Below is an interview between the host of CORE IM and Doximity, followed by a brief overview of the podcast.
Doximity: How did CORE IM get started?
Shreya P. Trivedi, MD: We started in late 2017. The heart of it really came from feeling like the hustle and bustle of the day was too demanding to have time to consolidate everything. I think there’s a lot of medical education: conferences, lectures, etc. While hearing people lecture at you information can feel good in the moment, you walk away and maybe two weeks later when a patient walks in with hypothyroidism, you have trouble remembering what to do or how to apply anything you learned.
At the time, I was learning a lot about adult learning theory and what teaching techniques help to transfer knowledge. There’s a lot of studies in the K-12 literature and some in medical education as well showing the importance of quizzing, spaced repetition, purposeful pausing, etc. and that’s something that I wanted to bring to medical education.
I was a resident when I first had this idea and I didn’t have any title or power to significantly influence learning. So I turned to podcasting; it was a medium through which I could craft my vision of what intentional medical education could be. That’s where “5 Pearls” came from: I met some other brilliant physicians who were also passionate about enhancing medical education. I asked them what lights them up and it was critical thinking and clinical reasoning in Internal Medicine and that’s where the segments Mind the Gap and Hoofbeats came from.
Dox: What’s the general format for the podcast?
ST: The “5 Pearls” segment starts off with five clinical questions with a cue for the listener to pause, quiz themselves, assess their baseline knowledge, and prime themselves to teaching points. The next part is five short conversations on the answers to each of those clinical questions with purposeful repetition of key points at the end of each section. The last pearl is often a throwback from a prior episode for spaced repetition.
“Mind the Gap” is inspired by Planet Money — so it’s a very fun, fast, bantering that questions why we do what we do in medicine. We go deeper into things in a fun way.
“Hoofbeats” is a clinical reasoning segment that goes through cases, but different than what you hear in morning reports. You’ll hear an expert go through what they think about a case out loud and then the host in their own commentary will highlight the metacognitive approach the expert is using.
Dox: You’ve talked about CORE IM not being a podcast before — what does it aim to be?
ST: Podcasting is just one of the exciting ways and future directions of medical education. We have also engaged a lot with the medical community with EKG #12leadThursday teaching points and #triviatuesday cases and small knowledge bites through social media and our website.
What I find is that as medicine becomes a more pressurized, fast-paced, metric-driven kind of health care system where it is [today], there isn’t much time to learn from each other and talk about hardships. Sometimes, a community aspect is needed in, and CORE IM has created a community around the podcast where physicians can engage with one another.
We do a “food for thought” segment on Sunday’s where we talk about a specific article and consider what was compelling, whether it’s about social justice or other aspects that would engage the whole physician. We keep hearing from our listeners that a core part of the podcast is feeling less alone in their training or practice of medicine.
Dox: Who makes up this community?
ST: Based on engagement on Twitter, Instagram, and emails, I would say medical students, residents, attendings, nurses, pharmacists — it really ranges.
Dox: How do you choose guests for the podcast?
ST: We’re pretty thoughtful about it — obviously we look for who’s an expert in the field who would be engaging to listen to. We’re also careful to feature an equal representation of women in medicine. I find that the majority of medical education podcasts feature men as both hosts and experts. I very much find that, now as we have a bigger audience for our platform, we have the responsibility to shape and change what people consider to be experts. Often times at our institutions, we see that our leaders, deans, or chairs are [mostly] men. CORE IM has a unique [opportunity] where we don’t have to wait years; we can elevate the voices of females trying to change the future of medicine.
Dox: What are some episodes that resonated with your audience?
ST: We just did a 5 Pearls episode on Pain Management with Shani Herzig who has done outstanding research in the field and gave a practical perspective on the topic.
Also, the PPI episode did an incredible job of connecting pathophysiology since a lot of it is forgotten in med school and why it matters for clinical practice.
All of the episodes on clinical reasoning, or “Hoofbeats” episodes, leave me so excited about Internal Medicine. A Mind the Gap episode on UTI and AMS was great at picking apart our assumptions of what we have always been taught and using data.
Dox: What does the future of the podcast look like?
ST: Vision for CORE IM is to really encompass “core” Internal medicine and to do so, we need to cover the day-to-day struggles that aren’t covered in guidelines, studies, or clinical reasoning. A new segment called “At the Bedside” will delve into the deeper into that realm.
This podcast is good for those who are interested in: medical education, critical thinking and reasoning
Typical length of episodes: About 15-35 minutes
How often a new episode comes out: Bi-weekly
Episode topics: PPIs, alcohol use disorder, delirium and UTIs, clinical reasoning on a patient with confusion, diarrhea or weakness
Sample episode — "5 Pearls on Pain Management": This episode questions the effectiveness of non-opioids. It looks into whether NSAIDs contraindicate in patients with kidney, liver, or heart diseases and if they can be used safely. In addition, there’s an exploration of best practices for patients with analgesia and how to minimize harm.
Tidbit about the show: Each episode has show notes and a complete transcript available on the website.
About the host: Shreya P. Trivedi, MD is a hospitalist at NYU Langone. She launched the podcast in October 2017. Heartfelt emails and positive feedback make all the hard work that goes into producing an intentional-high quality podcast worth it, according to Trivedi, who is an advocate of podcasts for lifelong learning and teaching.
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