For our NextGen Journeys series, host Hillary Acer sat down with Dr. Brian Le at a major moment of transition as he was just finishing up his residency in family medicine at Adventist Health in Glendale, California. As he embarks on his next chapter, Dr. Le reflects on the highlights of his medical education journey and takes stock of the key lessons he will bring forward with him. “I think the biggest thing that I've learned so far is you really don't know what you don't know, which goes to one of the reasons why I wanted to pursue medicine... there's always an endless pursuit of knowledge and of improving yourself,” he shares. There’s also an endless amount of knowledge coming at today’s clinicians which, he says, requires a good dose of humility. “Those who don't remain humble, in my opinion, can't really thrive in this environment just because there's always something new to learn.” Dr. Le’s learning journey included earning a DO from A.T. Still University School of Osteopathic Medicine in Mesa, Arizona -- one of Osmosis’ key learning partners -- a master's degree in medical health sciences from Touro University in California, and serving as an Osmosis Medical Education Fellow and curriculum consultant.  Considering that wealth of education and experience, it’s no wonder you’re in for a wisdom drop on learning, medicine, and the future of healthcare from one of the newest members of the next generation of caregivers.Mentioned in this episode: A.T. Still University School of Osteopathic Medicine

In this installment of in our Next Gen Journeys series featuring conversations with learners and early career practitioners in medical professions around the globe, we introduce you to Dr. Bradley Max Segal, a physician in the Department of Health, South Africa with a self-described passion for technology and innovation. Although he’s only a few years out of medical school, Dr. Segal has worked extensively at the intersection of healthcare and data science to develop solutions to the challenges found in low resource health systems, often serving as a bridge between technical and clinical teams. “Oftentimes you have groups that are speaking a completely different language so the approach I take is about being aligned in terms of what the problem is, aligning the language and aligning the solution,” he tells Raise the Line host Lindsey Smith. Of course one of the biggest questions in healthcare regarding the use of technology is the role of AI.  On the plus side, Dr. Segal sees great potential for AI chatbots to be used as an extension of very limited clinical staff in under resourced areas leading to improved patient engagement and understanding of their health. He cautions, though, that providers need to develop the ability to discern the quality of the many AI tools that are coming their way at a fast pace. “I think the main skillset that's going to become increasingly relevant is the ability to understand how these systems are evaluated and where they can go wrong. Understanding how not to use them is oftentimes more important than when to use them.” Join us for an insightful conversation on the realities of deploying technology in healthcare especially in low-resource areas.Department of Health South Africa  

Today on Raise the Line, we make a stop in Northern Europe on our ongoing tour of medical education around the globe and bring  you the perspective of Dr. Povilas Ignatavicius, a hepato-pancreato-biliary and liver transplant surgeon and vice dean at Lithuanian University of Health Sciences, which is the largest institution of higher education for biomedical sciences in that country. In particular, Dr. Ignatavicius shares his insights on medical simulation and student evaluations, which are among his areas of responsibility.  As he describes to host Michael Carrese, his school takes an approach to simulation that values a continual presence of instructors and distributes resources so that individual programs such as surgery and nursing can offer access to what he describes as improved simulation technology. “Our students are exposed to medical simulation starting in year one. Our plan for the next year is that they will spend about 30% of the time with medical simulation at different levels,” he explains. This enlightening conversation also touches on the growth of international students at the university, how AI is impacting education, and a key quality that he thinks sets his school apart from others in Europe. Mentioned in this episode: Lithuanian University of Health Sciences

Last year’s declaration by the U.S Surgeon General that loneliness and isolation are a public health crisis was based on research showing that they have a negative impact on mental health, blood pressure, cognitive performance and, most relevant to our discussion today on Raise the Line, immune system function. That’s why it’s important for people dealing with chronic illnesses to stay socially connected at whatever level they are capable of, says our guest Dr. Rose Perry, a neuroscientist and executive director of an applied research non-profit called Social Creatures. “When your symptoms aren't good, being isolated can be like throwing gasoline on the fire. I don't think lack of social connection is a cause of chronic illness, it's really about setting conditions that make healing maximally possible,” she says. At Social Creatures, Dr. Perry and her team create programs designed to help populations at risk for social isolation feel like they are connected and supported.  As she explains to host Raven Baxter of the Cohen Center for Recovery from Complex Chronic Illnesses at Mount Sinai, providers should be aware of programs like hers and affinity groups (e.g. knitting clubs) in their locality and engage in “social prescribing” as part of a treatment plan. “A lot of doctors will develop a resource list so they can pull it up and then kind of matchmake their patient with an organization.” Don’t miss this final episode in our special series on Post-Acute Infection Syndromes where you’ll hear about practical strategies providers can use to help address an often overlooked factor in someone’s ability to be as healthy as possible. Mentioned in this episode:Mount Sinai Health System Steven & Alexandra Cohen Foundation 

Medical school and residency are daunting enough without dealing with a chronic illness on top of it, but that has been the reality for our guest today, Dr. Kyle Dymanus. In this candid interview with Raise the Line host Hillary Acer, Dymanus shares a wealth of wisdom about balancing studies, work and wellbeing gained during her years as a med student at Medical College of Georgia and her current residency in urology at Rush University Medical Center.  A key for her was having a network of supporters outside of her professional circle to help her manage ulcerative colitis, a condition she was hesitant to disclose to colleagues and supervisors. “My friends and family were literally the ones on the ground calling my doctors to schedule appointments and following up when they didn't send medications to my pharmacy. I honestly could not have done it without them,” she shares. On a promising note, Dymanus believes more support is being made available within residency programs as recognition grows about the mental and physical health impacts that can result from the demanding, high stakes work involved. “The traditional thinking with residents and doctors is you need to be strong, you need to kind of suffer through this, but I think a lot of programs are now being more proactive, and they’re providing  supportive resources for residents ahead of time.” Hillary and Dr. Dymanus also touch on her interests in medical device development, outcomes research, quality improvement, and global health inequities. You won’t want to miss this inspiring episode in our Next Gen Journeys series featuring fresh perspectives on education, medicine, and the future of healthcare.Mentioned in this episode:Rush University Medical Center

Having a child with a complex illness can be especially challenging for parents because of differing opinions among providers about causes, symptoms and treatments for disorders such as long COVID and chronic Lyme. “A common theme I would hear from parents is that they really had to push their providers to consider Lyme. Sometimes they even had to beg for testing to be done because it just wasn't considered a possibility,” says Dr. Charlotte Mao, a pediatric infectious disease physician working with leading foundations in the Lyme disease and associated infections arena.  Adding to challenge is that kids often have trouble explaining their symptoms, says Dr. Lael Yonker, a pediatric pulmonologist at Massachusetts General Hospital. “I think takes a lot of patience by the pediatrician, listening carefully to the parents and patient, and really trying to dig into what their symptoms actually mean.” Join host Raven Baxter of The Cohen Center for Recovery from Complex Chronic Illnesses at Mount Sinai as she draws out valuable guidance on how providers can work effectively with both children and parents during a journey laden with uncertainty. Key tips include having humility for the limits of your own knowledge, keeping an open mind for unexpected possibilities and having respect for what patients know about their own body. Don’t miss this wisdom drop from these deeply experienced pediatricians and researchers as our series on Post-Acute Infection Syndromes continues. Mentioned in this episode:Mount Sinai Health System Steven & Alexandra Cohen Foundation 

“Helping patients with complex illnesses is a lot like rock climbing. You're looking for toe holds and finger grips that you can use to get from where you are to where this patient wants to be,” says Dr. Leo Galland, an internist and author who specializes in undiagnosed or difficult to treat illnesses. His fellow guest on this episode of Raise the Line, co-founder of the California Center for Functional Medicine Dr. Sunjya Schweig, agrees and says figuring out that next anchor point depends on taking the time to learn about all aspects of a patient’s life and lifestyle, and building a cooperative relationship with them. “Listening is the first therapeutic step,” he tells host Raven Baxter of The Cohen Center for Recovery from Complex Chronic Illnesses (CoRE) at Mount Sinai. In this deeply informative conversation, both experts underscore that working in this realm requires moving past differential diagnosis and symptom management and persisting in the search for root causes. “You have to embrace the complexity and the individuality of illness. Thinking for yourself and always questioning is really important and, you know, being a real pain in the butt kind of person is what you've got to be,” adds Galland. This special episode is packed with valuable insights on the limits of testing, the role of disease triggers and mediators, the power of lifestyle changes and much more as our series on Post-Acute Infection Syndromes continues. Mentioned in this episode:Mount Sinai Health System Steven & Alexandra Cohen Foundation 

One key theme in this episode of Raise the Line is that attention to details matters for both patients with post-acute infection syndromes and the clinicians helping them as they grapple with often debilitating symptoms caused by dysautonomia, cardiac complications and other disorders. For patients, it’s about paying close attention to their bodies and diet, and being intentional about their use of energy. For providers, it’s listening very carefully to patients as they describe their fatigue, pain, lightheadedness and other symptoms and keeping up with the latest research on  treatments so there are options to offer if there’s little or no progress being made in physical therapy, which is sometimes the case. “Don't just assume therapy is gonna go smooth. It rarely goes smooth. So, have an answer for the patient who says, ‘I'm not feeling better, what should I try next,’” says Dr. David Putrino, director of the Cohen Center for Recovery from Complex Chronic Illnesses (CoRE) at Mount Sinai. It’s also important to set expectations for patients who may think a few weeks of PT will resolve their issues, as is often the case with recovery from an injury. “What we're looking to do is reduce the number of flare-ups that happen, reduce the severity of those flare-ups, and ideally reach a point of symptom stability,” says Dr. Jenna Tosto, a leading expert in neurophysiological rehabilitation at Mount Sinai. To help patients understand the amount of progress happening, if any, host Dr. Raven Baxter, a long COVID patient herself, says keeping a daily journal and using fitness trackers can reveal important details. This expansive conversation includes valuable insights for patients and providers alike on breathwork, emotional regulation and other techniques to try during the search for improvement and recovery in complex chronic illnesses. Mentioned in this episode:Mount Sinai Health SystemSteven & Alexandra Cohen Foundation 

Caitlyn Brooksby from Canary Speech discusses using AI to analyze voice for health conditions like Huntington's, Alzheimer's. By focusing on vocal biomarkers, they aim for early and accurate detection. The technology screens for cognitive conditions within seconds of speech, showcasing its incredible potential in healthcare.

Exercise is good for you, except in very specific cases when it isn’t. One of the few examples, post-exertional malaise (PEM), is the subject of today’s Raise the Line episode in our series on post-acute infection syndromes produced in collaboration with the Cohen Center for Recovery from Complex Chronic Illnesses at Mt. Sinai. “The key to understanding PEM is that it's not just fatigue. It's really the worsening of symptoms or the onset of new symptoms after exercise,” says Dr. Rob Wust of Vrije University Amsterdam.  His research group is one of several around the world now focused on this previously obscure phenomenon due to the prevalence of long COVID in which PEM is a nearly universal symptom. And while it’s good news that this debilitating affliction is receiving new attention, no clear picture of causes and treatments has yet emerged. In terms of suspects, the body’s energy suppliers, mitochondria, are a popular target, but while Wust’s team and others attempt to unravel the mysteries of mitochondrial dysfunction, millions of patients suffering with PEM need strategies to avoid exhaustion. In that regard, Dr. David Putrino of the Cohen Center says patients and clinicians alike need to take all use of bodily energy into account, not just obvious activities such as walking. “The brain uses a lot of energy, so cognitive exertion will cause crashes. Emotional exertion will cause crashes and so will digestion and even sweating.” Join host Raven Baxter of the Cohen Center as she explores what can be done for patients as the race to find better diagnostics and treatments for PEM continues in some of the world’s top scientific centers. Mentioned in this episode:Mount Sinai Health System Steven & Alexandra Cohen Foundation Long COVID Physio