Raise the Line

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

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