This season finale examines the moral injury that the current U.S. health care system inflicts on physicians and trainees — and how they may be able to offer care that aligns with their values.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400700.

This episode considers what happens when the rigors of training and the pursuit of excellence in in medicine collide with the mental health needs of trainees.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400698.

In Season 2 of the NEJM podcast “Not Otherwise Specified” (NOS), host Lisa Rosenbaum delves into multiple facets of a burgeoning revolution in medical training. In discussions with a diverse group of trainees, educators, and experts on evolving cultural norms, Lisa explores the effects of the Covid pandemic, societal changes in attitudes toward work, trainee unionization, clashes of generational philosophies, the well-being movement, and other key strands of the rapidly changing fabric of medical culture.

In this episode of “Not Otherwise Specified,” Richard Rosenbaum, a neurologist and the uncle of host Lisa Rosenbaum, tells the story of his own progressive neurologic disease and considers his coping mechanisms and the care he has received.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301938.

“Not Otherwise Specified” host Lisa Rosenbaum talks with Marcella Alsan about her winding career path and her studies on medical mistrust, racial concordance between physicians and patients, and their effects on deeply entrenched health inequities.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301937.

“Not Otherwise Specified” host Lisa Rosenbaum talks with Ziad Obermeyer about his trailblazing work in the application of machine learning to population health, the fraught problems it seeks to solve, and its lessons for critical aspects of clinical care.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301936.

In this episode of “Not Otherwise Specified,” Lisa Rosenbaum talks with Meghan O’Rourke, author of The Invisible Kingdom: Reimagining Chronic Illness, about her journalistic investigation of her own illness, trust in health care, and how cultural narratives affect our experiences of illness.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301935.

In this episode of “Not Otherwise Specified,” physician-scientist and entrepreneur Ethan Weiss joins Lisa Rosenbaum to discuss perverse incentives in academic medicine, the risks of life as a self-appointed expert on social media, and his family’s ongoing debate over gene editing.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301934.

In this episode of “Not Otherwise Specified,” physician and advocate Heidi Behforouz joins host Lisa Rosenbaum to discuss structural violence and social determinants of health, the role of love in medicine, and how to truly listen to patients’ stories.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301933.

In this episode of “Not Otherwise Specified,” Paula Chatterjee and Atheen Venkataramani join host Lisa Rosenbaum to discuss the role of values in health care, social determinants of health, and what physicians can do to improve U.S. health care.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301932.

In the first episode of “Not Otherwise Specified,” host Lisa Rosenbaum talks with Shekinah Elmore about her hard-won insights into patients’ experiences of both illness and health care, the role of narrative in life and medicine, and how to achieve true shared decision making.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2301931.

In "Not Otherwise Specified," Dr. Lisa Rosenbaum, cardiologist and national correspondent for the New England Journal of Medicine, defies our sound-bite culture to go deep with some of medicine’s most innovative thinkers. Her guests’ stories and ideas about health care’s toughest challenges and greatest promise may change the way you think about medicine, health, and society.

This episode asks how medical educators should navigate between demanding intense commitment and hard-won excellence from trainees and seriously threatening their well-being.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400697.

Source from this episode:

https://www.culturalcomplications.com/

This episode takes a sobering look at the mental health of U.S. medical students and trainees, in an era when the pressures can be intolerable but the culture still treats depression as weakness.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400696.

Notes from this episode:

https://www.nytimes.com/2020/07/11/nyregion/lorna-breen-suicide-coronavirus.html

https://www.ama-assn.org/practice-management/physician-health/encourage-physicians-healing-make-it-ok-ask-help

In this episode, host Lisa Rosenbaum talks with two trainees whose lives and careers have been changed by educational debt, and to an economist who has a rather different take on the problem.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400695.

In this episode, Lisa Rosenbaum talks with an expert on generational change and a member of the current trainee cohort about generational values and the need for cross-generational dialogue.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400693.

In this episode, Lisa Rosenbaum talks with physician trainees and a former residency program director to weigh the benefits and risks of the new wave of trainee unionization.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400692.

In this episode, a medical educator goes on the record with widespread but rarely publicly voiced concerns about the slippery slope from “wellness days” to inadequate medical training.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400690.

In this episode, Lisa Rosenbaum explores the shift in people’s perceptions of work’s role in our lives and its effects on medical training and the psychological satisfaction of physicians.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400689.

In the first podcast episode of NOS Season 2, “The Quiet Revolution in Medical Training,” host Lisa Rosenbaum talks with trainees, educators, and experts about the seeds of the current upheaval.

A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2303616.

In the first podcast episode of NOS Season 3, "The Forever Crisis of Primary Care," Lisa Rosenbaum talks with primary care guru Asaf Bitton about the vast values gap between patients and the health care system. 

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514232.

Podcast host Lisa Rosenbaum talks with Steven Lin, a Stanford PCP and AI implementation expert, about the promise and perils of AI and its limits as a solution to the forever crisis of primary care. 

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514233.

In this episode of NOS, Lisa Rosenbaum and her guests consider the ideals and realities of primary care — and the expectations and misunderstandings that are contributing to its current crisis.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514234.

NOS host Lisa Rosenbaum and her guests explore the fraught relationship between medical training and primary care — and why even trainees who once aspired to be PCPs are changing course midstream.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514235.

Podcast host Lisa Rosenbaum and her guests examine the value system of American medicine and the systematic denigration of primary care that creates a dangerous vicious cycle.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514236.

NOS host Lisa Rosenbaum and her guests lay bare the joys and rewards of full-spectrum primary care practice and consider ways of stoking students’ passion, and strengthening their ability, to pursue it.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514237.

NOS host Lisa Rosenbaum and her guests dissect the common notion that the key to improving the primary care system is simply increasing reimbursement.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514238.

NOS host Lisa Rosenbaum and her guests consider what should be done to make primary care more accessible to the patients who need it most?

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514239.

NOS host Lisa Rosenbaum and her guests discuss the extent to which online influencers and AI could someday substitute for trustworthy, caring, broad-spectrum family doctors.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514241.

With increasing numbers of PCPs leaving traditional practice for concierge medicine or direct primary care, NOS host Lisa Rosenbaum and her guests explore the promise and perils.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514240.

If the future of primary care lies in teams, what makes a team and how should it function? NOS host Lisa Rosenbaum and her guests consider the possibilities of team-based care.

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514243.