Next time you’re squinting at a chest tube, feel confident you know exactly what to look for and why. Hear it explained in a way that really sticks!

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🔹 Transcript & Show Notes

Timestamps:

(02:50) | Xray vs. POCUS vs. CT for Pneumothorax Diagnosis

(07:29) | Do All PTXs Need Chest Tubes?

(11:55) | Explaining Pneumothorax to Patients

(14:58) | Understanding the Pleural Drainage System

(26:11) | Monitoring Air Leaks with the Water Seal Chamber

(32:27) | Managing Persistent Air Leaks

Tags: CoreIM, Internal Medicine, Pulmonology, Critical Care, Medical Education, 3-Chamber Drainage System, Endobronchial Valves and Pleurodesis

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How do you work up neutropenia? When is neutropenia benign? When do neutrophils recover? How can you diagnose neutropenic fever in the first 15 minutes and start antibiotics in the first 60 minutes? Do you always add MRSA coverages? Only Pseudomonas coverage? When do you add fungal coverage?

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🔹 Transcript & Show Notes

Timestamps:

(02:24) | Approach to Neutropenia & Duffy Null

(11:38) | Dose and duration-dependent neutropenia vs. immune-mediated neutropenia

(19:46) | When do neutrophils recover?

(29:56) | Classifying Neutropenic Fever Syndromes

(29:53) | Strategies for Managing Low-Risk Neutropenic Fever

(33:02) | Antimicrobial Therapy and Duration in Febrile Neutropenia

Tags: CoreIM, Internal Medicine, Oncology, Hematology, Medical Education, Physician Assistant, Nurse Practitioner, Neutropenic Fever Management, Antibiotics

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Have a good laugh and reflect deeply with these three stories that hit the feels in different ways.

If you'd love to hear more stories from Dr. Maria Rosasco, check out some of her other appearances on the podcast: July Stories and Handoffs & Contingency Planning.

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🔹 Transcript and Show Notes

Timestamps:

(01:04) | Story 1: Sharing a Personal Story for Patient Care

(03:42) | Story 2: Leading a Family Meeting

(06:52) | Story 3: Early Days of the COVID-19 Pandemic

(10:22) | What Rituals and Values Guide Your Path in Medicine

Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Narrative Medicine, Humanities

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What went wrong? What were the reasoning or contextual missteps that led us astray?

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🔹 Transcript and Show Notes

Timestamps:

(00:02) | Case Presentation and Initial Diagnosis

(02:47) | Tachycardia and Early Impressions

(04:10) | Clinical Deterioration and New Clues

(07:19) | Problem Representation and Reflection

(21:45) | Lessons on Reasoning and Bias

(26:55) | Final Takeaways and Action Steps

Tags: Clinical Reasoning, Internal Medicine, Diagnostic Accuracy, Hoofbeats, Cognitive Bias, Medical Education, Illness Scripts

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• Imaging Pearls | (01:12)
• Deciding on Thoracentesis | (04:00)
• Light’s Criteria and Pseudoexudates | (07:00)
• Pleural Fluid Studies: pH and Cell Differential | (16:56)
• Diagnosing and Treating Parapneumonic Effusions | (23:32)
• Malignant Pleural Effusions: Diagnosis and Management | (30:39)

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🔹 Transcript and Show Notes

Tags: Internal Medicine, Medical Education, Pulmonology, CoreIM, Clinical Reasoning, critical care, pulm

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Listen for some good laughs and relatable stories!

In this episode, we share raw and real stories from July — from rapid responses to unexpected kindness — and reflect on the emotional weight of starting out in medicine.

🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025

🔹 Transcript and Show Notes

Prior July Stories:

July Stories 2.0 (2023)

July Stories (2019)

Timestamps:

(00:32) | Dr. Ali Trainor's First Day as an Intern

(03:00) | The Patient's Critical Condition and Emotional Response 

(07:12) | Dr. George Tran's First Night Shift 

(10:38) | Dr. Ali Trainor's Second Rotation Experience 

(14:01) | The Importance of Co-Intern

Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Narrative Medicine, Humanities

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How much do beta blockers help after a heart attack, even when the heart’s pumping well? In this episode, we revisit the origins of beta blockers in post-MI care, examine how evidence evolved, and explore the REDUCE-AMI trial, which questions whether beta blockers are still needed for all.

Listen to this latest episode of Beyond Journal Club, a collaboration between Core IM and NEJM Group, where we put research into context tracing the arc of evidence, dissecting the clinical question, and exploring what the findings could mean for real-world patient care

🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply!

🔹 Transcript and Show Notes

Timestamps:

(00:48) | Background on Beta Blockers and Their Mechanism

(02:41) | Historical Context of Beta Blockers in Heart Disease

(04:56) | Capricorn Trial and Its Impact

(07:17) | Emergence of Doubts About Beta Blockers

(10:09) | Introduction to the REDUCED-AMI Trial

(15:52) | Discussion on Trial Interpretation and Clinical Implications

(16:18) | Comparison with Other Trials and Future Directions

Tags:  CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Cardiology

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🔹 What is invasive fungal disease, and who is most at risk for developing invasive fungal disease? (~ 02:46)

🔹 What are the main classes of fungi? (~11:35)

🔹 What are the pros and cons of B-D Glucan and Galactomannan (~19:16)

🔹 How to increase the yield of blood cultures? How to interpret yeast growth in sputum/BAL and urine cultures? (~ 30:42)

🔹 How is invasive fungal disease treated? (~ 35:14)

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📌 Transcript & show notes

Tags: CoreIM, IMCore, Infectious Disease, Hospital Medicine, Hospitalist, ICU, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, mold

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🔹What are clinically relevant limitations of an A1c vs. a CGM (1:40)

🔹What do the different parts of the ambulatory glucose profile tell you? (09:59)

🔹What are common pitfalls, medications, lifestyle patterns that are important to ask your patient about when seeing them for a visit to manage blood sugar? (15:19)

🔹 How can you titrate insulin based on when you see the hypoglycemia on the ambulatory glucose profile (20:00)

🔹 When there is too much hyperglycemia, how do you titrate insulin when adding on GLP-1 agonists? (26:30)

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📌 Transcript & show notes

Tags: CoreIM, IMCore, Endocrinology, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, diabetes management, insulin titration

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🔹When is an U/S vs. CT vs. MRI helpful before consulting Interventional Radiology?

🔹What factors go into an IR pre-op evaluation?

🔹 When do drains go in, and when do they come out?

🔹 When a patient has trouble with a drain, what are things you can do before calling IR?

🔹 What does outpatient IR follow up entail, and what does a capping trial of PCN tubes entail?

📌  Sponsor: Oakstone CME’s ACP MKSAP Audio Companion

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Transcript & show notes

Tags: CoreIM, IMCore, Gastroenterology, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, Medical Imaging, Bleeding Assessment, Drain Management, Procedural Sedation

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