RCP Medicine Podcast

What does it mean to be a good doctor when so much illness is produced beyond the walls of healthcare?

In this episode of the RCP Medicine Podcast, Dr Rohan Mehra speaks with paediatrician, public health researcher and broadcaster Dr Guddi Singh about health inequality, medical professionalism and her emerging concept of Justice-Based Medicine.

Drawing on clinical experience, doctoral research and her BBC Radio 4 series Three Ages of Child, Dr Singh explores how poverty, housing, food insecurity, education and structural inequality enter the consulting room - and why understanding these conditions makes us not only more compassionate, but more clinically effective.

The conversation examines the moral injury clinicians experience when they know what patients need but cannot provide it; the limits of the traditional “heroic fixer” model of medicine; and how physicians can combine scientific excellence with social understanding, collaboration and moral courage.

The episode also highlights communities already creating health beyond formal healthcare settings, and the work of WHAM - the Wellbeing and Health Action Movement - to help clinicians turn concern about inequality into practical, collective action.

BIOGRAPHY: Dr Guddi Singh is a Cambridge- and Harvard-trained neurodevelopmental and social paediatrician, public health researcher and broadcaster whose work explores what it means to practise good medicine when so much ill health is socially produced. Working clinically on the frontline and academically at King’s College London, her doctoral research examines how health professionals experience and respond to the social determinants of health. Through this work, she is developing the concept of Justice-Based Medicine, combining scientific excellence with social understanding, moral literacy and action on inequality. Guddi has worked with the World Health Organization, co-founded WHAM - the Wellbeing and Health Action Movement - and leads the award-finalist Powering Up programme. She was named a Global Top 30 Improver by the International Forum on Quality and Safety in Healthcare. Her broadcasting includes work for the BBC, Channel 4 and Al Jazeera, including the award-winning BBC One documentary, Why Is Covid Killing People of Colour?, and BBC Radio 4’s hugely influential Three Ages of Child.

Resources 

• WHAM: https://www.whamproject.co.uk/
• Three Ages of Child: https://www.bbc.co.uk/sounds/series/m002k385
• Race and Health Matters, a podcast on workforce inequality for the NHS Race and Health Observatory https://www.youtube.com/@nhsraceandhealthobservatory
• More than Medicine substack: https://drguddisingh.substack.com/
• "Leadership from below, change from within: revitalising medical professionalism through social justice": https://bmjleader.bmj.com/content/7/Suppl_2/e000817
• RCP Commentary - https://www.rcp.ac.uk/126813

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In this episode of the RCP Medicine Podcast, Dr Raj Amarnani, consultant in sport, exercise and musculoskeletal medicine, Fellow of the Faculty of Sport and Exercise Medicine, and current president of the Royal Society of Medicine Rheumatology and Rehabilitation Section, joins Dr Alice Cole, clinical education fellow at the Royal College of Physicians, to explore how motivational interviewing can support the NHS shift from treatment to prevention.

Raj explains why patients are often not lacking information but are instead overwhelmed, ambivalent or unsure where to start. Together, Raj and Alice discuss how motivational interviewing helps clinicians unlock a patient's own reasons for change, making conversations about physical activity, medication adherence, smoking cessation and other health behaviours more effective and patient-centred.

Using practical examples and role-play scenarios, they demonstrate simple techniques clinicians can introduce immediately, including the OARS framework, ask-offer-ask conversations, confidence scaling and strategies for supporting sustainable behaviour change. They also discuss physical activity guidance, exercise "microdosing" and how even brief conversations can have a lasting impact on patient outcomes.

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Coeliac disease is often viewed as a straightforward gastrointestinal condition, but its presentation, diagnosis and long-term management can be far more complex than many clinicians appreciate.

In this episode of the RCP Medicine Podcast Dr. Dushen Murugiah, Consultant Gastroenterologist and Trust Lead for Nutrition at Royal Surrey County Hospital NHS Foundation Trust, joins Dr Abhishek Ray to explore the modern approach to coeliac disease.

Together they discuss classical and non-classical presentations, the challenges of diagnosing an often under-recognised condition, the role of serology and small bowel biopsy, and the importance of considering celiac disease in patients presenting with unexplained anaemia, nutritional deficiencies and other extraintestinal manifestations. The conversation also explores refractory celiac disease, practical challenges associated with lifelong gluten avoidance, and promising future therapies currently under investigation.

This episode offers practical, evidence-informed insights for physicians, trainees and healthcare professionals involved in the assessment and management of patients with suspected or confirmed coeliac disease.

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In this episode of the RCP Medicine Podcast, respiratory consultant and clinical lead for environmental sustainability Dr Thom Daniels joins host Dr David Charles to explore why air quality should be treated as a core clinical issue rather than a distant environmental concern. Drawing on landmark coroner’s cases, including the deaths of Ella Adoo Kissi Debrah and Awaab Ishak, they examine how outdoor and indoor pollution contribute to asthma, COPD, cardiovascular disease, stroke, dementia and health inequalities across the life course. The discussion covers practical ways to ask about air quality in consultations, from unexplained coughs to secondary prevention clinics, and sets out simple, evidence informed advice clinicians can offer to patients. They also consider policy and global perspectives, racial and social justice dimensions, and how clinicians can support patients who feel fatalistic about the environment.

Resources 

https://www.rcp.ac.uk/policy-and-campaigns/policy-documents/a-breath-of-fresh-air-responding-to-the-health-challenges-of-modern-air-pollution/ 

https://www.rcp.ac.uk/news-and-media/news-and-opinion/air-pollution-linked-to-30-000-uk-deaths-in-2025-and-costs-the-economy-and-nhs-billions-warns-royal-college-of-physicians/

https://www.rcp.ac.uk/media/5r2kmmi4/rcp-full-report-a-breath-of-fresh-air-responding-to-the-health-challenges-of-modern-air-pollution.pdf

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In this powerful and timely episode, Dr Ahmed Seedat — respiratory and general internal medicine consultant, global health specialist, and former policy fellow — joins Dr Krishna Misra, an experienced GP in inclusion health, for an in‑depth exploration of migrant and refugee health. Together with host Dr Rohan Mehra, they unpack the realities facing displaced populations today: from the impact of geopolitical instability and the climate emergency, to the language and stigma shaping public attitudes, to the structural barriers embedded within UK health systems.

Through expert insight and frontline experience, the conversation delves into the drivers of forced migration, the consequences of restricted safe routes, the challenges created by the UK asylum backlog, and the complex interplay between trauma, mental health, and chronic disease. Importantly, the episode also highlights a successful collaborative model between primary and secondary care in South East London — demonstrating the power of relationships, community, and advocacy to improve outcomes for some of the most marginalised people in society.

Listeners will leave with a richer understanding of migrant health, actionable advice for clinicians, and a hopeful reminder that community truly is a superpower.

Resources

Doctors of the World:

Advice line - Doctors of the World

urgent_care_guidelines.pdf

 Home 2026 | Refugee Week

BMA:

Refugee and asylum seeker health resource updated 2025

BMJ:

Knights F, Munir S, Ahmed H, Hargreaves S. Initial health assessments for newly arrived migrants, refugees, and asylum seekers BMJ 2022

Initial health assessments for newly arrived migrants, refugees, and asylum seekers | The BMJ

Other

Maslow's Hierarchy of Needs

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In this episode of the RCP Medicine Podcast, Dr Aula Abbara, consultant in infectious diseases and internal medicine at Imperial College Healthcare NHS Trust and an infectious diseases and malaria advisor to MSF Amsterdam, joins Dr Bryony Alderman, palliative medicine consultant and RCP Sustainability Education Fellow. Together, they explore how climate change is reshaping global health, with a particular focus on infectious diseases, health inequalities, forced displacement, and the increasingly complex connections between environment, conflict, and disease transmission.

Resources
MSF UK | Médecins Sans Frontières

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In this episode of the RCP Medicine Podcast, Professor Jeremy Levy, consultant nephrologist in London, joins Dr Alex Crowe, consultant physician in Liverpool, for an insightful and practical conversation about chronic kidney disease (CKD). Together, they explore why CKD is so common, and often silent. How to distinguish acute from chronic kidney problems, and which investigations matter most.

The discussion also highlights the growing importance of cardiorenal metabolic medicine, offering clinicians a clear approach to assessing risk, optimising treatment, and supporting long‑term health. From EGFR trends to SGLT2 inhibitors, from lifestyle change to coding accuracy, this episode provides an essential, up‑to‑date guide for managing CKD in everyday practice.

Resources 

For kidney sake podcast:  Home | ForKidneysSake.com 

Excellent resources on CKD here from NHS NW London:  Chronic kidney disease

NICE guidelines: Overview | Chronic kidney disease: assessment and management | Guidance | NICE 

Hypertension in CKD from UK kidney association  FINAL UKKA NICE-KDIGO commentary December 2022.pdf

Exercise and Lifestyle in CKD from UK kidney association   Exercise and Lifestyle in CKD clinical practice guideline33_v4_FINAL_0.pdf 

SGLT2i in CKD  from UK kidney association  Sodium Glucose Co transporter 2 - UK Kidney Association.

KDIGO (international) guidelines on CKD management   CKD Evaluation and Management – KDIGO

KIDGO prognosis of CKD by Albuminuria Categories: KIDGO 2012 S126

American Diabetes Association guidelines including CKD   Volume 48 Issue Supplement_1 | Diabetes Care | American Diabetes Association

For Kidneys Sake

For Kidneys Sake is a clinician-led podcast from Imperial College Healthcare NHS Trust and North West London Integrated Care Board, offering practical, evidence-based insight into chronic kidney disease and cardio-renal care. Through short, accessible conversations with experts across primary and secondary care, the series supports shared learning on CKD detection, risk management and integrated patient care. The podcast is for GPs, pharmacists, nurses and multidisciplinary teams, and is relevant for clinicians, patients and anyone interested in improving kidney health.

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In this episode, Dr Bryony Alderman, palliative care consultant and RCP sustainability clinical education fellow, joins Dr Vasiliki Thanopoulou, rheumatology registrar and RCP clinical education fellow, for a wide‑ranging discussion demystifying modern palliative care.

Together they explore how the specialty has evolved beyond end‑of‑life support, highlighting early integration, symptom management across disease groups, and the importance of compassionate, individualised care.

The conversation dives deep into practical clinical considerations: appropriate timing of referrals, anticipatory prescribing, managing medications in renal/hepatic failure, handling chronic disease therapies at the end of life, and common misconceptions around syringe drivers. They also discuss communication challenges, including uncertainty in prognostication, hydration and nutrition decisions, and supporting families during difficult conversations.

This is an essential episode for clinicians looking to enhance confidence and skill in end‑of‑life care, while keeping person‑centred care at the heart of practice.

Resources 

https://www.spict.org.uk/

Lee C, Tran TT, Ross J Anticipatory prescribing in community end-of-life care BMJ Supportive & Palliative Care 2024;14:353-357

https://www.parkinsons.org.uk/professionals/resources/nil-mouth-medication-dose-calculators-and-guidelines

https://www.diabetes.org.uk/for-professionals/improving-care/clinical-recommendations-for-professionals/diagnosis-ongoing-management-monitoring/end-of-life-care

https://www.nacel.nhs.uk/about-nacel

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In this episode of the RCP Medicine Podcast, Professor Ewan Forrest, Consultant Hepatologist at the Glasgow Royal Infirmary, joins Dr Jennifer Tham, Gastroenterology Trainee in the West of Scotland, to explore the diagnosis and management of alcohol related hepatitis. A common but often misunderstood emergency presentation.
 
Through a detailed case, they unpack diagnostic challenges, key blood markers, distinguishing features from decompensated cirrhosis, and the practical steps clinicians should take in the first 72–96 hours. The episode also demystifies prognostic scoring systems, steroid use, nutritional support, and the future direction of ARH research and management.

Note:

This recording was made in 2025. In March 2026 NHS Blood and Transplant agreed to a further pilot of liver transplantation for selected patients with Alcohol-related hepatitis.
 

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In this episode of the RCP Medicine Podcast, transplant hepatologist Dr Mhairi Donnelly joins gastroenterology trainee Dr Jennifer Tham to explore the high‑stakes world of acute liver failure.

Through a detailed case of a young woman presenting with severe transaminitis and paracetamol toxicity, Mhairi and Jennifer guide listeners through the crucial steps in recognising acute liver injury, identifying early markers of deterioration, and escalating care at the right time.

The discussion covers the most common causes of acute liver failure in the UK, how to interpret markedly raised transaminases, the role of NAC beyond confirmed paracetamol toxicity, the importance of monitoring lactate and INR trends, management of hepatic encephalopathy in acute liver failure, and how psychiatric assessment influences transplant suitability. A must‑listen for anyone managing acutely unwell medical patients or seeking to deepen their understanding of this life‑threatening condition.

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