Just Medicine

In this second episode, I provide a primer on the medical aspects of pediatric gender affirming care. I provide you with the context of taking a history, treatment plans offered, considerations when providing this type of care and the transition from pediatric to adult settings.

In this first solo episode, I introduce you to the concept of pediatric gender affirming care. I cover the services offered for youth in British Columbia, which providers provide this care, and the steps required to access this type of care for patients.

Many Canadians may not realize that the apples in their fruit basket or the flowers brought home to family may be there because of the contributions of a migrant farm worker (MFW) to the nation. Despite having such a significant impact on the Canadian agricultural landscape, MFWs face inequities in health care access and delivery across the country. In this two-part series, Sebastian Lopez Steven, (UBC MSI 2) engages with healthcare workers that provide care to these individuals in British Columbia. Join us for enlightening conversations regarding the major health issues for MFWs and how to bring care to these individuals in a culturally competent manner. Episode 2 features a chat with Dr. Mary Kozial, a family doctor in Vancouver’s Lower Mainland who provides care for MFWs. We start off with a bit of background on Sebastian’s more informal thoughts on working with this population and then jump into the chat with our physician expert. While continuing to centre MFWs in this discussion, this episode also uses the topic as a jumping off point to chat more about broader equity practices in medicine – come for chats about MFW rights and health and stay to learn about the roles of cultural competent care and myoactivation (now that’s a name)!   Resources for the listener: 1. For information about cultural brokers: Brar-Josan, N., & Yohani, S. C. (2019). Cultural brokers’ role in facilitating informal and formal mental health supports for refugee youth in school and community context: a Canadian case study. British Journal of Guidance & Counselling, 47(4), 512–523. https://doi.org/10.1080/03069885.2017.1403010 2.    For information about anti-oppression as an emerging competency within the Royal College: Thoma, B., Snell, L., Anderson, R., Frank, J., Tourian, L., Fowler, N., Gomez Garibello, C., Hall, A. K., Constantin, E., Atkinson, A., Chan, T. M., Giuliani, M., Waters, H., Labine, N., Samson, L., Karwowska, A., & Van Melle, E. (2023). Emerging concepts in the CanMEDS physician competency framework . Canadian Medical Education Journal, 14(1), 4–12. https://doi.org/10.36834/cmej.75591 3.    For information about myoactivation: Lauder, G., West, N., & Siren, G. (2019). myoActivation: A Structured Process for Chronic Pain Resolution. IntechOpen. doi: 10.5772/intechopen.84377

Many Canadians may not realize that the apples in their fruit basket or the flowers brought home to family may be there because of the contributions of a migrant farm worker (MFW) to the nation. Despite having such a significant impact on the Canadian agricultural landscape, MFWs face inequities in health care access and delivery across the country. In this two part series, Sebastian Lopez Steven, (UBC MSI 2) engages with healthcare workers that provide care to these individuals in British Columbia. Join us for enlightening conversations regarding the major health issues for MFWs and how to bring care to these individuals in a culturally competent manner. Episode 1 focuses on a chat with Christelle Kuenzig, a nurse practitioner who provides care for MFWs in the Lower Mainland of British Columbia. We chat with Christelle about a general approach to healthcare provision in this population and what needs to change to ensure equity for MFWs across the province and the country. Resources for the listener 1. Overview of the Seasonal Agricultural Worker Program (SAWP) as part of the temporary foreign worker framework in Canada: https://www.canada.ca/en/employment-social-development/services/foreign-workers/agricultural/seasonal-agricultural.html 2. Salami, B., Meharali, S., & Salami, A. (2015). The health of temporary foreign workers in Canada: A scoping review. Canadian Journal of Public Health, 106(8), e546–e554. https://doi.org/10.17269/CJPH.106.5182 3. Istiko, S. N., Durham, J., & Elliott, L. (2022). (Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand. International Journal of Environmental Research and Public Health, 19(5). https://doi.org/10.3390/ijerph19052981

We’re back baby! For part three of our Reproductive Health series, I had the pleasure of chatting with Dr. Sheila Curran on the complexities of rural pregnancy care.  While pregnancy itself isn’t exactly a “walk in the park,” navigating pregnancy for those who live in rural locations comes with its own particular challenges. In this episode, we address both the practical (ex. financial) implications of rural pregnancy, as well as more nuanced topics such as the cultural implications of travelling for healthcare. If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com 

We are BACK with an exciting new conversation!!  Did you know that cervical cancer is a preventable disease? In this episode, Dr. Lauren Adolph and I discuss the importance of prevention and screening when it comes to cervical cancer, as well as why certain populations are disproportionately impacted by this condition. Tune in to learn more about this unique disease, the actionable barriers standing in the way of its eradication, and exciting new screening programs being implemented in Canada. If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com 

In this final episode of a 2-part series on Medical Assistance in Dying (MAiD) for mental health, I had a conversation with Dr. Derryck Smith where we explored the positive outcomes anticipated from this legislation. Join us as Dr. Smith shares his personal encounters with MAiD and why he believes this reform is pivotal in restoring human rights and empowering individuals suffering from treatment refractory psychiatric conditions. For more information on MAiD in Canada, check out the link below: ⁠https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html⁠

We're back again! As the first episode of a multi-part series on women's health, this month's episode addresses Access to Contraceptives in Canada. Listen in as expert guest speaker Dr. Yuyang Wang brings his enthusiasm, expertise and knowledge to the table. We've got a jam-packed episode ready for you, as we dive into topics including cost barriers, rural-specific factors, the importance of education, and other special considerations that can impact the accessibility of contraceptives. If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com "Sex & U" - Resource for sexual and reproductive health (by the Society of Obstetricians and Gynaecologists of Canada): https://www.sexandu.ca/ Global Contraception Policy Atlas (2023 version): https://www.srhrpolicyhub.org/region/?region=can

In this first episode of a 2-part series on Medical Assistance in Dying (MAiD) for mental health, I chatted with Dr. Diane McIntosh on the equity considerations that follow the legalization of MAiD for psychiatric conditions. Listen in as Dr. McIntosh shares her expertise and perspective on this issue, discussing the disproportionate impact MAiD might have on vulnerable populations, how a lack of access to care might drive individuals to seek MAiD, and some of the health equity concerns that are raised by the law. For more information on MAiD in Canada, check out the link below: https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html

We're back with another episode and this month we're focusing on one of the most important skills we learn in medicine, history taking! Specifically in this episode we focus on taking a good substance use history while remaining sensitive and providing patient-centred care. Please see below for the terms we discussed in episodes. Enjoy! Terminology (Terms can change over time and they are usually regionally specific, so this list is most specific to the West Coast) Substance names Up = Stimulants (Usually cocaine, in powder or crack form) Down = Opioids (Not specific to a single opioid, but usually in BC refers to fentanyl) Side = crystal methamphetamine (or crystal) Combinations: Speedball = cocaine and opioids Goofball = Crystal meth and opioids Quantity of substance A Point = 0.1 gram 8 ball/a ball = 1/8 of an ounce = 3.5 g Route of Injection Smashing = inject in any form (IV, IM, SC) Muscling = intramuscular injections Skin popping = subcutaneous injections Jugging = injection directly into the jugular vein