Cmaj Podcasts

Send us a textOn this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore a surprising case of scurvy. The conversation builds on the CMAJ practice article “Scurvy in a 65-year-old woman with severely limited function and social supports,” co-authored by Dr. Sally Engelhart, an internal medicine specialist at Mount Sinai Hospital.Dr. Engelhart recounts the case of her patient, whose unexplained bruising and other symptoms led to a diagnosis of a rarely seen condition, scurvy. She explains how food insecurity and a diet lacking fruits and vegetables contributed to the patient’s condition and discusses the practical steps taken to diagnose and treat her.Dr. Gary Bloch, a family physician at St. Michael’s Hospital and Inner City Health Associates, expands on the broader issue of food insecurity as a driver of nutritional deficiencies. He shares actionable strategies for identifying at-risk patients and connecting them with community resources, while highlighting the importance of addressin

Send us a textOn this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore Premenstrual Dysphoric Disorder (PMDD), a debilitating condition affecting 5% of people who menstruate, yet it is often misdiagnosed or misunderstood. The conversation builds on insights from the CMAJ article, “Five things to know about…: PMDD,” co-authored by Dr. Erin Brennand, an associate professor at the Cumming School of Medicine in Calgary.Abhi Bala shares her lived experience with PMDD, describing the profound impact of cyclical depressive symptoms, suicidal ideation, and emotional dysregulation on her life. Her journey from misdiagnosis to awareness highlights the importance of tracking symptoms and recognizing patterns linked to the menstrual cycle, which can lead to earlier diagnosis and treatment.Dr. Brennand explains how PMDD is frequently mistaken for depression or bipolar disorder, delaying accurate diagnosis and treatment. She highlights the importance of recognizing that PMDD's cyclical sympto

Send us a textOn this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham discuss the growing evidence around the impact of diet on mental health, particularly depression. The conversation is inspired by the CMAJ practice article, “Diet and depression,” co-authored by Dr. Nicholas Fabiano.Dr. Fabiano explains how the mechanistic connection between diet and depression is not well understood, but it is theorized that diets known to promote inflammation may play a part in exacerbating symptoms. He highlights findings from the SMILES trial, which demonstrated how dietary interventions like the Mediterranean diet—rich in leafy greens, fish, fruits, and whole grains—reduced depression symptoms in trial participants.Dr. Rachelle Opie, an accredited practicing dietitian and credentialed eating disorder clinician, offers practical advice on how physicians can coach patients toward dietary changes in a way that is inclusive, sustainable, and sensitive to individual needs. Drawing from her work on the SMI

Send us a textOn this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham speak with Dr. Sarina Isenberg and Dr. Modupe Tunde-Byass about the emotional and systemic challenges surrounding early pregnancy loss care in Canada. The conversation builds on themes from the recent CMAJ article, “Diagnosis and management of early pregnancy loss,” in which the authors advocate for a dedicated EPL pathway to care that bypasses the emergency department.Dr. Isenberg shares her personal experiences with early pregnancy loss and the stark disparity in care she received—from a lack of empathy in an emergency room to comprehensive support in a specialized clinic. Her story underscores the spectrum of care needed, particularly access to emotional support during one of the most vulnerable times in a patient’s life.Dr. Tunde-Byass, co-author of the CMAJ article and an obstetrician at North York General Hospital, highlights the success of dedicated early pregnancy loss clinics, which provide timely diagnosis, opti

Send us a textOn this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore the structural and cultural barriers faced by surgical residents and early career surgeons in balancing parenthood with their careers. The conversation centers around the points raised in the CMAJ article “Policies to better support childbearing surgeons”, which outlines the need for reforms to better accommodate surgical residents during pregnancy and early parenthood.The discussion highlights how surgeons experience higher rates of infertility and pregnancy complications, independent of age or other potential risk factors. Dr. Caroline Cristofaro and Dr. Maryse Bouchard, the article’s co-authors, propose solutions such as flexible call schedules, protected time for prenatal and postnatal appointments, and clear institutional guidelines supporting the needs of pregnant surgeons.Beyond structural barriers, the prevalent culture within surgical departments, such as the glorification of exhaustion and the perception

Send us a textOn this episode of the CMAJ Podcast, Dr. Kirsten Patrick speaks with Dr. Shane Neilson, the author of a CMAJ Encounters article entitled, “Professional stigmatizations.” Dr. Neilson is a physician, writer, and academic, who shares his experiences navigating medical school and practice as a neurodiverse physician with bipolar disorder and autism. Dr. Neilson reflects on the challenges he faced during medical school, including a moment when a preceptor told him, "There’s something wrong with you," without offering any support or guidance. He shares how this, along with the pressure to conform to normative expectations in medicine, made his training difficult, especially without any accommodations for neurodiverse students.Dr. Patrick relates to these struggles, recounting her own experiences of feeling out of place in medical school. Together, they discuss how the culture of medical education at the time did not accommodate students who did not fit the traditional mold.Dr. Neilson notes

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore effective ways to manage pain during intrauterine device (IUD) insertions. They also address a broader issue: how women’s pain is often neglected during gynecologic procedures, and the failure of physicians to adequately seek consent. They are joined by Dr. Kristina Arion, an obstetrician and gynecologist at the Children's Hospital of Eastern Ontario, and Dr. Nadia Von Benzon, a lecturer and social geographer at Lancaster University.The episode begins with Dr. Arion discussing the CMAJ article she co-authored, which outlines strategies for better management of pain during IUD insertions. She explains that the IUD is recommended as the first-line therapy for birth control and period management by the Canadian Pediatric Society and the Society of Obstetricians and Gynaecologists of Canada. Dr. Arion highlights how patient anxiety, lack of sedation options, and inconsistent practices contribute to unnecessary pa

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss how artificial intelligence (AI) significantly improves the identification of hospital patients at risk of clinical deterioration compared to physician assessments alone. They are joined by Dr. Amol Verma, a general internist at St. Michael’s Hospital in Toronto, an associate professor at the University of Toronto, and the holder of the Temerty Professorship in AI Research and Education, who shares findings from his recent CMAJ article, “Clinical evaluation of a machine learning-based early warning system for patient deterioration”.Dr. Verma explains how the AI system, ChartWatch, analyzes over 100 variables from a patient’s electronic medical record to predict deterioration more accurately than traditional early warning scores like the NEWS score. He discusses how the integration of AI into clinical workflows improves patient outcomes by complementing human decision-making, leading to better results than relying

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore the ongoing public health concern of meningococcal disease, focusing on meningitis B outbreaks in Canadian universities. They are joined by Dr. Cristin Muecke, a medical officer of health in Halifax, and Dr. Savita Rani, a public health specialist at the University of Saskatchewan. The episode also features the personal story of Megan Plamondon, a Queen’s University student who contracted invasive meningococcal disease.The discussion opens with a look at recent meningitis B outbreaks, including cases at Dalhousie University in 2022 and Queen’s University in 2023. The Halifax outbreak led to a targeted vaccination effort offering publicly funded MenB vaccines to students in congregate living environments, such as dormitories and residences.Dr. Muecke provides insights into the Halifax outbreak and the public health response that followed. She discusses the complexities of identifying and controlling meningococcal d

Send us a textOn this episode of the CMAJ Podcast, Dr. Eve Purdy makes it clear what’s at stake when it comes to incivility in medicine. "It's very simple. Incivility kills patients, and that needs to be the single line of every healthcare leader responsible for managing and leading teams.” Dr. Purdy joins Dr. Sarah Kim and hosts, Drs. Blair Bigham and Mojola Omole, for an urgent panel discussion that looks into the deep-seated reasons behind incivility in medical settings. Dr. Eve Purdy is an emergency medicine physician and applied anthropologist at Gold Coast Hospital and Health Service in Australia. She focuses on helping healthcare teams perform at their best. Dr. Sarah Kim is a family physician and an assistant professor in the Department of Family and Community Medicine at the University of Toronto. She's also the Medical Education Health Humanities Lead at Temerty Faculty of Medicine, where she researches the intersection of high performance and hierarchical systems.Together, they explo

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole address the increasingly urgent issue of adolescent vaping. Rates of use of e-cigarettes containing nicotine  by youth in Canada continue to be among the highest in the world. They speak with Dr. Madelynn Hannah, a clinical pharmacist, and Dr. Trisha Tulloch, a pediatrician specializing in adolescent and addiction medicine at CAMH and SickKids Hospital in Toronto. Both co-authors of the CMAJ article "E-cigarette use in adolescents.”  Dr. Madelynn Hannah provides critical insights into the stark differences between nicotine exposure from vaping versus traditional cigarettes, highlighting the unexpectedly high nicotine concentrations found in many vaping products. She also shares her clinical experiences managing adolescents in nicotine withdrawal and the practical challenges of using nicotine replacement therapy (NRT). Dr. Tulloch discusses the broader physiological impacts of nicotine on adolescents, including cardio

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle the complex issue of "socially admitted" patients, sometimes uncharitably referred to as "granny dumping." They explore the factors leading to these non-acute medical admissions, the challenges faced by healthcare providers and innovative solutions to the problem.Dr. Jasmine Mah, a geriatrics fellow at Dalhousie University, shares insights from her qualitative study published in CMAJ, titled "Managing “socially admitted” patients in hospital: a qualitative study of healthcare providers' perceptions". She provides examples of typical “social admissions”, such as patients with chronic conditions whose care circumstances have changed, and highlights the high mortality rates associated with these cases.The discussion moves to the attitudes of healthcare providers towards “socially admitted” patients, the systemic failures leading to these admissions, and potential solutions. Dr. Mah e

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore groundbreaking advancements in HIV treatment and prevention. They examine various innovative approaches that are transforming the landscape of HIV care.Dr. Darrell Tan, a clinician scientist at St. Michael's Hospital and associate professor at the University of Toronto, discusses the article he co-authored, "Long-acting injectable antiretroviral therapy for HIV-1 infection in adults." He explains the newly approved long-acting injectable cabotegravir for PrEP, an integrase inhibitor administered as a deep intramuscular injection administered every two months. Dr. Tan highlights its superior effectiveness compared to daily oral PrEP, emphasizing its adherence benefits and potential to revolutionize HIV prevention. Additionally, he covers the long-acting injectable treatment regimen for HIV, which combines cabotegravir with rilpivirine, administered as two intramuscular injections every one to two mon

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the latest concerns surrounding the H5N1 virus. They explore the current state of its transmission, symptoms and treatments. They also assess our pandemic preparedness and whether we are applying the lessons learned from COVID-19 to this new potential threat.Dr. Robert Kozak, a microbiologist at Sunnybrook Health Sciences Center and co-author of the article "Five things to know about highly pathogenic avian Influenza A: H5N1 Virus," addresses the recent cases of H5N1 transmission from dairy cattle to humans, explaining the symptoms and severity of the infections. He also discusses the current treatments available, the potential for human-to-human transmission, and the need for increased awareness among clinicians.Dr. Thomas Piggott, the Medical Officer of Health and CEO of the city and county of Peterborough, Hiawatha, and Curve Lake First Nation Public Health, provides insights on pandemic preparedness.

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the evidence supporting exercise as an effective treatment option for mild to moderate depression. They explore how exercise might be used effectively and the challenges involved in implementing it for patients.Dr. Nicholas Fabiano, a second-year psychiatry resident at the University of Ottawa, is co-author of the paper "Exercise as treatment for depression." He surveys the evidence showing that exercise can be as effective as antidepressants and psychotherapy for mild to moderate depression. He explains the FITT principle (frequency, intensity, type, and time) for prescribing exercise and stresses the need for setting realistic goals. Dr. Fabiano's article recommends physicians reference a practical guide for exercise for people who have depression, written by Dr. Michelle Fortier and colleagues.Dr. Fortier, a physical activity psychologist and professor at the University of Ottawa’s School of Huma

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle an unexpected yet urgent topic: the resurgence of measles. With rising cases globally and in Canada, they discuss the implications and necessary actions for healthcare professionals.Dr. Sarah Wilson, a public health physician at Public Health Ontario, provides a comprehensive overview of the current measles situation. She explains the factors contributing to the increase in cases, including disruptions to immunization services during the COVID-19 pandemic and preexisting trends in declining vaccine acceptance. Dr. Wilson also highlights the severe complications of measles, especially for vulnerable groups such as children under five, pregnant individuals, and those who are immunocompromised.The conversation shifts to practical steps for healthcare providers. Dr. Wilson details the importance of considering measles in differential diagnoses for patients with fever and rash, particularly those with relevant exposure

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the heated debate over proposed updates to the CanMEDS framework. The controversy ignited when an interim report placed principles of equity, social justice, and anti-racism at the heart of the framework, rather than medical expertise.Dr. Kannin Osei-Tutu, author of a commentary in CMAJ, proposes a new model for CanMEDS that places shared humanity and compassion at the centre. He argues that the current model of medical education and practice needs to be reimagined, as it has resulted in gross systemic inequities in health outcomes that urgently need to be addressed. He calls for expanding and enriching the concept of medical expertise to incorporate principles of inclusive compassion and social justice.Dr. Philip Berger agrees on the need for healthcare to be free from bias, discrimination, systemic injustice, and racism but criticizes Dr. Osei-Tutu’s model and the interim CanMEDS revisions for not placing medica

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore the intricate relationship between medical assistance in dying (MAiD) and palliative care in Canada. They focus on a qualitative study titled "Perspectives of Canadian healthcare leaders on the relationship between medical assistance in dying and palliative and end-of-life care services: a qualitative study," which interviewed 36 professionals from both fields. The study reveals significant gaps in collaboration and coordination, leading to feelings of exclusion among MAiD providers.Dr. Gilla Shapiro, a co-author of the study, discusses the diverse perspectives of health leaders on the integration of MAiD and palliative care services. She highlights the challenges posed by geographical, institutional, and personal factors in standardizing the relationship between these services. Dr. Shapiro shares insights into the initial tensions and the gradual improvements in cooperation, stressing the necessity for

Send us a textOn this episode of the CMAJ Podcast, Dr. Eve Purdy makes it clear what’s at stake when it comes to incivility in medicine. "It's very simple. Incivility kills patients, and that needs to be the single line of every healthcare leader responsible for managing and leading teams.” Dr. Purdy joins Dr. Sarah Kim and hosts, Drs. Blair Bigham and Mojola Omole, for an urgent panel discussion that looks into the deep-seated reasons behind incivility in medical settings. Dr. Eve Purdy is an emergency medicine physician and applied anthropologist at Gold Coast Hospital and Health Service in Australia. She focuses on helping healthcare teams perform at their best. Dr. Sarah Kim is a family physician and an assistant professor in the Department of Family and Community Medicine at the University of Toronto. She's also the Medical Education Health Humanities Lead at Temerty Faculty of Medicine, where she researches the intersection of high performance and hierarchical systems.Together, they explo

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole closely examine anorexia nervosa in male adolescents, a topic that frequently escapes notice. Their discussion highlights the disorder's prevalence, especially among high-risk groups like LGBTQ+ individuals and those from varied racial and ethnic backgrounds. It also underscores the severity of anorexia nervosa in young males and stresses the critical need for early recognition and intervention.This episode features an in-depth conversation with Sterling Renzoni, a fourth-year biochemistry student at Trent University, who shares his personal journey through diagnosis, treatment, and recovery from anorexia nervosa. Sterling's narrative provides valuable insights into the complexities of identifying and treating the disorder in males, highlighting the societal and personal challenges that can impede recognition and care.Next, Drs. Omole and Bigham speak with Dr. Basil Kadoura, an adolescent medicine physician at B