Explore every episode of the podcast Raise the Line

Today, our ongoing global tour of medical education on Raise the Line stops in the Republic of Ireland by way of a conversation with the head of school at Trinity College Dublin School of Medicine, Dr. Colin Doherty, who is in the midst of revising the school’s curriculum. In that process, particular attention is being given to how medical education needs to change to adjust to the potentially transformative impacts on health, healthcare and society from artificial intelligence, big data and climate change. As Dr. Doherty tells host Caleb Furnas, a recent creative workshop with internal and external stakeholders produced reassuring results. “It was really gratifying that central to the future of our workforce is not technology, but the humanity of the healthcare worker.” The widely-published epileptologist believes achieving that will require a regulatory framework that strikes the right balance. “Let AI help us with making the right choices for treatment, but don't put it between us and our relationship with the patient.” There is much to contemplate in this fascinating discussion of advances in understanding epilepsy, managing change in academia, instituting love as an outcome measure, and the many challenges and opportunities of leading a 300-year-old medical school into the future.

Mentioned in this episode: Trinity College Dublin School of Medicine

On this episode of Raise the Line, we're going to learn about the organization behind one of the most important exams in healthcare: the NCLEX, which is the licensing exam for nurses in the US. The influence of the test, which is overseen by the National Council of State Boards of Nursing (NCSBN), is hard to overstate because of its role in driving what nursing students and educators focus on. That was made evident when the heavily revamped Next Generation NCLEX, launched in 2023, placed much greater emphasis on clinical judgment than had been the case on past exams. “I think the education transformation prompted by the new exam is still going on. The launch was more of a catalyst than I expected,” says Dr. Philip Dickison, CEO of NCSBN, who was director of Health Professions Testing at Elsevier before joining the Council in 2010. Through administering licensing exams and serving as the collective voice of nursing regulators across the country, Dickison says NCSBN strives to achieve its ultimate goal, which is building public confidence in the competence of nurses.  “I see our job at the Council as making sure there is a moment of trust between a patient and their nurse.” Join host Liz Lucas, Senior Content Manager for Nursing at Osmosis from Elsevier, as she explores the important work that goes on behind the scenes in the healthcare industry to help ensure public health and safety, and uncovers what Dickison learned as a military medic that still influences his work today.

Mentioned in this episode:

National Council of State Boards of Nursing

We have a special Raise the Line episode today that takes a look at some behind-the-scenes work happening at Osmosis from Elsevier to expand the reach and impact of our educational content, which is now being used by learners in nearly 200 countries. Over the past year, dozens of volunteers have been hard at work translating over 100 Osmosis videos into Arabic while simultaneously researching whether these translations increase student engagement and comprehension, and improve educational equity. Our host, Dr. Amin Azzam -- who has played an oversight role in this project -- is joined by two other key members of the team: Mohammad Kabakibi, the founder of Chain of Education, an online learning platform he developed while in school at Lebanese American University; and Dania Reina, who is an e-learning creator and a pharmacist from Brazil. “In the beginning, we had one or two volunteers, but now we have more than fifty. This is huge and this only happens because we are building this for us and to leave for other healthcare professionals who will hopefully keep it going,” says Reina. Research has shown significant learning improvement among video watchers and as a bonus, the people doing the subtitles report enhanced knowledge of the subjects they work on. These positive outcomes have spurred Kabakibi to look for other opportunities to make an impact, including helping Arabic speakers learn how to do research in English. “I believe one of the legacies that this project will carry through me will be my continuous mission in reducing barriers when it comes to healthcare and education,” he shares. Check out this inspiring episode to learn about other offshoots of the project, how this work supports lifelong learning, and why AI is not up to the task.

Mentioned in this episode:

Chain of Education

Osmosis Video with Arabic Translation

We kick off 2025 on Raise the Line by sharing some good news for providers struggling to keep up with the growing number of applications for genomic testing: a new book from Elsevier Science Direct has been designed to arm you with the knowledge you need. Genomics in the Clinic: A Practical Guide to Genetic Testing, Evaluation, and Counseling dives into the use of this important tool in diagnosis and screening, indicating how individuals may respond to drug therapies, and more. “We really need to educate all healthcare providers about the practice of genetics because they're going to be involved directly or indirectly in genetic testing and conveying information about what the results mean to patients and their families,” explains co-author Dr. Ethylin Wang Jabs, enterprise chair of the Department of Clinical Genomics for Mayo Clinic. Jabs and her co-author, Dr. Antonie Kline, director of Clinical Genetics at the Harvey Institute for Human Genetics at Greater Baltimore Medical Center, chose a format that makes heavy use of case studies to help readers get a better grasp on this complicated field and they also include chapters on direct-to-consumer testing and the ethical and social implications in genomic medicine. “Any kind of potentially predictive testing can have ethical issues related to it, including insurance coverage, testing for family members, protections for minors, and more,” says Dr. Kline. Join host Caleb Furnas for an illuminating episode on an area of discussion in medicine that’s growing in importance as the use of genetic testing rapidly increases.

Mentioned in this episode: Genomics in the Clinic: A Practical Guide

Brothers Inspire and Share Life Lessons Through Endurance Sports: Kyle and Brent Pease of the Kyle Pease Foundation

Today, we have an especially inspiring episode in our Year of the Zebra series on rare conditions featuring Kyle Pease and his brother Brent, who recently helped each other complete the 140.6 mile Ironman World Championship in Hawaii, a challenge they also took on together in 2018. What makes their story extraordinary is that Kyle, who was born with cerebral palsy and spastic quadriplegia, participated in these races with Brent's assistance, making them the first push-assist brother duo to finish the grueling competition. With over 125 endurance races under his belt, Kyle has become a leading disability advocate, demonstrating resilience and breaking barriers through sports. “Competing really reminds me of my life. I go through many ups and downs throughout my day just as I do in this sport. You get through a lot of different challenges throughout the competition by just focusing on the idea that anything is truly possible,” he tells host Lindsey Smith. To amplify their message of inclusivity and determination, the brothers co-founded the Kyle Pease Foundation which sponsors races and other awareness building events and they deliver speeches to a variety of organizations to share the lessons they’ve learned. “We want to encourage people to figure out what their finish line looks like. What are the things you work for and how do you get there,” says Brent. Tune in for an uplifting conversation to learn about the Foundation’s workforce inclusion program, their book, Beyond the Finish, and the “secret weapon” that makes their racing and other endeavors possible.

Mentioned in this episode:

Kyle Pease Foundation

Beyond the Finish

The use of simulation in nursing education has been growing in recent years not only because of its proven effectiveness as a training method, but because of limits on clinical training placements, and a dearth of nursing faculty. Today on Raise the Line, we’re happy to welcome one of the pioneers in this area, Dr. Pamela Jeffries, the Dean of the Vanderbilt University School of Nursing which is consistently ranked among the top graduate nursing schools in the US. “Now that we've moved to competency-based education and outcomes, I feel simulation is one of the mechanisms that's going to help faculty to see our students demonstrate those competencies needed across domains,” Jeffries tells host Maria Pfrommer, director of Nursing Education at Osmosis from Elsevier. Dr. Jeffries is also known for her work improving the online learning landscape in nursing education. “Online learning is so important in nursing because if you look at our students, they're typically working part-time or even full-time and need that flexibility.” Maria and Dr. Jeffries also get into the details of Vanderbilt’s graduate nursing programs and discuss the game changing potential of AI in nursing education and practice in this informative episode.

Mentioned in this episode:

Vanderbilt University School of Nursing

“Being a provider yourself doesn't protect you or your loved ones from illnesses and it really brings the humanity back into medicine to recognize that we're all struggling and that the  patient in front of you is processing what they hear in their own way,” says Dr. Marta Perez, and OB-GYN and mother of a child with a rare condition. As Perez shares with host Lindsey Smith, her young daughter’s struggles with Smith-Magenis Syndrome – which causes an array of developmental delays and other challenges -- has made her, and her physician husband, better doctors by sharpening their understanding of the difficulty patients have navigating the healthcare system and dealing with dismissive providers. “That's been something really formative for us in how we approach patients in our own practices. We understand the stresses in medicine.” In this candid interview, Perez talks about how she and her husband juggle two demanding jobs and a child with special needs, the impediments to finding treatments for rare diseases and the emotional impact of realizing your child will not have the kind of life you hoped they would have. Don’t miss an episode rich with lessons for providers and parents as our Year of the Zebra series continues. 

Mentioned in this episode:

@Dr.MartaPerez

Smith Magenis Syndrome

This episode of Raise the Line is special for a couple of reasons. Our guest, Toh Hong Keng recently graduated from medical school at the age of seventy, making him one of the oldest medical students in the world; and Shiv Gaglani is taking a break from his 3rd year of medical school -- which he is completing at the age of 35 -- to make a rare appearance hosting the show so he can compare notes with Toh about being a non-traditional med student and to learn from his inspiring example. Toh is a retired tech sales executive who earned his medical degree this summer from Southwestern University PHINMA in the Philippines after a long career in the Asia-Pacific region. As he tells Shiv, Toh brushed aside the opinions of acquaintances that pursuing a medical degree in his late sixties was a little crazy. “I’m a firm believer that at this age, we should be able to do what we like to do, not what people think we should be doing.” Tune in to find out what sparked his interest in getting the degree, what his biggest challenges were, how his classmates interacted with him, what he considers highlights of the experience, and what he plans to do next.  You’ll also learn about the concept of “sayang” which Toh relied on when he was facing doubts along this very difficult, but rewarding journey. 

Mentioned in this episode:

CNN Article About Toh

Southwestern University PHINMA School of Medicine

Leaning into the ancient wisdom that ‘practice makes perfect’ nursing educators are increasingly embracing approaches such as simulation and competency based education that provide students with low-risk opportunities to practice skills. You might even say that the  ‘see one, do one, teach one’ framework has evolved into ‘see one, do one, debrief, get assessed and do it again.’ But while research shows these hands-on methods lead to increased patient safety and better clinical outcomes, they can be challenging to implement as we’ll learn on this episode from April Rowe Neal, PhD, RN, the graduate nursing simulation educator at Winona State University College of Nursing & Health Sciences. “It can be hard for a lot of faculty because it's not necessarily how we've all been trained, right? You have to take more of that ‘guide on the side’ role rather than having all of your lecture notes perfectly typed to deliver to your students,” she explains to new Raise the Line host Kelsey LaFayette, DNP,  Senior Content Manager at Osmosis from Elsevier. On the plus side, Rowe Neal thinks these methods build a partnership between the learner and the teacher. Find out why that happens, learn how her program uses scaffolding to set students up for success and get Rowe Neal’s take on the role of mindfulness for medical learners and providers in this insightful conversation.

Mentioned in this episode:

Winona State University College of Nursing & Health Sciences

2024 is the year today’s Raise the Line guest, Michelle Hughes, is supposed to die. That’s according to the diagnosis she received three years ago from an oncologist who told her she had a rare, incurable form of cancer that had already caused innumerable tumors throughout her body.   As a mother of three – with her youngest child being just a few weeks old at the time of her diagnosis – this was obviously devastating news.  But fortunately, the optimism and encouragement of a second oncologist allowed for a new path forward. “It changed my entire world when that one doctor had hope,” she tells host Lindsey Smith.

Fueled by the advice of her new doctor “to just live your life” Michelle embraced a healthy lifestyle that includes distance running, including a recently completed triathlon. She has also embraced the role of empowering others to face their challenges through “My Journey to Just Live” an organization she created that keeps her busy doing a blog, social media posts, speaking engagements fundraisers and other activities. Join us for a special edition of our Year of the Zebra series focused on rare diseases to learn about Michelle’s challenging journey to motherhood, being a parent to three young children, and living with terminal cancer. “I remind my children and myself that cancer doesn't define me. I'm so much more than that.”

For information on the November 16th online premiere of a documentary about Michelle’s story, visit My Journey to Just Live

What good are dazzling advancements in science – such as the rapid development of an effective COVID vaccine – if public distrust of science and medicine leads people to reject them?  That’s the sort of question animating the work of today’s Raise the Line guest Dr. Kathy Reeves, president and CEO of the Arnold P. Gold Foundation. A key part of the answer, Reeves believes, is to increase the level of humanism in healthcare, defined as providing kind, safe, trustworthy care. “Humanism in healthcare is the vehicle to allow science to make an impact, and it is what is needed to change a broken healthcare system,” she tells host Caleb Furnas. Her conviction is based on numerous studies showing that patients who feel heard, understood, and treated with empathy by their healthcare providers report higher satisfaction levels and improved quality of life. The approach boosts provider satisfaction and lowers costs as well. “There's more science in the value of humanism than in many of the things I learned almost thirty years ago when I was a pediatric resident.” Tune in to this insightful episode to discover what providers can do in less than a minute to create a connection with patients, what Reeves and the foundation are doing to support providers who want to incorporate humanism into their practice, and how the White Coat ceremony got started. 

Mentioned in this episode: 

Arnold P. Gold Foundation

We've learned quite a bit on Raise the Line about the growing trend of providing medical care in the home, particularly as it relates to services enabled by advances in remote monitoring technologies. In this episode, we’re adding to that base of knowledge by focusing on what's happening with in-home physical therapy services. Our guide will be Palak Shah, PT, the co-founder and head of clinical services at Luna, a leading provider of in-home physical therapy that has completed one million patient visits in twenty-eight states since its founding in 2019. “Our patients appreciate this option so much because there are so many hurdles to access -- time constraints, ability to come to a clinic, the cost of travel, the dependency on family and caregivers -- and Luna eliminates all of that,” Shah tells host Michael Carrese.  The company has also focused on convenience for its 3,000 licensed providers through developing an app that integrates documentation, care coordination, billing, scheduling and other administrative tasks. But can you actually provide high-quality care for a full range of patient needs in what might often be small spaces? Based on data from its patient population in Southern California, Shah says Luna found that 87% of people can be seen in the home because large pieces of equipment are not needed to provide the required treatments. Tune in to learn how the services are paid for, how the system works for the hospitals and practice groups the company partners with, and what Luna’s providers say about working in the home environment.

Mentioned in this episode: Luna

Over a long and very active career as a researcher, clinician and educator, Dr. Nicholas Talley has witnessed the traditional mind/body dichotomy fade in relevance as science has determined just how integrated they really are. “The body talks to the mind, the mind talks to the body, and we're exploring how this happens and what we can do to interfere, if you like, to make a difference and perhaps restore health by doing so,” he says. Dr. Talley, a distinguished laureate professor at the University of Newcastle in Australia, is an international authority in the field of neurogastroenterology with more than 1,000 peer reviewed publications. Much of his work centers on disorders of gut-brain interaction, including functional dyspepsia, irritable bowel syndrome, and GI complications in diabetes. “What keeps me going is this idea that gut-brain connections are going to be very important, not just in gastrointestinal diseases, but in fact in many diseases that affect people across the spectrum of internal medicine.” Join Raise the Line host Caleb Furnas for a fascinating look at this burgeoning field as well as insights on probiotics, possible pharmaceutical interventions on the horizon and how artificial intelligence is impacting medical education. 

Mentioned in this episode:

University of Newcastle

Today’s Raise the Line guest provides a great example of how to embrace the range of career options that are available to medical practitioners. In the dozen years since earning his medical degree, Dr. Andres Acevedo-Melo has been a medical liaison and advisor for two of the largest pharmaceutical companies in the world, provided recruitment support for clinical trials, and been an editor with a publisher of open access journals. He also spent two years as a student leader in our Osmosis Medical Education Fellows program. “You might have a plan for your whole medical career, but you can also have alternatives. Consider your life like a stack of possibilities where you can choose one, but if you get detoured from that path, you can learn something from that,” he tells host Michael Carrese. Dr. Acevedo-Melo, who just finished an internal medicine residency program at Fundación Santa Fe de Bogota, also discusses his interest in coaching as a tool to improve the leadership skills of providers. “I think we can use coaching to help our students and our colleagues know themselves better so they can try to identify what leadership style they should use to get results. Because at the end, if we are benefited, our patients will also benefit so it would become like a snowball effect.” Don’t miss this engaging interview that offers insights on the use of AI in clinical trial recruitment, why providers need to prioritize their mental health, and the connection between golfing and effective leadership as our NextGen Journeys series continues.

Mentioned in this episode:

Fundacion Sante Fe de Bogota

PLOS ONE Journal

“I thought that education and medicine was a pathway for me to not only get out of my small town but to also make a huge impact somewhere in the world,” says Jermaine Blakely, a third-year medical student at Howard University College of Medicine. But Blakely didn’t wait for medical school to start making a difference. While an undergrad at Morehouse College, he created a program that paired students with local churches to help the homeless, as well as women who were victims of domestic violence. Although he was pre-med at Morehouse, his path to medical school included detours to get a Masters in Health Policy and Management at NYU and several years working in healthcare IT at hospitals in the San Francisco Bay area, giving him a broader perspective than his younger classmates on the opportunities before them. “I think we're asking the wrong question to medical students. Instead of asking what they want to specialize in, we should ask ‘what do you want to do with your medical degree’ because I think your degree should be a passport to many different career paths.” Possibilities for Blakely include creating a medical device company, joining a venture capital firm or maybe falling in love with a specialty and having a clinically-focused career. Regardless, there’s little doubt we will be hearing about his positive impact in the years ahead. Don’t miss meeting this inspirational young leader as our NextGen Journeys series continues. 

Howard University College of Medicine

One way to look at today's guest is that if he were a zebra, he would have extra stripes because, unfortunately, he has more than one rare condition, which is a first for a guest in our Year of the Zebra series. After struggling with various GI issues most of his life, Brian Kennedy, an Elsevier colleague, was diagnosed several years ago with exocrine pancreatic insufficiency (EPI), a rare disorder that prevents the pancreas from playing its proper role in aiding digestion. At the same time, he was told he had MALS, another rare condition, that interferes with blood flow in the abdomen. Both of these disorders can cause chronic pain in addition to a host of other difficult symptoms. While it was a relief to finally have answers, Brian says it also sparked a long period of grief. “You start to realize your life is not going to go back to the way you had it, but you just have to accept it and then you sort of think about the things I can do and focus on those and not the things that I can't do anymore,” he tells host Michael Carrese. That shift in perspective and connecting with a community of other EPI and MALS patients has helped Brian to stay as positive as possible and focus on being as healthy as he can under the circumstances. Listen-in to learn about these challenging diseases, the therapy that is helping Brian eat without subsequent debilitating pain and his advice to providers about dealing with rare disease patients. 

Mentioned in this episode:

Primal Pancreas by A. Toxopeus

Mission Cure

“If you really want to build a relationship with your patients, a model based on insurance doesn't enable you to spend enough time with them to build that connection,” says Dr. Ginamarie Papia, a practitioner of integrative medicine based in New York. That explains why the 30-something entrepreneur has just launched her own virtual “direct-to-patient” medical practice that she describes as a more affordable version of the concierge model. The move reflects frustration among providers of her generation with the confining, administrative approach to healthcare delivery that’s contributing to high levels of burnout, and their desire for a better work-life balance.  It also reflects a realization that millennials and subsequent generations are digital natives who grew up in a culture with high expectations for convenience.  Dr. Papia tells host Michael Carrese that her primary care practice will provide natural, holistic solutions with a particular focus on weight loss and women’s health, including options beyond birth control medication for younger women struggling with hormone or menstrual cycle issues. Join us for a grassroots-level look at evolving models of healthcare delivery, the benefits of integrative medicine and the role of social media in providing patient education. 

Divinely Guided Health

The Upward Spiral Podcast

As we continue our Year of the Zebra focus on rare disorders, we’re going to focus on the productive relationships that can develop between the families of children with rare diseases and the researchers who are trying to develop treatments and cures.  Join Raise the Line host Lindsey Smith as she explores the various dimensions involved with Jennifer Wells, whose young son has a neurodevelopmental syndrome called CAGS (Chopra Amiel Gordon Syndrome) and her son's physician, Dr. Maya Chopra, a clinical geneticist who co-discovered the gene in question and who is leading an international study on CAGS. “It's so important as researchers that we engage and include families in our research design and methodology so we understand what are the most relevant and meaningful endpoints that we're going to use for trials,” explains Dr. Chopra, director of Translational Genomic Medicine at the Rosamund Stone Zander Translational Neuroscience Center at Boston Children’s Hospital. In turn, family members can be a critical connection to the tightly-knit communities that grow up around specific disorders which are eager for the latest information. “As materials become available from Dr. Chopra and her research team, then I try to partner with them to get it out to the community and have those resources available,” says Jenifer. Tune in to this fascinating discussion to learn about other benefits of these relationships, what’s happening in CAGS research, and an approach to research being pursued by Dr. Chopra that will help make small studies more scalable, potentially benefitting multiple conditions at once. 

Mentioned in this episode:
Rosamund Stone Zander Translational Neuroscience Center

In 2010, our guest, Rob Long, was on the cusp of an NFL career after being a star punter at Syracuse University. But that bright future was sidelined when Rob was diagnosed with a rare and aggressive brain tumor just five days after his final college game. Fortunately, emergency surgery and treatment gave him a second chance. As you’ll learn in this fascinating episode of Raise the Line, a new purpose took the place of his NFL dreams and today he's the executive director of Uplifting Athletes, a nonprofit using sports to raise awareness and resources for rare diseases. One signature program developed under his leadership is the Young Investigator Draft held annually since 2018 at the home stadium of the Philadelphia Eagles. “Our program is modeled after the NFL draft, but instead of drafting the top athletes in the country, we draft and fund the next generation of rare disease researchers,” Long tells host Lindsey Smith. So far, Uplifting Athletes has provided fifty researchers with over one million dollars in grants through this approach. Tune in to learn about other innovative work that has connected hundreds of rare disease patients with professional athletes and provided opportunities for researchers to attend patient & family conferences as our Year of the Zebra focus on rare disorders continues. 

Mentioned in this episode: 

Uplifting Athletes

Given Osmosis from Elsevier’s mission to educate the next generation of healthcare providers, it’s fitting that our 500th episode of the Raise the Line podcast features a conversation with Parsa Mohri, a medical student at Acibadem University in Turkey.    As you’ll learn in this thoughtful interview with host Hillary Acer, Parsa applied a “Monday morning” test in choosing medicine as a career: what kind of job would he feel motivated to go to at the start of every work week for decades. “I picked medicine because I could find meaning and value in the work as well as enjoying it at the same time,” he explains. Parsa has also sought out meaningful roles on campus, including serving as a member of a committee that gathers feedback from students on the effectiveness of the education they are receiving and shares it with faculty. “This gives faculty a chance to offer any form of alternatives so when the next students come by, they will have a smoother and a more efficient education.” That drive to improve medical education also explains Parsa’s involvement in the Osmosis Health Leadership Initiative where he is guiding and mentoring fellow medical students and helping to foster a supportive and inclusive learning community. Parsa is a great example of the many compassionate and creative medical learners we have featured throughout the 500 episodes of Raise the Line, and we hope to introduce you to many more inspiring future clinicians as the podcast continues. 

Mentioned in this episode:

Acibadem University

“When I make a diagnosis of cancer, that's changing the landscape of that patient's life forever. Their trajectory is being set by the words I write down on my report. So, that’s why I say pathologists are the most important doctors you’ll never meet,” explains Dr. Jennifer Hunt, interim dean at the  University of Florida College of Medicine. As she tells host Michael Carrese, it was the intervention of mentors that facilitated her exploration of pathology, sparking a passion in her for the importance of mentorship and sponsorship. Her career as a practitioner, educator and leader at some of the most prestigious health systems in the country has provided Dr. Hunt with many opportunities to pay that assistance forward and has led to an interest in coaching as an additional modality for career and personal development.  “In medicine, coaching has been underutilized but as a dean, I'm seeing more requests for recruitment packages that include coaching, and I think that shows it's becoming a more mainstream tool.”  This Raise the Line episode also covers how the college is preparing students to practice medicine in a world being reshaped by artificial intelligence, and the advantage of being able to offer them a wide range of clinical settings from urban to rural, and academic to community-based. “We have educational venues that cover all of the practice of medicine and that also opens up possibilities for doing community-based research and clinical trials enrollment across lots of different settings.” 

Mentioned in this episode: University of Florida College of Medicine

“Nurses have a lot of answers. We're problem solvers. We're innovators,” says Dr. Sarah Szanton, who is a case in point for using her experience doing home visits as a nurse practitioner to help pioneer an innovative model of elder care called CAPABLE. It’s a four-month long program in which a nurse, occupational therapist and handy worker address difficulties an older adult may have in daily living as well as the safety issues in their home so they are able to age in place while achieving the best possible health status and quality of life. So far, it has served 10,000 people in twenty-three states, and efforts are underway to scale the model as broadly as possible to meet the needs of the country’s burgeoning senior population. “If the CAPABLE program were a drug, it would be a blockbuster. It cuts disability in half and saves seven times what it costs,” she explains. As you’ll learn in this informative conversation with our new Raise the Line host Caleb Furnas, Dr. Szanton is in a position to shape healthcare delivery far beyond elder care in her role as dean of the Johns Hopkins School of Nursing. Tune in to learn about a community healthcare model being developed based on work in Costa Rica, and how the school deploys simulation technologies to hone difficult skills and develop empathy for both patients and fellow providers.

Mentioned in this episode: 

Johns Hopkins School of Nursing

CAPABLE

You might think training for and completing ultramarathons while managing the long hours and other demands of a medical residency would be too much to handle, but in the case of Dr. Estello Hill, athletics have fueled his success on the job. “It's really taught me what I'm capable of, how I can push myself and when I should dial back. I think it's given me an intense sense of balance with everything,” he explains. Dr. Hill just wrapped up his internal medicine residency at the University of British Columbia and has begun a fellowship there in gastroenterology where he can pursue his special interest in the gut microbiome. “It's an exciting space that I think is going to open up some new understanding for a lot of disease processes that we don't actively understand now, and also potentially open up new treatment pathways.” In this inspiring installment in our NextGen Journeys series, Hill and host Hillary Acer also discuss how he sees AI being integrated into medical care, and his interest in longevity medicine, complete with book recommendations on nutrition and other keys to a healthy lifestyle. 

Mentioned in this episode:  The University of British Columbia

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 System

Steven & Alexandra Cohen Foundation 

We continue our Year of the Zebra focus on rare diseases today by exploring the ability of AI technology to aid in the diagnosis of rare and other conditions by analyzing the voice and speech of the patient. This approach is promising enough that the National Institutes of Health has invested in research projects to test its effectiveness, and the private sector is pursuing it as well, including the company Canary Speech whose technology can be trained to detect conditions that are traditionally difficult to identify, or those where early identification is crucial to treatment. “With just seconds of conversational speech, we can screen for multiple behavioral and cognitive conditions,” says Caitlyn Brooksby, Canary's vice president of Marketing and Strategic Partnership. One prime example she offers is a study on Huntington’s disease done in collaboration with Beth Israel Deaconess Medical Center in which more than a thousand features of speech were identified differentiating healthy patients from those with the disease. “Every ten seconds, we're looking at millions of data points, but we don't look at the words you say. We're looking at biomarkers within speech such as duration per word, word-per-second, bandwidth and contrast. It's really incredible what we can gather from speech alone,” she explains. Canary is in the second iteration of its Huntington’s model which is showing accuracy rates of 90% and above, and it recently added mild cognitive impairment, Alzheimer's, and Parkinson's disease to its offerings. Join host Lindsey Smith on this episode of Raise the Line to learn more about this promising approach to diagnosis.

Mentioned in this episode:
Canary Speech 

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 

It’s hard for many to believe a tick bite or case of COVID can lead to severe mental illness, but we’ll be hearing from someone on this episode of Raise the Line who lived through just that experience. Dr. Raven Baxter also happens to be the host of this special series on post-acute infection syndromes produced in collaboration with the Cohen Center for Recovery from Complex Chronic Illnesses at Mt. Sinai. While struggling with long COVID, Raven developed panic attacks and other mental health problems, and even though she explained to providers that she previously had no history of mental illness, there was reluctance to attribute the symptoms to her body’s reaction to SARS‑CoV‑2. Unfortunately, this is not surprising to Dr. Shannon Delaney, a psychiatrist whose patients share similar stories. “People who are going through this can be suffering a lot, not only because of their symptoms, but because of invalidation from the medical community,” says Delaney, who believes brain inflammation caused by immune system dysregulation can explain why mental health issues emerge in this context. While Raven’s other guest, Dr. Mike VanElzakker, concurs, his research at Massachusetts General Hospital and the PolyBio Research Foundation focuses on the vagus nerve as a contributing factor to symptoms of various types. “I would argue at least part of what people with these complex chronic illnesses are experiencing is an ongoing sickness response and that may be because there is a signal that's constantly bombarding the vagus nerve, which may be sensitized by inflammation.” This is an eye-opening look at mind-body connections that are challenging conventional wisdom.  

Mentioned in this episode:

Mount Sinai Health System 

Steven & Alexandra Cohen Foundation 

“I think education is very much of an artistic process. I love to think of this as kind of being in a museum. It's about curation of an experience,” says Alex Kendall who oversees the physician assistant training program at Emory University. As he takes on the role of director, Kendall’s background in art and anthropology give him an interesting perspective from which to build on and realize the program’s vision and mission, which are rooted in evidence-based education, leadership development, interprofessional education and creating patient-centered, community-oriented clinicians. Toward that end, one curated experience is participation in the longstanding Emory Farm Worker project in which students care for thousands of migrant workers from Florida, Georgia and other states. Among other things, it’s a great opportunity to deepen awareness of the social determinants of health and practice caring for diverse populations. Looking to the future, Kendall and colleagues are keen to prepare their students for growing trends that will impact their work as clinicians including team-based care, the aging of the population and the increase in climate-related health problems. “We ask ourselves what does the future of health and society look like in ten years and what is needed from physician assistants? Our job is to identify what medical education then needs to look like in order to meet those future challenges.” This expansive conversation with host Hillary Acer also touches on Emory’s cognitive apprenticeship curriculum, scaffolded learning, making primary care an easier choice of specialty and the growing interest in point of care ultrasound.

Mentioned in this episode:

Emory University School of Medicine PA Program 

Emory Farm Worker Project

Why do patients with long COVID have such a wide array of symptoms affecting so many bodily systems? That bedeviling question is the focus of this episode of Raise the Line featuring Dr. Resia Pretorius, head of the Department of Physiological Sciences at Stellenbosch University in South Africa and a renowned researcher in coagulation. “The underlying concept of what is happening, in our minds, is that long COVID is a widespread vascular endotheliitis, which is driven by the presence of all sorts of inflammatory molecules in circulation,” she tells host Dr. Raven Baxter of the Cohen Center for Recovery from Complex Chronic Illnesses (CoRE). Because endothelial cells line blood vessels that travel to every part of the body, their impairment produces a range of symptoms. Dr. Pretorius and her research colleagues have discovered that “microclots” – abnormal proteins that prevent clots from breaking down – are another ingredient in the long COVID recipe due to their possible role in reducing oxygen flow to the brain and other organs. Because of their unusual structure, microclots are not detected by customary blood tests, leading Dr. Pretorius to add her voice to the chorus of stakeholders calling for the development of new diagnostic tests and additional treatments. “We need a concerted effort for trials. We need FDA approval for the laboratory test that we developed. I’m confident we will get it done, but it will take time, which is sad.” Tune in to learn about the possible causes of microclots, promising research on anticoagulation therapy and why long COVID is not a “checklist” disease, as our special series on post-acute infection syndromes continues. 

Mentioned in this episode:

Mount Sinai Health System

Steven & Alexandra Cohen Foundation

In a word cloud generated from this episode of Raise the Line, ‘communication’ would dominate: communication between the immune system, nervous system and connective tissue; communication between patients and providers; and communication among providers to solve challenging diagnostic puzzles. As our special series on post-acute infection syndromes continues, host Raven Baxter of the Cohen Center for Recovery from Complex Chronic Illnesses (CoRE) is joined by neurologist Dr. Ilene Ruhoy, immunologist Dr. Anne Maitland and physical therapist Dr. Valerie Iovine Rogers to unravel the interconnectedness at work in these diseases and reveal key insights about caring for patients. “In the complex disease world, there isn’t a nice protocol that we have in other parts of medicine, so it takes a lot of listening and a lot of trial and error,” says Dr. Ruhoy. “The most important thing is to continue digging into that story and building that practitioner-patient relationship so that there's trust there,” adds Dr. Maitland. All agree that a lack of specialists in mast cell activation syndrome, hypermobility disorders and related areas puts a premium on developing referral networks so that diagnostic roadblocks do not end the search for answers. “It really harps on the importance of an interdisciplinary care team where all of us have to communicate with one another and educate the patient so they know what they're advocating for and where they need to go,” Dr. Rogers explains. Don’t miss this instructive conversation on both the art of patient care and the science of these often debilitating illnesses. 

Mentioned in this episode:

Mount Sinai Health System 

Steven & Alexandra Cohen Foundation 

If we didn’t know Dr. Brian Ogendi, we might be concerned about someone being able to pull off a residency and two fellowships while being a father of two young boys, but we do know Brian through his work with our Osmosis Medical Education Fellows (OMEF) program in which he played a major role while earning both his MD and MBA degrees. In other words, we’re not worried. Host Hillary Acer checked in with Brian recently as he was wrapping up med school and preparing to start a residency in Internal Medicine/Physician-Scientist Pathway at UVA Health with a fellowship in infectious disease and critical care medicine. “For me, medicine and research really go hand in hand. They enhance each other, they sharpen each other,” he explains. He’s already demonstrated that in his role as research advisor to the OMEF program where he drew on his work at the NIH and elsewhere to provide grounding and encouragement to learners. Brian is hoping to put all of this education and experience to work providing care to underserved communities both in the United States and in his native Kenya, leveraging a global network built through Osmosis to do so. Don’t miss this uplifting installment in our Next Gen Journeys series full of advice on juggling heavy workloads and family responsibilities while gaining the skills to become an effective, community-minded physician.

Mentioned in this episode: 

UVA Health

Diagnosing Post-Acute Infection Syndromes: Special Series from The Cohen Center for Recovery from Complex Chronic Illnesses at Mount Sinai

“Tick-borne illnesses are incredibly stealthy and complicated and if I wasn't living and breathing it every day and seeing the intensity of these symptoms in patients, I would never believe it,” says Shannon Delaney, a psychiatrist in private practice in New York City. The complexity of such illnesses and the symptoms they cause is a key reason it can often take years to reach a diagnosis, which is the focus of this episode of Raise the Line, part of a special series on post-acute infection syndromes that Osmosis from Elsevier has created in partnership with the Cohen Center for Recovery from Complex Chronic Illnesses (CoRE) at the Icahn School of Medicine at Mount Sinai Hospital. In addition to Dr. Delaney, host Dr. Raven Baxter of CoRE welcomes Dr. Amy Kontorovich, an associate professor in Cardiology and Genomic Medicine at the Icahn School and Dr. David Putrino, director of Rehabilitation Innovation at Mount Sinai, to explore the limitations of current diagnostic tools and protocols and what changes are needed to improve patient care. Key themes include developing better tests for pathogens and educating providers to listen more carefully to patients. “In a typical medical encounter, the biggest dropped ball is completely disregarding an acute infection in the medical history,” stresses Putrino. All agree that providers need to be more comfortable with uncertainty and resist the urge to develop treatment plans that don’t address root causes. “If more doctors could just say, ‘I don't know’ I think it would do a great service to patients," adds Kontorovich. This is a candid and enlightening discussion about the importance of developing a collaborative, patient-centered mindset to provide the best care for those suffering with a range of post-acute infection syndromes.

Mentioned in this episode: 

Mount Sinai Health System

Steven & Alexandra Cohen Foundation 

Today, we add another voice to our ongoing conversation on Raise the Line about how to improve the nurse staffing crisis faced by the US healthcare system. That voice belongs to Bhavdeep Singh, founder and CEO of Global MedTeam, a startup focused on bringing foreign-born nurses to the US to fill staff shortages. When Singh, who has deep experience in healthcare management, learned from a hospital executive that the annualized cost of employing one travel nurse can reach into hundreds of thousands of dollars in some locations, he realized there was room, and a need, for new approaches. “There's some wonderful work being done in this space, whether it's process improvement, remote monitoring, or software to make sure that we have the right kind of scheduling…all of these things are very helpful, but that's not going to get us to where we need to be. We will still have a huge shortage.” Singh believes employing pre-credentialed nurses from abroad, especially from the Philippines which has a long history of sending nurses to the US, is a viable part of the solution and his firm has put processes in place to make it a turnkey experience for employers. “We handle everything for the client including immigration from start to finish.” Join host Michael Carrese as he explores potential healthcare impacts on the “supplying” countries, the storied reputation of Filipino nurses and how this approach might also work for shortages in allied health professions. 

Mentioned in this episode: Global MedTeam

Today, we’re excited to bring you the first episode in a special Raise the Line series that Osmosis from Elsevier has created in partnership with the Cohen Center for Recovery from Complex Chronic Illnesses (CoRE) at the Icahn School of Medicine at Mount Sinai Hospital. PAIS: Root Causes, Drivers, and Actionable Solutions is a ten-part examination of a range of post-acute infection syndromes such as long COVID, tick-borne illness, chronic fatigue syndrome, and connective tissue disorders. Your host, Dr. Raven Baxter, a molecular biologist and Director of Science Communication at CoRE, will be joined by an impressive array of specialists in the field to explore causes, symptoms, diagnoses and treatments, as well as the devastating impact on patients who often struggle for many months or even years with a troubling span of symptoms affecting everything from muscle movement to mental health. As you’ll learn in the series, diagnostic protocols are lacking for many of these conditions, leading to delayed treatment and prolonged suffering for patients. In this inaugural episode, Dr. Baxter is joined by microbiologist Dr. Amy Proal, CEO of the PolyBio Research Foundation; Yale University Professor of Immunobiology, Dr. Akiko Iwasaki; and Dr. Edward Breitschwerdt, Professor of Medicine and Infectious Diseases at North Carolina State University College of Veterinary Medicine who will discuss the Building Blocks of PAIS.

Mentioned in this episode: 

Mount Sinai Health System 

Steven & Alexandra Cohen Foundation 

For those proponents of psychedelic-assisted therapy concerned that demand for therapists will outstrip supply in the coming years, you may be reassured by today’s conversation with Dr. Ingmar Gorman and Dr. Elizabeth Nielson, psychologists who have been involved in FDA-approved clinical trials of MDMA and psilocybin, and the co-founders of a company called Fluence Training which is working to scale education for this purpose. As they explain to host Shiv Gaglani, they see their task, broadly speaking, as serving three categories of people: those with general interest in the field; all types of clinicians who want to be able to have informed conversations with patients wishing to discuss their current and/or future use; and those who want to become therapists in this modality. Fluence is especially well-positioned for that last group because of Gorman’s and Nielson’s involvement in designing therapy protocols in clinical trials, but also because of their work developing therapy manuals for drug companies. “If and when their drugs go to market, we’ll be able to train clinicians in the community who will be working with those compounds,” says Gorman. One bottom line message in this richly-informed discussion is that the field needs all comers and they hope people aren’t dissuaded by misconceptions about what’s required. “We hear all the time, 'I want to be involved, but I’d have to go back to school and get all these years of clinical experience' when the reality is there's just so many ways now to get involved,” says Nielson. This is a great overview of the status of training, the potential pitfalls awaiting the field, the importance of managing patient expectations, and much more.

Mentioned in this episode: https://www.fluencetraining.com/

Part of why we love bringing Raise the Line to you is we get to introduce you to creative, committed people who see challenges in the healthcare system as opportunities to improve it.  Today’s guest, radiation oncologist Dr. David Grew, is a perfect example. In the depths of COVID when his patients had to meet with him unaccompanied by a support person, he realized his ability to help people understand the complexities of their care was more important than ever, so he doubled-down on his practice of making simple drawings for them on whatever piece of paper was handy. When patients told them they were bringing the papers home so they could explain things to family members, he realized he needed to up his game. “That’s when the light bulb went off. I need to digitize these drawings so that we can scale this educational moment between a doctor and a patient,” he tells host Michael Carrese. Armed with a laptop and basic educational software, Dr. Grew founded the company PRIMR and started building a library of short, animated videos containing the most common explanations he would give patients. When clinical trial managers noticed what he was doing, they wanted in and so a major focus of PRIMR is educating potential trial participants as well. “I'm on a mission to make sure that patients have an easy way to understand clinical trials.” Listen in to find out about a major medical and societal benefit to better education about these trials and to learn how Dr. Grew thinks PRIMR can help with the crisis of physician burnout.

Mentioned in this episode: https://www.primrmed.com/

“Maybe we think we’re just students and we’re just learning, but you can have an impact as a medical student,” says Dr. Desiree Franco Lugo, who has acted on that insight throughout her recently completed journey at Anáhuac University, Mexico and during her participation in the Osmosis Medical Education Fellowship, where she has served as a Regional Lead for the past two years. Des, as we’ve come to know her, has happily embraced one of the most important roles Regional Leads play: being a mentor to fellow med students. “I love talking to them and seeing how they develop and follow their own dreams. I literally feel like a proud mom with them,” she tells host Hillary Acer. Speaking of which, Hillary, as leader of the OMEF program, has the same pride in all that Des has done to support her peers through hosting events, writing blogs, conducting research and so much more. Beyond Osmosis, Des has developed a global footprint in medical education through internships and being selected to participate in prestigious international conferences. All of those experiences have stoked a previously unknown passion for medical education, and given her confidence to pursue other passions for entrepreneurship and leadership. This is an invigorating conversation in our NextGen Journeys series that underscores what can come from jumping at opportunities, or as Des puts it, having an attitude of ‘less fear and more go for it.’

Mentioned in this episode: 
Osmosis Health Leadership Initiative https://www.osmosis.org/community

Promising research, a growing respect for the patient voice and innovative ways of using technology to support patients might be adding up to a new reality of Alzheimer’s and other dementias being experienced as chronic diseases like some cancers are now considered to be. We’re going to learn about that trend and other positive developments in the space on this special episode of Raise the Line with the leaders of CaringKind - one of the nation’s premier organizations focused on Alzheimer’s and dementia caregiving - who took time out from preparing for its annual gala on June 3 for an in-depth discussion of what’s new, what’s coming and what’s most important for the individuals and families affected by dementia. One welcome theme is that the voices of those with lived experience are being given more weight. “We're going to see more grassroots-driven change where people living with dementia are not just participants in research, but they are partners in research, and they’re actually pushing policy change," says Chief Innovation Officer Stephani Shivers. Tune in as host Michael Carrese explores advancements in diagnostics and research with CaringKind adviser Dr. Anne Kenney; gets briefed on a new Medicare pilot program from Stephani; and learns about the “Forget-Me-Not” gala -- which includes dancing robots -- from CEO Eleonora Tornatore-Mikesh. “For the gala, we're really excited about weaving in the work that we're diving into in the next couple of years to ‘connect to living’ -- to culture and music, people, science and services. Being able to utilize technology to bring joy and socialization back to your life is part of that.” This is a revealing look at the current and future state of caregiving for diseases that are affecting a rapidly growing number of Americans and their families. 

Mentioned in this episode: https://www.caringkindnyc.org/gala/

“There is a revolution at hand in which, after years of struggling to locate a new source of organs, there may finally be an answer and to everyone's surprise it is animal organs. Pigs may save the day,” says Dr. Andrew Cameron, chief of the Division of Transplantation at Johns Hopkins Medicine. While he’s encouraged by recent progress in using genetically-modified pig organs in humans, Cameron points to other ways of addressing this chronic shortage which include creative use of social media to raise awareness of the need, and even compensating people for donations. But, as you’ll learn on this episode of Raise the Line with host Shiv Gaglani, running the transplant program is just one of the hats Cameron wears. As director of the Department of Surgery and surgeon-in-chief, he has a hand in overseeing all surgical subspecialties, so Shiv also explores his thoughts on the role of robotics and other technologies in both performing operations and in training surgeons. And in what is perhaps an unexpected turn, Cameron expresses his excitement about non-surgical developments to improve health such as the new class of weight loss drugs. “We're not here for me to do fancy surgeries. We're here to take care of sick people, so if there is a non-operative solution that’s better for the patient, we're all in on that, too.” It’s an expansive and fascinating conversation you won’t want to miss.

Mentioned in this episode:

Johns Hopkins Department of Surgery: www.hopkinsmedicine.org/surgery

DONOR App: www.thedonorapp.com

TEDx Talk on Xenotransplantation

Today’s Raise the Line guest has a simple but powerful message for medical providers, born of a mother’s heartbreak. “It's going to be rare in your career to meet a zebra but the impact you can have is phenomenal. An early diagnosis could make the difference between life and death for these children,” says Bethan Keall who lost her young daughter Matilda (Tilly) in 2022 to neuroblastoma, a rare cancer most commonly found in children. Because some symptoms of the disease can be easily attributed to other causes, early diagnosis is difficult, particularly if providers are not on the lookout for it. Tilly’s diagnosis of an aggressive form of neuroblastoma introduced Bethan and her husband to the unfortunate realities of a lack of funding and coordination in the UK around pediatric oncology. “For childhood cancer you really need as much collaboration among doctors as possible to understand how treatments can get better because there are relatively few cases,” she explains to host Lindsey Smith. In coping with Tilly’s tragic death at the age of four, her parents have dedicated themselves to Neuroblastoma UK to support research efforts and have benefitted from the emotional and social support provided by a charity called Jak’s Den, founded by the family of a victim of childhood cancer. This is a wrenching, illuminating episode in our Year of the Zebra series offering important insights from a parent’s perspective for providers and policymakers alike. 

Mentioned in this episode: 
Jak’s Den https://www.teamjak.org.uk/
Neuroblastoma UK https://www.neuroblastoma.org.uk/

Today, we're continuing our close look at clerkships and residency programs and what students can do to be successful in them with Dr. Sharon Bord and Dr. Amelia Pousson, who are both physicians and assistant professors in emergency medicine at Johns Hopkins University, where, as most listeners know, Osmosis co-founder and Raise the Line host Shiv Gaglani is pursuing his third year of medical school. “I think one of the things that students really feel when they rotate in the ED is the team-based atmosphere. Emergency medicine providers help each other be the best versions of ourselves that we can in medicine. That is really unique,” explains Dr. Bord, who serves as the emergency medicine clerkship and sub-internship director. For her part, Dr. Pousson wants students to realize there are many paths to becoming a wonderful emergency physician. “There's lots of ways to sort of peel the orange and get it just right even if the path there looks a little bit different for each person,” she says.  Both agree that among the keys for success are rigorous honesty and self-reflection about your goals and limitations, and whether the specialty is a good fit. Tune in for an expansive conversation that provides valuable wisdom and fascinating insights into one of the most vital and challenging of medical specialties. 

Mentioned in this episode: Johns Hopkins Core Clerkship in Emergency Medicine

Medical school is so demanding that it’s always impressive to meet students who make time for other activities, and doubly impressive when what they devote their precious free time to is intended to improve healthcare.  That’s why we’re delighted to welcome Drs. Lawsen Parker, Rebecca Wolff and Stephanie Koplitz to Raise the Line today.  As they were wrapping up their terms as leaders of the Student Osteopathic Medical Association this Spring, they joined host Hillary Acer for an inspiring conversation about medical education, the role of students as advocates, and the future of healthcare. Lawsen, Rebecca and Stephanie also reflect on what being a medical student in the COVID era has been like and how it has shaped their perspectives on healthcare and leadership. Perhaps Lawsen sums it up best by telling Hillary that after his experience in SOMA, “I can’t imagine my career without being a leader, and an advocate for my colleagues, my patients and myself.” Don’t miss this opportunity to hear what is on the minds of these future leaders in healthcare. 

Mentioned in this episode: https://studentdo.org/

Today’s guest is a trailblazing surgeon who performed the first successful nerve allograft, among other important achievements, but that’s actually not what host Shiv Gaglani wanted to focus on in this interview with Dr. Susan Mackinnon. After seeing her speak recently at a Johns Hopkins Grand Rounds presentation, Shiv immediately asked her to be a guest on Raise the Line because of her passion to change the culture and climate in the medical profession, partly by reconnecting it with its core mission. “We need to get it to a point where you can take the Hippocratic oath, which says if I don't agree to look after the care for prince and slave alike, I should die. We need to get back to that.”  Mackinnon candidly details her own journey to being able to recognize and regulate her energy state so that she can perform at the highest level of creativity with colleagues and rise above the counterproductive “I win, you lose” mindset that often prevails in medicine. This free-flowing conversation is packed with insights gathered over a long career and offers much food for thought about how to find happiness and spur innovation at work, and the importance of self-care for providers. There’s also more book recommendations than in any other Raise the Line episode!

Mentioned in this episode: 
Energy Leadership by Bruce Schneider

Taking the Leap by Pema Chodron

Where Good Ideas Come From by Steven Johnson