BMJ talk medicine

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the May 2023 issue of DTB. They celebrate 60 years since DTB became independent from The Medical Letter and discuss what DTB stands for (https://dtb.bmj.com/content/61/5/66). They review a retrospective cohort study involving people taking oral anticoagulants that compared the risk of bleeding and embolic events in new users of NSAIDs with those not prescribed NSAIDs (https://dtb.bmj.com/content/61/5/67). They also talk about the main review article that explores the therapeutics of siRNA medicines (https://dtb.bmj.com/content/61/5/72). They begin by discussing the UK Government’s recent Budget statement that the MHRA will introduce a new approval process for medicines that have been licensed elsewhere.

When we think of being a ‘good enough’ medical student, our thoughts might go straight to exams. Have we passed them all? What about merits, or even distinctions? It’s easy to prioritise exam scores above all else as it is one of the only times we get clear, concrete feedback - or a number that tells us how ‘good’ we really are.

But can exam results capture everything or is something missing here when we talk about being a ‘good enough’ medical student or doctor? Can written papers or practical exams like OSCEs ever really sum up whether we’ll be ‘good doctors’? And despite so much pressure to excel, do we really need doctors to be the best or do we need them to be good enough?

Expert guests:

Abi Rimmer is a news reporter and careers editor at The BMJ. She is responsible for the careers content and reports on workforce-related and NHS policy issues. She was also recently treated as a patient for stage III rectal cancer.

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This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

Editor-in-Chief of the Archives of Disease in Childhood, Dr. Nick Brown, and Senior Editor of ADC, Dr. Rachel Agbeko, bring you the monthly Atoms - the highlights of the May 2023 issue.

Read it on the Archives of Disease in Childhood website: https://adc.bmj.com/content/108/5/i

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In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Helen Routledge from Worcester Royal Hospital, UK. They discuss all aspects of intervention for ischaemic stroke, including the workforce challenges in delivering this lifesaving therapy. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper:

https://heart.bmj.com/content/109/10/794

Adhesive capsulitis affects 2% to 5% of the population. It is slightly more common in women than in men, and is most common in people between the ages of 40 and 70.

And it can cause a range of problems - including pain, stiffness, and loss of function. So it is important that we get the diagnosis and management of this condition right.

To give us more details about this problem and what we can do about it, Kieran Walsh, Clinical Director at BMJ, speaks with Professor Lance LeClerc, Associate Professor of Orthopedic Surgery at Vanderbilt University Medical Centre in Nashville.

For more on adhesive capsulitis, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/1043

Competing interests: None

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. Giuseppe Caruso and Prof. Nicoletta Colombo to discuss updates on PARPi in ovarian cancer. Dr. Caruso is a fifth-year resident in Obstetrics and Gynecology and a first-year fellow of the PhD in “Network Oncology and Precision Medicine” at the Sapienza University of Rome in Italy. Over the past year, he has been attending the Department of Gynecologic Oncology at the European Institution of Oncology (Milan) and had the huge opportunity to follow the clinical, surgical and research activities of an international center of excellence, under the mentorship of Prof. Nicoletta Colombo and Prof. Giovanni D. Aletti. His main interest areas are gynecologic oncology, personalized oncology, clinical research, and medical writing. Prof. Nicoletta Colombo is Chair of Gynecology Program and Director of the Ovarian Cancer Centre at the European Institute of Oncology in Milan. Principal investigators of several international clinical trials and author of several publications, she was President of ESGO and Chair of the ESMO-ESGO-ESTRO Consensus Conference in endometrial cancer (2015) and the ESMO-ESGO Consensus Conference in ovarian Cancer (2018). In 2020, Prof. Colombo received the IGCS Lifetime Achievement Award in recognition of her work in gynecological oncology.

Highlights:

- PARPi should be preferred in the upfront setting for both efficacy and safety reasons.

- Mutational status and platinum response are key factors for personalizing the maintenance treatment.

- Identifying better predictors of resistance to platinum and PARPi is an unmet need.

- PARPi combinations could become a strategy for overcoming PARPi resistance.

- The best treatment algorithm after PARPi progression needs prospective validation.

Everyone has coping mechanisms, but sometimes those ways of coping become problem behaviours - addictions.

In this episode of Doctor Informed, we're focussing on how to spot the signs that you may be sliding into addiction, how to have conversations with friends and colleagues if you worry about their behaviour, and how seeking treatment is the best way to avoid GMC scrutiny.

Joining Clara Munro are Liz Croton and Zaid Al-Najjar, GPs who work for NHS Practitioner health - a mental health and addiction service specifically for health professionals. They are also joined by Ruth Mayall, a retired consultant anaesthetist who has experienced addiction herself, and has contributed to the Association of Anaesthetists guidance on drug and alcohol abuse.

Some resources mentioned in the podcast;

NHS Practitioner Health

https://www.practitionerhealth.nhs.uk/

The Sick Doctor's Trust

http://sick-doctors-trust.co.uk/

British Doctors & Dentists Group

https://www.bddg.org/

Substance use disorder in the anaesthetist

https://anaesthetists.org/Home/Resources-publications/Guidelines/Substance-use-disorder-in-the-anaesthetist

Substance abuse in anaesthetists

https://academic.oup.com/bjaed/article/16/7/236/2196385?login=false

On this episode of the AMSSM Sports Medcast, host Dr. Jake Wessels, MD, is joined by Dr. Katie Rizzone, MD, MPH, and Dr. Megan Burleson, DO, to discuss the upcoming 2023 Collaborative Research Network (CRN) Research Summit on Justice, Equity and Inclusion.

Dr. Burleson and Dr. Rizzone are members of Summit Planning Committee for the one-day conference, which takes place Friday, April 28, in Phoenix, AZ. This conference, will emphasize specific areas within sports and exercise medicine where health disparities have been previously identified or where they need to be further investigated. It will also highlight best practices for conducting meaningful research in the field of sports and exercise medicine through an equity lens.

In this conversation, they address the following topics and questions:

* Origin and mission of the Collaborative Research Network

* The primary aims of the 2023 CRN Research Summit

* The current lack of available research regarding health disparities and how this conference seeks to explore those topics

* Some of the potential outcomes and future research directions of the Summit, and why they will be based on the conversations that happen during the conference

* The inclusive nature and applicability of the Research Summit, especially for clinicians who are not heavily involved in research

* Some of the biggest surprises the organizers have experienced while preparing for the Research Summit and the biggest highlights to look forward to

In-person and virtual attendance options are still available for the summit. Find complete details about the Research Summit and register here: https://annualmeeting.amssm.org/researchsummit.php

Dr. Kate Diomede, social media editor at Thorax, is joined by Prof. Nick Hopkinson(1) to delve into the history of smoking policy in the UK, as well as detailing the lay of the land in current smoking-cessation practices, especially pertaining to vaping.

Hear the previous discussion with Prof. Andrew Bush on recent developments in paediatric therapy: https://on.soundcloud.com/PY9Nz

(1) Prof. of Respiratory Medicine, Imperial College London,

Respiratory Consultant, Royal Brompton Hospital,

Associate Editor of Thorax,

Chair of ASH (Action on Smoking in Health) UK Charity

https://twitter.com/COPDdoc

Relevant papers and references:

Millennium cohort – child smoking uptake related to parents and peers smoking https://pubmed.ncbi.nlm.nih.gov/30442657/

Confirming the impact of standardised packaging

https://pubmed.ncbi.nlm.nih.gov/33093164/

Effectiveness of ban on smoking in cars with children

https://pubmed.ncbi.nlm.nih.gov/31988266/

Smoking and increased risk from COVID

https://pubmed.ncbi.nlm.nih.gov/33402392/

https://pubmed.ncbi.nlm.nih.gov/34580193/

Javed Khan’s independent report commissioned by UK Govt: Making Smoking Obsolete

https://www.gov.uk/government/publications/the-khan-review-making-smoking-obsolete/making-smoking-obsolete-summary

Cochrane systematic review suggests vaping is more effective for smoking cessation than NRT

https://www.cochrane.org/CD010216/TOBACCO_can-electronic-cigarettes-help-people-stop-smoking-and-do-they-have-any-unwanted-effects-when-used

Recent evidence update on risk of vaping for OHID concludes, “vaping poses only a small fraction of the risks of smoking.”

https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidence-update-summary

NICE guidance on nicotine vapes to help smokers quit https://www.nice.org.uk/guidance/ng209/chapter/recommendations-on-treating-tobacco-dependence#stop-smoking-interventions

British Thoracic Society guidance on tobacco harm reduction

https://www.brit-thoracic.org.uk/document-library/governance-and-policy-documents/position-statements/tobacco-and-smoking-march-2020/

National Centre for Smoking Cessation Training

https://www.ncsct.co.uk/publication_Support_stop_vaping.php

Cigarette Smoking: An Assessment of Tobacco's Global Environmental Footprint Across Its Entire Supply Chain

https://pubs.acs.org/doi/10.1021/acs.est.8b01533

ASH: Use of e-cigarettes (vapes) among young people in Great Britain

https://ash.org.uk/uploads/Use-of-e-cigarettes-among-young-people-in-Great-Britain-2022.pdf

Competing interests: None declared.

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This week, we're going to be returning to a guest we heard from a while ago - Claire Kaye.

Claire was a GP before deciding to become a coach, and we found her way of thinking through our wants and needs so useful, we decided to invite her back.

This week we're going to be talking about that holding onto that feeling of excitement you had at the beginning of your career, a feeling that's difficult to hold onto, as the pressures on general practice mount.

Our guest:

Claire Kaye, formerly a GP, is an executive coach. She specialises in career development.

Instagram: @drclairekayecoaching

LinkedIn: @drclairekaye

Website: www.drclairekaye.com