CMAJ Podcasts

On 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 symptoms align specifically with the luteal phase—the final two weeks of the menstrual cycle. Dr. Brennand also discusses evidence-based treatments, including SSRIs, oral contraceptives, and, in severe cases, GnRH agonists.This episode provides valuable insights into diagnosing and managing PMDD, helping physicians better support their patients.For more information from our sponsor, visit rainbowhealthontario.caComments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

In this enlightening discussion, Nicholas Fabiano, a psychiatry resident at the University of Ottawa, and Rachelle Opie, an expert dietitian specializing in eating disorders, share insights on the connection between diet and depression. They explore how diets high in inflammation can exacerbate symptoms and highlight findings from the SMILES trial, which showed that dietary interventions like the Mediterranean diet can significantly reduce depression. Opie emphasizes patient-centric dietary changes, advocating for trauma-informed approaches that focus on positive additions rather than strict restrictions.

On 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, options for management, and a supportive environment. She emphasizes that emergency departments, often overstretched and lacking privacy, are not designed for the unique needs of early pregnancy loss patients. Instead, she argues for dedicated spaces staffed by trained personnel, including nurses and counselors, who can provide both medical care and emotional support.Together, they explore practical solutions, including integrated care pathways outside of emergency departments, self-referral options, and the provision of bereavement resources. Dr. Tunde-Byass advocates for a holistic approach that could be standardized across Canadian hospitals, enabling patients to access sensitive, informed care without the retraumatization that often comes from repeating their stories in high-stress environments.To learn more about exciting physician careers from our sponsor, Vancouver Coastal Health, visit vch.ca/jobyouwantFor more information from our sponsor, visit rainbowhealthontario.caComments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Joining the conversation are Caroline Cristofaro, a resident chair advocating for wellness in orthopedic residency, and Maryse Bouchard, an associate program director at the University of Toronto. They discuss critical barriers faced by surgical residents balancing parenthood with demanding careers. Their insights highlight the need for policy reforms like flexible schedules and institutional support. Cultural issues, such as the glorification of overwork, are also addressed, emphasizing the importance of compassionate leadership and open dialogue to foster a more supportive environment.

On 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 that while there are "little teeny, tiny occasional tales of change" happening now, such as program directors becoming more aware of neurodiversity and making small accommodations for students, these changes are still incremental. He expresses hope that this will continue to evolve, leading to broader acceptance and support for neurodiverse individuals in the medical profession.He further argues that including neurodiverse physicians enriches the profession in several ways. By challenging rigid norms in medicine, neurodiverse individuals push the profession to be more inclusive and compassionate. They also provide care that is uniquely attuned to the needs of neurodiverse patients, offering identity-aligned support that can enhance patient satisfaction and outcomes. Dr. Neilson stresses that by fostering diversity, the profession not only lives up to its values but also improves care for all patients.Comments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

On 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 pain.Her key advice to doctors: listen to patients, explain each step of the procedure, and provide adequate pain management options.Dr. Von Benzon broadens the discussion beyond IUD pain management to the neglect of women’s pain and autonomy during other gynecologic and obstetrical procedures. Her research article "My doctor just called me a good girl, and I died a bit inside: From everyday misogyny to obstetric violence in UK fertility and maternity services," illustrates how women’s pain is frequently dismissed and their consent overlooked. She discusses the long-term impact of these practices, with some women opting out of future pregnancies due to trauma. She advises healthcare professionals to clearly explain procedures, seek consent, and prioritize patient comfort and autonomy.Dr. Omole and Dr. Bigham reflect on how patriarchal structures and time constraints within healthcare systems often lead to the failure to prioritize women’s pain and autonomy. The episode closes with a powerful call for healthcare providers to take the time to listen to their patients, ask questions, and ensure that consent and comfort are prioritized at every stage of care.For more information from our sponsor, go to Rainbow Health Ontario.Comments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

On 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 on physicians or AI alone.The episode also looks at the potential future of AI in medicine, with Dr. Verma sharing insights on how AI tools should be thoughtfully integrated to support clinicians without overwhelming them. He stresses the need for AI systems to fit seamlessly into clinical workflows, ensuring patient care remains the priority. While AI is currently a tool to assist clinicians, Dr. Verma argues that the full extent of AI's role in healthcare—and its impact on the physician's place within it—remains ultimately unknowable.For more information from our sponsor, go to medicuspensionplan.comComments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

On 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 disease in university settings, where asymptomatic carriers of Neisseria meningitidis can unknowingly contribute to the spread of the infection.Dr. Rani expands on the current state of MenB vaccination, explaining why the vaccine is not included in routine immunization schedules and outlining the challenges of securing broader vaccine coverage across the country. She emphasizes the importance of early detection, given that meningitis can present with nonspecific symptoms which complicates diagnosis.Megan Plamondon’s story brings a lived experience perspective to the conversation, highlighting the severe impact of meningococcal disease and the critical need for prevention efforts, particularly among students entering congregated living environments for the first time.Comments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

On 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 explore the structural failures, embedded cultures, and the detrimental role "a few bad actors" can have on the effectiveness of entire teams. The conversation underscores the importance of prioritizing healthy communication practices, cultivating respect within healthcare teams, and the essential role leadership needs to play in combating incivility to safeguard patient care.The episode begins with a conversation with Dr. Armand Aalamian, a family physician and executive director at the Canadian Medical Protective Association. He is a co-author of the article in CMAJ titled, "Five things to know about…Physician incivility in the health care workplace.” Dr. Aalamian reviews the evidence of the pervasive nature of incivility in health care, its detrimental effects on professional relationships, and its direct correlation to patient outcomes. The discussion not only highlights the problem but also proposes actionable solutions, emphasizing, once again, the role of leadership in fostering a culture of civility.This episode is structured to arm medical professionals with both an understanding of the causes of incivility and the skills to combat it.Comments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

On 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 cardiovascular issues and the potential for seizures. She emphasizes the need for behavioral interventions and technological tools, such as mobile apps, to aid in vaping cessation. Dr. Tulloch also highlights the critical role of parental involvement in supporting youth through their journey to quit vaping.The conversation covers recent regulatory efforts, including Ontario's ban on vaping in schools, and calls for stronger enforcement and possible bans to protect young people. The guests argue for more stringent measures and better education to mitigate the health risks of vaping among adolescents.Throughout the episode, the guests underscore the urgent and serious nature of adolescent vaping, and the need for immediate action. They advocate for a multifaceted approach that combines policy responses, such as increased taxation with comprehensive education for parents and young people about the dangerous and addictive nature of vaping.For more information from our sponsor, go to medicuspensionplan.comComments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions