Western General Hospital, Edinburgh
-- Resources -- https://doi.org/10.1002/14651858.cd004405.pub5 https://doi.org/10.1016/j.jinf.2016.01.007 https://doi.org/10.1136/emj.2009.075598 https://doi.org/10.1056/nejmoa040845
In this episode of Clinical Conversations, Dr Rachel Williamson talks about the assessment and management of patients presenting to the Acute Medical Unit with signs and symptoms of thyroid disease.
Dr Williamson is a consultant endocrinologist at the Borders General Hospital, with an interest in teaching and medical education. She is also Secretary of the Scottish Society of Physicians.
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Dr David Ryan interviews Dr Xiao Liu about machine learning in diagnostic testing, the current state of research and use in real-world medicine.
Dr Liu is an ophthalmology doctor and clinical researcher at the University of Birmingham and University Hospitals Birmingham. She is interested in clinical evaluation and implementation of digital health technologies (particularly machine learning algorithms as diagnostic tests) to improve patient care and healthcare delivery.
Her recent work has been around identifying gaps in reporting and methodology in clinical AI studies, and providing guidance for clinicians to critically appraise the evidence supporting AI health systems. She led the development of the SPIRIT-AI and CONSORT-AI guidelines - new reporting guidelines for AI clinical trials. She also plays an advisory role to NHS X, the AI in health and care award and the WHO/ITU focus group for AI for Health.
-- Resources -- A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: a systematic review and meta-analysis - https://doi.org/10.1016/S2589-7500(19)30123-2
-Spirit and Consort AI- https://www.spirit-statement.org/ http://www.consort-statement.org/
In silico - by means of computer modelling or computer simulation.
Dr George Thomas interviews Dr Mike Wilkinson about the role of SAS doctors, how and why doctors might consider this type of role, and the route to the specialist register via CESR.
Dr Wilkinson is an Associate Specialist in Geriatrics and SAS Tutor for Gateshead Health NHS Foundation Trust. HEE NE & North Cumbria Associate Dean for SAS Doctors & Dentists, and SAS Representative for RCPE Trainees & Members’ Committee.
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In this episode we are joined by Dr Phil Reid, a Respiratory Consultant in Edinburgh who talks about assessing the patient with lung cancer in the acute medical admissions unit.
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Dr Tina Ryan interviews Dr Lara Mitchell about syncope. They discuss assessment, the importance of a history taking, driving advice, and how to setup a syncope service.
Dr Mitchell is a Consultant Geriatrician at the Queen Elizabeth University Hospital in Glasgow where she setup a syncope service.
-- Resources -- Syncope Unit Rationale - https://doi.org/10.1093/europace/euv115
Syncope pathway article (Br J Cardiol 2019;26:133–6) - http://dx.doi.org/10.5837/bjc.2019.040
ESC Guidelines - https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Syncope-Guidelines-on-Diagnosis-and-Management-of
Nice Guidelines - https://www.nice.org.uk/guidance/conditions-and-diseases/neurological-conditions/transient-loss-of-consciousness
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In this episode Dr Anda Bularga interviews Dr Justin McKee, Consultant in Medical Ophthalmology in NHS Lothian. He talks about the ocular manifestations of systemic illnesses and clinical presentation and management of these patients. Dr McKee also gives an overview of the training path and a career in Medical Ophthalmology.
Dr McKee works between the Princess Alexandra Eye Pavilion and Department of Clinical Neurology in Edinburgh, specialising in diabetic retinopathy, Uveitis, Thyroid eye disease and Neuro-ophthalmology.
Ophthalmology specialty training - https://www.jrcptb.org.uk/specialties/medical-ophthalmology - https://www.rcophth.ac.uk/
Dr Tina Ryan talks to Dr Rosie Baruah about microaggressions, how to recognise them and actions you can take.
Dr Baruah is a Consultant in Intensive Care Medicine, Western General Hospital and Hon. Clinical Senior Lecturer, University of Edinburgh
-- The Seven Acts of Allyship --
Appetite – Do you have the appetite to immerse yourself in the complex, emotive world of race equality? Ask – Ask questions about race, be curious, read, learn and educate yourself. Accept – Accept there is really a problem. More data aren’t needed. Acknowledge – Openly acknowledge that the problem needs to be dealt with. Apologise – Express sympathy that racism is affecting people of certain races. Assume – Don’t. Instead develop informed views by seeking to understand individuals. Action – Take demonstrable action steps to establish equality and be accountable.
7 A's Infographic - https://twitter.com/yvonnecoghill1/status/1280744970102636550
https://twitter.com/rosieICM
In this Episode Dr Jonathan Bardgett interviews Dr Murray Blackstock, a Consultant in Intensive Care Medicine and Anaesthesia. He talks about the presentation and management of patients with subarachnoid haemorrhage (SAH) and gives some useful advice on how to refer these patients to neurosurgery and critical care. He refers to NICE guidance and his own personal experience of managing the patient with acute onset headache.
NICE Guidelines - https://www.nice.org.uk/guidance/conditions-and-diseases/cardiovascular-conditions/cranial-aneurysms
In this episode Dr Jonathan Bardgett interviews Dr Snehashish Banik about the importance and practicalities of using point of care ultrasound in the acute medical admissions unit. He talks about how trainees can learn this specialist skill.
Dr Banik is Consultant Physician in Acute and General Internal Medicine. He is FAMUS (Focused Acute Medicine Ultrasound) supervisor in Scotland.
www.acutemedicine.org.uk/famus/
www.famus.org.uk
FAMUS YouTube - www.youtube.com/channel/UCW5COwTFePkExC2CMkgj-gA/videos
Dr David Ryan interviews Professor Emma Baker and Dr Dipender Gill about Clinical Pharmacology discussing their day to day experiences and why everyone should consider it as a specialty.
British Pharmacological Society www.bps.ac.uk
Professor Baker is Professor of Clinical Pharmacology, St George's, University of London with an interest in polypharmacy, translational research and education. Clinical Vice President of the British Pharmacological Society, with the remit of promoting Clinical Pharmacology and Therapeutics as a medical specialty. Training Programme Director for Clinical Pharmacology and Therapeutics in London with a passion for making sure that specialty training is excellent!
Dr Gill work at St. George's Hospital and St. George's, University of London, where he is appointed as a an NIHR Clinical Lecturer. Dipender also works flexibly as a Specialist in the Genetics Department of the Novo Nordisk Research Centre in Oxford and has continued an honorary affiliation at Imperial College London, where he is supported by the British Heart Foundation Centre of Research Excellence.
In this episode of Clinical Conversations, Dr Martin Wilson, a Consultant in Medicine of the Elderly, talks about Frailty and Polypharmacy.
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Dr Wilson is a Consultant in Care of the Elderly, Raigmore Hospital, Inverness. Interest in care of the elderly in remote rural areas, community hospitals and Parkinson's Disease. Commissioner on Committee for Human Medicines MHRA. Long standing interest in Polypharmacy and involved in NHS Scotland's Polypharmacy Guideline from the outset
Polypharmacy Guidance: Realistic Prescribing, 3rd edition (2018) https://managemeds.scot.nhs.uk/
Dr Alastair MacGilchrist talks about alcohol-related liver disease and alcohol dependence. He discusses how to prevent, assess and treat patients with this disease and talks about public health initiatives on this area of medicine.
Scottish Health Action on Alcohol Problems (SHAAP): https://shaap.org.uk
Feedback on this episode: https://bit.ly/CCRCPEFeedback
In this episode Dr Roger Smyth, Consultant Liaison Psychiatrist, talks about the mental health aspects of alcohol misuse, management of alcohol withdrawal syndrome and the process of liver transplantation assessment.
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In this episode Dr Jack Andrews gives as an overview of the recent updates in the assessment and management of patients with acute coronary syndrome. We discuss immediate management and long term risk stratification of patients with myocardial infarction.
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Dr Jack Andrews is a senior cardiology registrar specialising in interventional cardiology, currently working at the Royal Infirmary of Edinburgh.
This episode is on medical education, focussing mainly on simulation training. Dr Vicky Tallentire discusses her career in medical education and explains how medical trainees can get involved in simulation training and research. She reflects on her time as an education fellow, an education coordinator at the Scottish Centre for Simulation and Clinical Human Factors (SCSChf) and her other roles.
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Dr Tallentire is a Consultant in Acute Medicine, an Associate Postgraduate Dean and a simulation enthusiast and facilitator at SCSChf. She is a passionate believer in being able to admit, understand and learn from mistakes in all aspects of life.
Resources: https://www.asme.org.uk https://scschf.org/courses/ https://www.scotlanddeanery.nhs.scot/trainee-information/internal-medicine-training-imt-simulation-programme/ https://www.ed.ac.uk/medicine-vet-medicine/postgraduate/clinical-education
Dr Jonathan Bardgett interviews Prof Najib Rahman about the assessment and management of patient's presenting with pleural effusion.
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Professor Rahman runs the Oxford Pleural Unit and Directs the Oxford Respiratory Trials Unit. He is co-chair of the BTS Pleural Guidelines 2021, Chair of the BTS Pleural Intervention Committee, and Chair of multiple ERS guidelines on pleural disease.
British Thoracic Society - Guidelines https://www.brit-thoracic.org.uk/quality-improvement/guidelines/
American Thoracic Society - Guidelines https://doi.org/10.1513/AnnalsATS.201809-620CME
My Pleural Effusion https://mypleuraleffusionjourney.com/
Training Standards for Thoracic Ultrasound http://dx.doi.org/10.1136/bmjresp-2019-000552
RAPID Score for Pleural Infection https://www.mdcalc.com/rapid-score-pleural-infectionl
Dr Jonathan Bardgett talks to Dr Ingrid Hoeritzauer about functional neurological disorders, how to diagnose them and discuss the positive features necessary to make a diagnosis with patients and their families.
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Resources: Recognising and explaining functional neurological disorder https://www.bmj.com/content/371/bmj.m3745/infographic
https://www.neurosymptoms.org
https://twitter.com/FndPortal
Dr Rachel Sutherland interviews Professor Mark Strachan about how to approach the hyperglycaemic patient who presents in the acute receiving unit.
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Professor Mark Strachan is a Consultant Physician in Endocrinology, Diabetes and Acute Medicine at the Western General Hospital, Edinburgh and Honorary Professor of the University of Edinburgh.
Dr Sutherland is a Consultant in Stroke and General Medicine in the South East of Scotland. She has an interest in integrated, real time analytics and spent some time outside of medicine working as a medical informaticist. She is a passionate advocate for Flexible working and training for doctors.
Feedback and suggested future topics are very welcome, please contact us via email at: cme@rcpe.ac.uk
Dr Rachel Sutherland talks to Professor Mark Strachan about C-Peptide, and how it can be used to help identify the underlying cause of diabetes.
Professor Mark Strachan is a Consultant Physician in Endocrinology, Diabetes and Acute Medicine at the Western General Hospital, Edinburgh and Honorary Professor of the University of Edinburgh.
Feedback and suggested future topics are very welcome, please contact us via email at: cme@rcpe.ac.uk
In this episode Dr Claire Gordon talks about 'Leadership and management in the Acute Medical Unit' with Dr Jonathan Bardgett. Dr Gordon is an Acute Medical Consultant working South East Scotland. She shares her experience of leadership and management during the COVID-19 pandemic and discusses working with Acute Internal Medicine.
In this episode Dr Xan Hughes (pronouns they/them) talks to Dr David Ryan (pronouns he/him) about being an openly transgender doctor working in the NHS. The topics covered include an introduction to some common terminology relevant to talking about trans healthcare and about how easy changes to practices can help both trans colleagues and patients have a better experience.
Dr Xan Hughes, is a Foundation year two doctor working at a large London teaching hospital. Their research interests include barriers to healthcare and widening access especially to preventative care.
Dr Dominique Baker, senior Registrar in Obstetrics and Gynaecology in the South East of Scotland Deanery gives us an overview of acute medical problems in pregnancy, we talk about the clinical assessment and multidisciplinary management of these patients.
Resources
Maternity Early Warning Score: https://ihub.scot/media/5308/national-mews-chart_web.pdf Prescribing in pregnancy(BUMPS: https://www.medicinesinpregnancy.org
This episode of Clinical Conversations is with Dr James Tiernan, a Respiratory Consultant in South East Scotland. He talks about the investigation and management of acute pulmonary embolism and the follow up of this disease in the current COVID-19 pandemic.
PE Wells Score: https://www.mdcalc.com/wells-criteria-pulmonary-embolism Simplified Geneva Score: https://www.mdcalc.com/geneva-score-revised-pulmonary-embolism NICE Guidelines: https://cks.nice.org.uk/topics/pulmonary-embolism/
In this episode Dr Jonathan Bardgett and Dr Francesca Moroni discuss the importance of recognising and treating malnutrition in the acutely ill patient. This podcast offers practical advice on assessing malnourished patients and provides an overview on available interventions from simple dietary adjustments to artificial feeding. Particular interest is posed on recognising patient at risk of refeeding syndrome and how to prevent it. A multidisciplinary approach to the malnourished patient is key in the successful management of malnutrition with specific focus on the fundamental role of the dieticians.
Dr Moroni touches upon different tubes and feed modalities and practical advice on managing high NG aspirates. A brief mention on parenteral nutrition can stimulate the listener to read more about it. The extreme malnutrition scenario is offered by patients with anorexia nervosa who require admission in acute medicine. These patients should be treated with extreme caution and involvement of gastroenterologist, dietician and psychiatrist should be priority.
MUST Tool: https://www.bapen.org.uk/screening-and-must/must/introducing-must
Reefeeding risks: National Institute for Health and Care Excellence. Nutrition support in adults. Clinical guideline 32: https://www.nice.org.uk/guidance/CG32
Moroni F, Metcalfe E, McKinlay A. Assessing the nutritional status of an acutely ill patient. BMJ 2017; 357 doi: https://doi.org/10.1136/sbmj.j1448 (Published 31 May 2017)
MARSIPAN Guidelines: https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr189.pdf
Dr Addy McLeod and Dr Paul Coulter discuss the importance of resilience training and mental wellbeing for a successful career. Dr Coulter shares his experience of a holistic approach to building resilience and confidence.
Dr Addy McLeod is a senior geriatrics registrar in the North East Deanery and Chair of the Trainees and Members Committee at the Royal College of Physicians Edinburgh.
Stories from Patient Voices open workshops http://www.patientvoices.org.uk/pilgrim.htm
Help me! I'm only human... | Adam Crizzle | TEDx https://www.youtube.com/watch?v=w7JSDvJh23M
In this episode of clinical conversations Dr Colin Stirrat, Consultant Cardiologist at the Royal Infirmary of Edinburgh gives us an overview of the updated clinical guidelines on the assessment and management of patients with atrial fibrillation.
European Society of Cardiology Guidelines: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Atrial-Fibrillation-Management
We discuss the recommended integrated approach to managing AF patients with stroke prevention, better symptom control and risk factors evaluation and management.
Please join us for the 60th St Andrew's Day Festival symposium: Updates on Acute Medicine from the 24th to the 27th of November 2020. https://events.rcpe.ac.uk
In this episode of Clinical Conversations Dr Tina Ryan and Dr Brain discuss the clinical assessment and management of critically unwell patients. This podcast covers some key aspects in these patients' care such as the importance of monitoring, fluid resuscitation, referral to Intensive Care Unit and life support.
Dr Tina Ryan is a senior Geriatric Medicine Registrar in the West of Scotland
Dr Neil Brain is a senior Intensive Care Specialist Registrar in the West of Scotland
In this episode of 'Clinical Conversations' Dr Ailsa Oswald, our Vice Chair for Education and Oncology Trainee interviews Dr Mark Stares, Senior Oncology Registrar in NHS Lothian.
They discuss in depth the topic of 'Cancer of Unknown Primary' and give some useful insights on the latest evidence on investigating, managing, and caring for oncology patients in whom the primary tumour is not identified.
Feedback and suggested future topics are very welcome, please contact us via email at: cme@rcpe.ac.uk
Dr Tina Ryan and Dr Greg Waddell discuss quality improvement (QI) projects, the difference between clinical audits and QI projects, how to approach, and to avoid the pitfalls. QI projects are an annual requirement for trainees to undertake towards their ARCP.
Dr Ryan is a Geriatric Medicine Registrar in the West of Scotland
Dr Waddell is a Geriatric Medicine Consultant, QI Lead, and Scottish Quality and Safety Fellow.
Feedback and suggested future topics are very welcome, please contact us via email at: cme@rcpe.ac.uk
Dr Adelina Mcleod and Dr Alisha Khanna discuss the prevalence of social isolation in an ageing population, the impacts of COVID-19 on Geriatric Medicine, and how hospital-based care could change to better support elderly patients.
Dr Khanna has just completed FY1, now an FY2 working in London.
Dr Mcleod is Chair or the RCPE T&MC committee, and specialty trainee in geriatrics with a specialist interest in cognition and delirium.
Please share this episode with your colleagues and suggest future interviewees by emailing us at cme@rcpe.ac.uk
In this episode Dr Paolo d'Arienzo and Dr Nicola Robinson discuss how the COVID-19 pandemic has impacted the MRCP(UK) PACES exam and what changes candidates can expect.
Dr d'Arienzo is a CT2 IM Trainee at Barts Health NHS Trust, London, and a junior member of the RCPE Trainees and Members’ Committee.
Dr Robinson is a clinical research fellow and ST6 in Respiratory and General Medicine, MRCPUK trainee representative for PACES, and is Vice Chair of the RCPE Trainee and Members' Committee.
For more information on PACES and RCPE Diploma Ceremonies: https://www.rcpe.ac.uk/careers-training/preparing-paces-exams
Please share this episode with your colleagues and suggest future interviewees by emailing us at cme@rcpe.ac.uk
In this episode Dr Ailish Nimmo is joined by Dr Wilf Okoroafor, a senior renal registrar in Bristol with a keen interest in clinical education. They discuss the investigations and management of patients with proteinuria
Welcome to Clinical Conversations! Dr Baker joins us for an interesting discussion on training, changes over time and some practical advice regarding Internal Medicine Training and the application process.
If you want to find out more information about IMY3 application process please follow this link: https://www.imtrecruitment.org.uk/imy3/overview/
Please share this episode with your colleagues and suggest future interviewees by emailing us at cme@rcpe.ac.uk
Recorded: 3 August 2020
Welcome to Clinical Conversations!
This new podcast series is brought to you by the Trainees & Members' Committee of the Royal College of Physicians Edinburgh. We aim to discuss a multitude of clinical topics ranging from interesting clinical cases and diagnostic conundrums to updates on clinical guidelines. These clinical podcasts will be relevant for doctors at any stage of training and wWelcome to Clinical Conversations!
We hope you enjoy them and share them with colleagues. Feedback and suggested future topics are very welcome, please contact us via email at: cme@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s podcast series which presents different perspectives on COVID-19 from health care professionals on the frontline.
In this episode Dr Felicity Baines, from The Borders General Hospital discusses her experiences and tips as an FY1 during COVID-19 with Dr Rachel Sutherland.
Please share this episode with your colleagues and suggest future interviewees by emailing us at standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s podcast series which presents different perspectives on COVID-19 from health care professionals on the frontline.
For our eleventh episode Chair of the Trainee and Members Committee Dr Adelina McLeod interviews Dr Anna Olsson-Brown, Trainees and Members Committee Elected Member(England & Wales) where they discuss trainee representatives during Covid-19.
Please share this episode with your colleagues and suggest future interviewees by emailing us at standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s podcast series which presents different perspectives on COVID-19 from health care professionals on the frontline.
For our tenth episode Dr Rachel Sutherland interviews Dr Martin Dennis, Chair of Stroke Medicine at The Centre for Clinical Brain Sciences, University of Edinburgh to discuss stroke and Covid-19.
Please share this episode with your colleagues and suggest future interviewees by emailing us at standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s podcast series which presents different perspectives on COVID-19 from health care professionals on the frontline.
For our seventh episode, Dr Paolo Davide D'arienzo, CT1 Internal Medicine at Barts Health NHS Trust, Dr David Ryan, F1 Doctor at St George's University Hospital NHS Foundation Trust and Dr Jemma Proudfoot, Academic FY2 at Liverpool University Hospitals Trust, discuss their top tips for new FY1s. Recorded on 15 April 2020.
Please share this episode with your colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s podcast series which presents different perspectives on COVID-19 from health care professionals on the frontline.
For our eighth episode, educational psychologist Julie McDonald shares advice for looking after your mental health.
Please share this episode with your colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s new podcast series which presents the latest on COVID-19 from health care professionals on the frontline.
For our sixth episode, Dr Ailish Nimmo, ST5 (renal), interviews Dr Pippa Bailey, consultant and senior lecturer in nephrology at Southmead Hospital Bristol. Together they discuss the impact COVID-19 has on renal disease.
Please share this episode with your colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s new podcast series which presents the latest on COVID-19 from health care prrofessionals on the frontline.
For our fifth episode, Dr Mike Jones, RCPE Director of Training and Consultant Physician and Clinical Director, University Hospital of North Durham covers questions and concerns trainee doctors may have during this time.
Please share this episode with your colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s podcast series which presents different perspectives on COVID-19 from health care professionals on the frontline.
For our ninth episode, educational psychologist Julie McDonald shares advice on ways to deal with stress and uncertainty.
Please share this episode with your colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Ethical Decision Making in the Time of Covid - II (27 April 2020) by Royal College of Physicians of Edinburgh
Ethical Decision Making in the Time of Covid - I (27 April 2020) by Royal College of Physicians of Edinburgh
Sandy Cameron; Former Director of Social Services in the Scottish Borders and South Lanarkshire, and the Chair of the board for several social care organisations in the third sector and Annie Gunner-Logan; Director of the coalition of Care and Support Providers Scotland (CCPS) discuss social care during the COVID-19 pandemic.
https://learning.rcpe.ac.uk/course/view.php?id=707
Recorded 24 April 2020.
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s new podcast series which presents the latest guidance and advice on COVID-19 from health care professionals on the frontline.
For our fourth episode, Vice-Chair for Career and Communications, Dr Rachel Sutherland will be interviewing Dr Mike Farquhar a Consultant in sleep medicine at Evelina London Children’s Hospital. In This Podcast he discusses strategies for a better night's sleep during Covid-19.
Please spread the word with colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s new podcast series which presents the latest guidance and advice on COVID-19 from health care practioners on the frontline.
For our third episode Chair of the Trainee and Members Committee Dr Adeline McLeod will be interviewing Marcus Cassop-Thompson, a recent graduate from Newcastle University talking about his perspectives on becoming an FY1 during a global pandemic.
Please spread the word with colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s new podcast series which presents the latest guidance and advice on COVID-19 from health care professionals on the frontline.
For our second episode Chair of the Trainee and Members Committee Dr Adelina McLeod will be interviewing Dr Mike Cooke, a GP working in Newcastle. Today he will be discussing with Dr McLeod the impact COVID-19 has as on GPs.
Please spread the word with colleagues and suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s new podcast series which presents the latest guidance and advice on COVID-19 from physicians on the frontline. Trainees and Members’ Committee Chair, Dr Adelina McLeod and Vice-Chair for Career and Communications, Dr Rachel Sutherland will be interviewing colleagues from across the UK, to hear how they’re responding to the global pandemic.
Please spread the word with colleagues and you can suggest future interviewees by emailing us at: standards@rcpe.ac.uk
Welcome to COVID-19 Conversations, the Royal College of Physicians of Edinburgh’s podcast series which presents different perspectives on COVID-19 from health care professionals on the frontline.
For our first episode, Vice-Chair for Career and Communications, Dr Rachel Sutherland will be interviewing Professor Mark Strachan, Consultant Physician in Endocrinology, Diabetes and Acute Medicine at the Western General Hospital, Edinburgh and Honorary Professor of the University of Edinburgh.
Professor Strachan's major research interest is in cognitive impairment in Type 2 diabetes and he is one of the principal investigators of the Edinburgh Type 2 Diabetes Study. He has published over 100 original articles and book chapters. Professor Strachan and Dr Sutherland discuss the impact COVID-19 has on diabetes patients.