CMAJ Podcasts

An “old wives’ tale” has persisted in the treatment of anterior epistaxis. A practice article in CMAJ entitled, "Five things to know about anterior epistaxis" discusses what many are doing wrong and the proper way to treat anterior epistaxis. On this episode, co-author and rhinologist Dr. Leigh Sowerby elaborates on the causes and the full suite of options for treating this common cause...

A practice article in CMAJ presents 8 images of monkeypox mucocutaneous lesions presenting in Canadian patients from May to July 2022.  The images show a spectrum of common lesions seen in patients with human monkeypox during the 2022 outbreak in non-endemic countries.  On this episode, Dr. Sharon Sukhdeo and Dr. Darrell Tan, two co-authors of the article discuss their intention that the image atl...

Artificial intelligence, such as computer-aided detection and computer-aided diagnosis or differentiation uses complex algorithms to identify and characterize polyps in situ during screening for colorectal cancer.  Emergent evidence suggests that the performance of AI models is superior to current standards of practice. On this episode, Drs Bigham and Omole speak with Dr. Michael Byrne, co-author...

Efforts to combat anti-Black racism in Canadian healthcare are underway but much remains to be done to dismantle the ideas, systems and implicit biases that underpin this specific form of discrimination. On this special one-hour episode, Drs Omole and Bigham explore the history of anti-Black racism in Canada’s medical schools, in particular at Queen’s University, where a ban on Black students was...

Black and immigrant populations are disproportionately underrepresented in regular screening for cancer. Race-based data from Canada are minimally-available, but research from the United States and Europe has shown that the lifetime risk of developing prostate cancer is much higher among Black people compared to white people and Black people who do get the disease tend to have more aggressive tumo...

Several hospitals are known for providing particularly excellent care to people experiencing a sickle cell crisis.  For example, the ER at UHN meets a key recommendation from the 2017 Ontario Clinical Handbook that patients receive analgesia within  30 minutes of triage. The handbook also recommends that centres support patients’ individual coping strategies through ready access to food, phone cha...

Hereditary angioedema (HAE) is a rare autosomal dominant disorder characterized by recurrent episodes of painful swelling without urticaria that leads to substantial morbidity and even mortality if left untreated. On this episode, Dr. Victoria Cook, an immunologist working in Victoria, BC, describes the case of a woman who had 6 emergency department presentations, 1 hospital admission and saw 5 di...

Many families of organ donors describe feeling alone and abandoned at the moment when their loved one is taken to the operating room for donation. Heather Talbot says she and her family were left on their own as her son was wheeled into the OR. The experience left her thinking, “Well, they got what they wanted and they’ve moved on.” A qualitative study in CMAJ examined the experiences of donor fam...

Functional Neurological Disorders (FND) make up a significant portion of referrals to neurology, maybe as high as 30%. However, misconceptions regarding these disorders remain across medicine, and patients are frequently dismissed as “faking it.” FND are neuropsychiatric conditions in which patients experience neurologic symptoms due to a “functional” disruption of brain networks rather than a “st...

When contemplating issues of diversity and inclusion, medicine needs to consider menopause. A commentary in CMAJ argues that discussion about and, where needed, accommodation of menopause is a necessary step toward providing women physicians with a supportive and comfortable work environment. On this episode, Drs. Bigham and Omole speak with the lead author of the commentary “Hot Flash: Experienci...

This is an encore presentation of our most popular episode of the past year. Postural orthostatic tachycardia syndrome (POTS) is a disorder that can profoundly affect patients' quality of life. Its main characteristic is tachycardia on standing without a drop in blood pressure. Patients complain of lightheadedness and palpitations when upright, which sometimes leads to syncope. This can cause...

The short answer to this question, according to a new guideline published in CMAJ, is “No.” In this special episode, CMAJ editor in chief, Dr. Kirsten Patrick, talks to Dr. Eddy Lang, lead author of the guideline entitled Recommendation on instrument-based screening for depression during pregnancy and the postpartum period produced by the Canadian Task Force on Preventive Health Care. They discuss...

In an effort to reduce the high burden of injury in Canadian youth ice hockey, most associations have restricted bodychecking nationally among leagues for younger players (age 11–12 yr), as well as in certain nonelite divisions of play in older age categories (age 13–17 yr.) This has been shown to be associated with reduced rates of injury, including concussion.  However, despite the evidence, som...

Drug shortages are a persistent problem in Canada and around the world. They interfere with patients’ ability to consistently take medication to manage chronic diseases. And they disrupt urgent care as critical drugs like epinephrine and propofol face shortages.  The COVID-19 pandemic led to concerns that the pandemic would exacerbate existing issues with drug shortages in Canada. Canadian policy-...

The author of a new study in CMAJ says the risk of suicidality among transgender youth, “is really a crisis.”   Mila Kingsbury and her co-authors found that trans and non-binary teens were as much as 7 times more likely than cishet peers to have thought about or tried suicide. More than half of the trans 15-17 year olds in a nationally-representative Canadian survey said they’d thought about suici...

People who use drugs are at elevated risk of death due to the toxic illicit drug supply. Providing easy access to a supply of safe, clean substances may reduce overdose deaths, decrease harms associated with substance use, and improve users’ trust in addiction care.  Safer Alternatives for Emergency Response (SAFER) is a low-barrier, flexible safe supply program that provides several replacement o...

Drowning accounts for hundreds of deaths in Canada every year. A study published in CMAJ examines how pre-existing medical conditions contribute to drowning deaths. Drs Mojola Omole and Blair Bigham speak with the study’s lead author Dr. Cody Boone about what the study’s findings mean for physicians and patients. They then speak with Audrey Giles, a professor of human kinetics at the University of...

In this episode, Dr. Kaveh Shonjania argues that despite the billions of dollars spent on clinical and quality improvement research, most of the interventions that are studied are shown not to work and those that do work produce only marginal benefits for some patients. Dr. Shojania is the Vice Chair of Quality and Innovation for the Department of Medicine at the University of Toronto and past Edi...

A study of more than 3000 health care leaders in Canada found that while gender parity was present, racialized executives were substantially under-represented. Diversity among health care leaders in Canada: a cross-sectional study of perceived gender and race was published in CMAJ. It found that at the ministry level fewer than 7 percent of health care leaders were racialized.  The representation...

COVID-19 disrupted the medical licensing examination system in Canada.  During the pandemic,  exams delivered by The College of Family Physicians of  Canada  (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) were delayed, canceled or adapted, disrupting the lives of hundreds of physicians. However, those challenges prompted many to rethink the historical approach to medical...

Postural orthostatic tachycardia syndrome (POTS) is a disorder that can profoundly affect patients' quality of life. Its main characteristic is tachycardia on standing without a drop in blood pressure. Patients complain of lightheadedness and palpitations when upright, which sometimes leads to syncope. This can cause substantial functional disability, which may be economically devastating. De...

Physicians working in hospitals see the mountains of medical waste generated each day. Meanwhile, the climate crisis challenges the medical system to reduce its contribution to greenhouse gas emissions. Globally, healthcare systems contribute as much carbon dioxide as the airline industry. In Canada, healthcare accounts for 4.6% of our total emissions. The problem is urgent, but potential solution...

The clinical teaching unit is a widely-used clinical training model that requires reform to prepare physicians for practice in the 21st century. In a systematic review in CMAJ, Dr. Brandon Tang and co-authors identified practices in internal medicine clinical teaching units that contribute to improved clinical education and health care delivery. Dr. Tang, a PGY4 in general internal medicine at the...

Reported gonorrhea cases have more than doubled in recent years. Untreated gonorrhea may occasionally cause potentially fatal conditions, such as infective endocarditis.  In this episode, Dr. Carl Boodman, infectious disease and medical microbiology fellow at the University of Manitoba, discusses a case of disseminated gonococcal infection in a 54- year old man who presented to ER with a new heart...

Operative vaginal delivery (OVD) is considered safe if carried out by trained personnel; however, the rate of maternal trauma following OVD in Canada greatly exceeds that of any other OECD country. In Canada, maternal trauma occurred in more than one-quarter of deliveries with forceps, whereas in the UK, the rate is 8%-12%, and in Australia, it sits at ​​9.3%-14.1%. A research study published in C...