In this episode of the RCP Medicine Podcast, we explore the pressing challenges facing resident doctors in the NHS and the transformative work of the Next Generation campaign. Joining us is Professor Mumtaz Patel, President of the Royal College of Physicians, Vice President for Education and Training, and Chair of the Next Generation Oversight Group. Professor Patel shares her extensive experience in medical education and workforce planning, offering candid insights into recruitment pressures, training reform, and the future of postgraduate medical education.

Alongside Professor Patel, Dr Jemima Sellicks, a resident doctor and committee representative, brings a frontline perspective on the realities of training today. Together, they discuss competition ratios, the IMT application process, exam integrity, and the results of the recent Next Generation survey, which revealed stark concerns about burnout and retention.

Whether you’re a trainee, educator, or policymaker, this episode offers practical solutions, hope for systemic change, and a call to action for shaping a fairer, more supportive training environment.

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In this episode of the RCP Medicine Podcast, we explore the critical issue of health inequalities during pregnancy and the postpartum period. Joining us is Dr Maria Mouyis, Consultant Physician & Rheumatologist with Specialist Interest in Obstetric Medicine, alongside Dr Vasiliki Thanopoulou, RCP clinical education fellow, Rheumatology/GIM Specialist Registrar. Together, they unpack why pregnancy itself can be a risk factor for health inequality, the findings from the MBRRACE report, and the systemic, cultural, and clinical challenges that impact maternal and neonatal outcomes.

From disparities in maternal mortality among ethnic minority groups to the role of unconscious bias and digital exclusion, this conversation highlights practical steps clinicians can take to improve equity in care. We also discuss innovative initiatives such as maternal medicine networks, preconception clinics, and community engagement projects that aim to empower women and reduce adverse outcomes.

Whether you’re a clinician, policymaker, or advocate, this episode offers actionable insights and resources to help drive change.

Resources: 

UK Obstetric Surveillance System (UKOSS) | UKOSS | NPEU

Reports | MBRRACE-UK | NPEU

Special interest groups | British Society for Rheumatology

Eastern Obstetric Medicine Group: EOMG Meetings | MacDonald Obstetric Medicine Society

Multidisciplinary Approaches to Maternal Health - elearning for healthcare

Racism in pain management causes needless suffering | The BMJ

FIVEXMORE

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In this collaborative episode between the RCP Medicine Podcast and the British Society for Rheumatology’s Talking Rheumatology series, consultant rheumatologist Dr Tam Malley from the Royal Free Hospital joins Dr Vasiliki Thanopoulou, RCP Clinical Education Fellow and registrar, to explore the complexities of inflammatory myositis. Through a compelling case study and rich clinical discussion, they unpack the diagnostic challenges, multidisciplinary considerations, and treatment strategies for this rare autoimmune condition.

Listeners will gain insights into recognising subtle signs, interpreting investigations, and understanding the importance of early intervention. Whether you're a rheumatologist, general physician, or trainee, this episode offers practical pearls and thoughtful reflections on managing inflammatory myositis in real-world settings.

Resources

Idiopathic inflammatory myopathies - Symptoms, diagnosis and treatment | BMJ Best Practice

British Society for Rheumatology guideline on management of paediatric, adolescent and adult patients with idiopathic inflammatory myopathy | Rheumatology | Oxford Academic

International Guideline for Idiopathic Inflammatory Myopathy-Associated Cancer Screening: an International Myositis Assessment and Clinical Studies Group (IMACS) initiative | Nature Reviews Rheumatology

Polymyositis Masquerading as Motor Neuron Disease | Neurology | JAMA Neurology | JAMA Network

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In this RCP Medicine podcast and BSR Talking Rheumatology podcast collaboration Dr Roz Benson and Dr Lisa Waters discuss a challenging case of a patient with an acute hot joint who presented to the acute medical unit. It covers wide ranging topics including diagnosis and management of gout, investigation of the acute hot joint and how to treat septic arthritis. Dr Roz Benson is a Consultant Rheumatologist at NHS University Hospitals of Liverpool Group, BSR Digital Learning Editor, and Talking Rheumatology host and Dr Lisa Waters is a Rheumatology and Acute Medicine Consultant at Manchester University Hospitals. She is clinical lead for Acute Medicine and a former RCP Chief Registrar.

Resources 

NICE: Diagnosis and management of gout

https://www.nice.org.uk/guidance/ng219/chapter/Recommendations

The British Society for Rheumatology Guideline for the Management of Gout 

https://academic.oup.com/rheumatology/article-abstract/56/7/e1/3855179?redirectedFrom=fulltext

If you liked this check out related Talking Rheumatology spotlight episodes 

• Episode 9 - Diagnosis and management of gout
• Bonus episode - a tricky case of infection and arthritis

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In this episode of the RCP Medicine Podcast, Dr Sagen Zac-Varghese, Consultant in Diabetes and Endocrinology, East and North Herts Teaching NHS Trust is joined by Dr Samantha Scholtz , Consultant Psychiatrist, Imperial Weight Centre, St Mary’s Hospital to explore the complex relationship between obesity and mental health. Drawing on clinical experience and recent research, they discuss the stigma surrounding obesity, its psychological impact, and how healthcare professionals can better support patients. The conversation covers the physiological drivers of weight regain,  and the evolving role of bariatric surgery and GLP-1 agonists in treatment. Dr Scholtz  also shares practical advice on screening for mental health disorders, managing eating behaviours, and navigating sensitive conversations in clinical settings.

Resources

RCP elearning - Obesity

Binge eating disorder: 

https://www.beateatingdisorders.org.uk/

https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/binge-eating-disorder

https://www.nationaleatingdisorders.org/feast-resources/

Weight stigma:

https://www.worldobesity.org/what-we-do/our-policy-priorities/weight-stigma

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In this episode of the RCP Medicine Podcast, Dr Lisa Hamza, HIV and Sexual Health Consultant at St George’s Hospital, London, joins Dr Rohan Mehra, Infectious Diseases and Microbiology Registrar, to explore the evolving landscape of HIV care. Together, they delve into the virology, history, and treatment of HIV, highlighting the remarkable progress made over the past four decades - from the early days of the epidemic to today’s cutting-edge therapies and prevention strategies.

Dr Hamza shares insights from her work as HIV Network Lead in South West London and co-chair of the HIV London Forum, discussing the challenges of stigma, late diagnosis, and health inequalities. The conversation also covers the UK’s HIV Action Plan, the impact of opt-out testing, and the promise of long-acting treatments and pre-exposure prophylaxis (PrEP). This episode is a powerful reminder of how far we've come and how much further we must go to reach zero transmissions, zero deaths, and zero stigma.

RCP Archive, Heritage Library and Museum 

The Royal College of Physicians Heritage library, Archive and Museum are seeking to collect objects, documents and publications to reflect the experiences of physicians delivering HIV/AIDS care and people living with HIV/AIDS. Further information can be found at: https://history.rcp.ac.uk/collections/call-for-donations-related-to-HIV-AIDS

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In this episode of the RCP Medicine podcast, we delve into the complexities of obesity and the importance of person-centred care. Hosted by Dr Vasiliki Thanopoulou, a rheumatology and general internal medicine specialist registrar and RCP Clinical Education Fellow, she is joined by Dr Charles Fox and Dr Anne Kilvert, both retired consultant diabetes physicians with over 30 years of experience in teaching healthcare professionals how to deliver empowering, person-centred care.

Together, they explore how stigma, unconscious bias, and assumptions can hinder effective communication and care for people living with obesity. Drawing on NICE guidelines and their own clinical experiences, Anne and Charles offer practical strategies for fostering empathy, respect, and shared decision-making in clinical encounters. This episode complements the RCP’s e-learning modules on obesity and is part of the broader initiative to address health inequalities.

Whether you're a clinician, educator, or learner, this conversation will challenge you to rethink how you approach weight-related discussions and empower patients to take control of their health journey.

Resources

RCP elearning - Obesity

NICE guidelines: Overweight and obesity management | Guidance | NICE

Lancet: Definition and diagnostic criteria of clinical obesity - The Lancet Diabetes & Endocrinology

The European Association for the Study of Obesity: A new framework for the diagnosis, staging and management of obesity in adults - EASO

Dr Charles Fox and Dr Anne Kilvert: www.diabetescounselling.co.uk

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In this episode of the RCP Medicine Podcast, Dr Vincent Simpson, diabetes and endocrine registrar based in Derriford, Plymouth joins Dr Bryony Alderman, palliative medicine consultant and RCP Education Fellow in Sustainability. Together, they explore the intersection of diabetes care and environmental sustainability, focusing on Vincent’s pioneering work around reusable cartridge insulin pens.

From the initial spark of curiosity during a training session to national-level conversations with NHS England, Vincent shares his journey of uncovering the environmental impact of diabetes devices and advocating for change. The discussion covers practical steps clinicians can take, the importance of behavioural change, and how small interventions can lead to significant improvements in both patient care and environmental outcomes.

Whether you're a physician, policymaker, or someone living with diabetes, this episode offers valuable insights into how sustainability can be seamlessly integrated into clinical practice.

Dr Vincent Simpson and team recently won an RCP Excellence in Patient Care award for Sustainability – reducing the environmental impact of healthcare 

Resources

Paper: https://onlinelibrary.wiley.com/doi/10.1111/dme.15409

Local guidelines: https://sustainablediabetes.short.gy/guidelines

Website: https://sustainablediabetescare.com

Linkedin: https://uk.linkedin.com/in/dr-vincent-simpson

Bluesky:https://bsky.app/profile/drvsimpson.bsky.social

Credits

Dr Bryony Alderman, consultant in palliative medicine, is the RCP Sustainability Fellow. Financial support for this clinical fellowship was provided as an Independent Medical Education Grant from Pfizer Limited. Pfizer Limited had no involvement in candidate selection, and no influence on the work of the clinical fellowship.

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In this episode of the RCP Medicine Podcast, Consultant Respiratory Physician Milind Sovani joins Respiratory Registrar Daniella Draicchio and Foundation Doctor Masooma Ali to explore a compelling case of progressive breathlessness in a 45-year-old woman. What begins as a seemingly routine presentation unfolds into a diagnostic journey.

Together, the team discusses the challenges of diagnosing chronic type 2 respiratory failure, the importance of recognising paradoxical breathing, and the role of non-invasive ventilation and surgical intervention. This episode is a masterclass in clinical reasoning, multidisciplinary collaboration, and the value of thorough bedside examination.

We would like to acknowledge Dr Patience Ehilawa, Consultant Respiratory Physician at Nottingham University Hospitals , for her contribution to the content design and planning of this podcast.

References

• A retrospective cohort study of idiopathic diaphragmatic palsy: a diagnostic triad, natural history and prognosis ERJ Open Research 2021 00953-2020; DOI: https://doi.org/10.1183/23120541.00953-2020 
• Diagnosis and management of nontraumatic unilateral diaphragmatic paralysis (complete or partial) in adults - UpToDate
• Treatment of diaphragmatic paralysis using an expanded surgical protocol: review of the largest worldwide experience  European Respiratory Journal 2018 52 (suppl 62): PA806; DOI: https://doi.org/10.1183/13993003.congress-2018.PA806 
• Diaphragm dysfunction: how to diagnose and how to treat? Breathe 2025 21(1): 240218; DOI: https://doi.org/10.1183/20734735.0218-2024 

This podcast has been made with an educational grant from Bristol-Myers Squibb Pharmaceuticals Limited (“BMS”). BMS has had no input or involvement in the design, development or content of the podcast whatsoever.

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In this RCP Medicine podcast and BSR Talking Rheumatology podcast collaboration Dr Pip Watson and Dr Rik Patel discuss an interesting case of a patient presenting with headache to the acute take. Topics include tips on history and examination, an update on treatment including the use of tocilizumab and the role of fast-track pathways.  Pip is a Rheumatology Consultant in Manchester,  BSR Digital Learning Editor, and Talking Rheumatology host, Rick is a Rheumatology and Acute Medicine consultant in Manchester, working at one of the specialist centres for vasculitis.

If you liked this check out related Talking Rheumatology spotlight episodes 

• Episode 6 giant cell arteritis
• Episode 14 polymyalgia rheumatica
• Bonus case non GCA headache 

 Resources

NICE GCA guideline https://cks.nice.org.uk/topics/giant-cell-arteritis/

BSR GCA guideline https://academic.oup.com/rheumatology/article-abstract/59/3/e1/5714024?redirectedFrom=fulltext

GCAPS paper https://ard.bmj.com/content/83/Suppl_1/1100.2

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