Core IM | Internal Medicine Podcast

If your patient asks you about a left atrial appendage closure device, what should you tell them?    In the latest episode of the Beyond Journal Club podcast from CORE IM and NEJM Group, the hosts will help you:  Understand the trade-offs : stroke prevention, bleeding, procedural risks, and medications afterward.  Build clinical judgment: weigh which approach may better serve the individual patien...

“Should you stop screening for colorectal cancer (CRC) at 75?”   This episode explores how to individualize screening decisions based on life expectancy, prior colonoscopy findings, and procedural risks. Learn how to navigate these nuanced conversations, avoid age-based assumptions, and use strategies like mailed FIT kits and offering screening choices to help more patients get screened. 🔹 Sponso...

“What’s the best way to screen?” This episode breaks down the pros, limitations, and follow-up needs of FIT, Cologuard, CT colonography, and colonoscopy to help you choose the right screening option for your patients. Also learn practical colonoscopy surveillance intervals based on polyp size, number, and pathology. 🔹 Sponsor:   Search “ Amazon Pharmacy Nationwide Home Delivery" in your EHR t...

“The triglycerides are high. Now what?” This episode breaks down a practical approach to elevated TGs, from knowing when to check ApoB or non-HDL-C to choosing lifestyle changes, lipid-lowering medications, and when to suspect an underlying genetic disorder.  🔹 Transcript and Show Notes 02:17 | Check a non-HDL-C or ApoB if TGs are ≥150 mg/dL  07:18 | Address waist circumference and lifestyle befo...

“Too young for colon cancer.” This episode unpacks the red flags of early-onset CRC, from blood in the stool and iron deficiency anemia to persistent abdominal pain and changes in bowel habits, and offers practical pearls for closing the clinical loop. Also learn why a “negative” family history may need a yearly refresh. 🔹 Sponsor: Search “ Amazon Pharmacy Nationwide Home Delivery" in your EH...

“It didn’t work.” This episode breaks down practical treatment options (dosing options for naltrexone, acamprosate, topiramate, gabapentin) and counseling pearls to help you meet patients where they are and support their recovery. Also discover blind spots in detox and rehab centers. 🔹 Transcript and Show Notes 🔹 Explore ACP’s Substance Use Disorder Education Hub for videos and an AI-powered pat...

Have you ever lost a patient and found yourself thinking about them long after the shift ended? This episode explores the grief clinicians can carry after a patient dies, including the losses that aren’t always obvious. We also discuss ways to work through that grief, recognize when it becomes complicated, and lean on your team for support .   🔹 Transcript and Shownotes 04:12 | What is Clinician...

How to choose between RUQ ultrasound, CT, HIDA, MRCP, EUS, and ERCP based on the clinical picture? When should you move from diagnostic imaging to therapeutic ERCP, and what should you know about sphincterotomy, stents, and stone removal ? Plus, how to interpret bile duct dilation without jumping straight to obstruction? 🔹 Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://w...

Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you start treatment? Join us for a practical, physiology-driven approach to hyponatremia management, from fluids and solutes to loop diuretics and identifying the underlying cause.  🔹 Sponsor:  S...

Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT ( ARBs, Calcium Channel Blockers, Thiazides ) is the preferred first-line framework, and how to personalize medication choices based on...

Learn from primary care docs what has been practiced and changed from the 2026 ACC/AHA Lipid Guidelines! Learn how the new CPR framework (Calculate, Personalize, Reclassify) and PREVENT risk calculator change statin decisions, why LDL targets are back , and when to use Lp(a), ApoB, and coronary artery calcium (CAC) testing. Discover updated risk-enhancing factors, expanded indications for non-stat...

MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a FIB-4 enough, and when should we move to elastography or hepatology referral? And are we finally entering an era where we can meaningfully treat MASH? In this Beyond Journal Club episode, we unp...

What blood pressure should we target in patients on hemodialysis? Why volume control remains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on medication timing around dialysis, drug dialyzability , antihypertensive selection, and strategies to prevent intradialytic complications while optimizing long-term outcomes.  🔹 Sponsor:  ...

Why is fluid management the most important part of dialysis care? This episode explores the fundamentals of hemodialysis , why ESKD patients have unique physiology , and how volume overload, not just hypertension, drives many complications. Learn practical pearls on dry weight, sodium restriction, diuretics, and the strategies that can reduce hospitalizations and improve patient outcomes.  🔹 Spon...

Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical context still matters. When evidence is incomplete, and every patient is different, can AI truly practice medicine or only assist the clinicians who do? This episode explores the space between alg...

We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes divert, how ground medical support works, altitude physiology, legal protections, and how to stay calm when medicine suddenly happens at 35,000 feet. By the end, you may still sweat a little…but h...

Can you distinguish benign eosinophilia from a sign of serious disease, and know exactly when to act at the bedside? In this high-yield episode, test your clinical reasoning as we tackle: When eosinophilia becomes dangerous and why it matters How to distinguish if its from atopy vs. systemic disease Which medications to stop (and which to watch) How travel, diet, and exposure history shape your wo...

Is coffee helping or harming our patients’ hearts? In this Beyond Journal Club, we unpack the  CRAVE trial  and use it as a lens to answer a bigger question: How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust? Listen for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle. 🔹 Sponsor: Oakst...

Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students, residents, and clinicians who want a clear, usable approach. .🔹Sponsor:  DoxGPT  by Doximity  - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, char...

A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded? A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI? A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter? And the classic inpatient dilemma: your heart...

Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help . In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them. • Do cholinesterase inhibitors really work? • What should clinicians know about lecanemab and donanemab before referring patients? • How much benefit should we expect and for how...

Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI? 🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, sec...

From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden. 🔹  Sponsor : Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group:  https://cme-info.nejm.org/core-im/ 🔹 Transcr...

Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside , learn how clinicians should act when ethics, law, and trust collide. 🔹 Sponso...

Baby alligators   - those betrayals of purpose  , or, death by a thousand paper cuts  ! Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with: Regulated curiosity Strategic empathy Small, well-chosen moves... ...and change that is  big enough to matter, and small enough to win! 🔹 Sponsor: Caraway’s cookware set is a favorite for a reason. For 1...