Girl Doc Survival Guide

Christine J Ko, MD
  • 4.8 (12)
  • MEDICINE
  • UPDATED WEEKLY

Young doctors are increasingly in ‘survival’ mode.    Far from flourishing, the relentless pressure of working in medicine means that ‘balance’ is harder than ever to achieve.   On the Girl Doc Survival Guide, Yale professor and dermatologist Dr Christine J Ko sits down with doctors, psychologists and mental health experts to dig into the real challenges and rewards of life in medicine.    From dealing with daily stressors and burnout to designing a career that doesn’t sacrifice your personal life, this podcast is all about giving you the tools to not just survive...    But to be present in the journey.

  1. 3D AGO

    EP209: The Art of Diagnosis: Insights from Dr. Lisa Sanders

    Dr. Lisa Sanders on Diagnosis, Cognitive Bias, and Making Time to Listen Christine interviews Dr. Lisa Sanders, Yale School of Medicine professor and Medical Director of Yale’s Long COVID Multidisciplinary Care Center, known for the New York Times “Diagnosis” column and consulting on House. Sanders describes switching from Emmy-winning CBS News producer to physician after seeing a sports medicine doctor perform CPR and save a drowning woman, and realizing she wanted to save lives. She discusses avoiding diagnostic cognitive bias by staying aware you can be wrong, keeping a differential diagnosis, and “trust but verify,” sharing a case where she accepted a patient’s self-reported POTS diagnosis and later found hyperthyroidism. Sanders argues diagnostic errors often stem from rushed visits and urges physicians to demand more time, noting she secured hour-long new-patient visits and 30-minute follow-ups. She addresses patients not being believed, especially with post-infectious syndromes like long COVID, POTS, MECFS, and fatigue, and advises support for non-linear career paths. 00:00 Welcome and Guest Intro 01:00 From TV News to Medicine 01:31 The CPR Moment That Changed Everything 03:42 Fighting Diagnostic Bias 04:45 Trust but Verify POTS Mix Up 06:49 Reclaiming Time With Patients 10:45 Why Patients Aren't Believed 12:11 Fatigue and Post Infectious Syndromes 13:45 Advice for Nonlinear Careers 14:43 Final Thoughts and Farewell

    15 min

  2. MAR 4

    EP208: Dr. Adam Rubin on Medicine, Investing, and Life Lessons

    Dr. Adam Rubin on Adapting, Coalition-Building, and Time in a Dermatology Career Christine hosts Dr. Adam Rubin, Director of Dermatopathology at NYU Langone and Editor-in-Chief of the Journal of Cutaneous Pathology, reviewing his extensive roles in nail disorders, dermatopathology organizations, and major textbooks. Rubin shares an anecdote about taking a medical dermatology fellowship with Dedee Murrell in Sydney after discovering a fellowship listing was a misprint, and describes learning to adapt to different clinical cultures, emphasizing that individuals must adjust to existing systems. He advises building forward momentum in small steps, using coalition-building and organized meeting processes learned at the AMA, and focusing on relationship-centered leadership and big-picture decisions in journal work despite resource limits. Career tips include doing work you love while maintaining non-work interests, learning investing basics early to benefit from compounding, and being selective with time by thoughtfully saying no.  00:00 Welcome and Guest Intro 01:39 A Fellowship Misprint 03:05 Adapting to New Systems 03:48 Career Progress and Coalitions 05:40 Leading a Journal 06:51 Do Work You Love 07:40 Investing and Compounding 08:31 Protect Your Time 09:10 Host Reflection on Stress

    10 min

  3. FEB 25

    EP207: Dr. Kevin Ko: New Horizons in Oral and Dermatopathology

    Dr. Kevin Ko on Biomarkers, Oral Dysplasia, and the Limits of H&E Diagnosis Christine interviews Dr. Kevin Ko (DMD, MD), a pathologist at the BC Cancer Agency with training in oral and maxillofacial pathology, anatomic pathology, and dermatopathology. They discuss his ASDP 2025 lecture on using p53 in oral dysplasia as a potential new approach and the broader problem of diagnostic discordance and over-diagnosis when relying on H&E alone. Dr. Ko shares examples from practice, including recognizing oral porokeratosis (previously followed as dysplasia for years) and a chemotherapy-related lip lesion initially suspected to be severe dysplasia but supported by wild-type biomarker results and clinical history, resolving after stopping chemotherapy drugs. He emphasizes the need for reproducible biomarkers and possibly molecular-based classification to improve consistency and patient outcomes, while also describing the pressure to be near-perfect in pathology, the risk of burnout, and efforts to build sustainable systems (QA sessions, colleague consultation, protected time). The conversation closes with his approach to presentations as storytelling, interest in prospective multi-center research, and a final message about balancing perfectionism with rest while remaining open-minded to new diagnostic methods to improve patient care. 00:00 Welcome & Meet Dr. Kevin Ko (DMD/MD, Dermpath at BC Cancer) 01:00 The Controversial Idea: Using p53 Biomarkers in Oral Dysplasia 01:18 Oral vs Skin Pathology: Discovering Porokeratosis in the Mouth 02:07 Diagnostic Error & Overdiagnosis: Why Reproducible Biomarkers Matter 05:19 Case Study: “Severe Dysplasia” vs Toxic Erythema of Chemotherapy —Context Changes Everything 06:36 The Perfectionism Trap in Pathology (and Why 95% Isn’t Good Enough) 08:04 Burnout, QA Systems, and Building Sustainable Workflows 09:14 Work–Life Balance, Kids, and Choosing Priorities (Family vs Research) 11:14 How to Build a Great Talk: Storytelling, Cases, and Future Studies 11:38 Final Takeaways: Balance, Open-Mindedness, and Better Diagnostics

    12 min

  4. FEB 18

    EP206: The Art and Science of Diagnosing: Dr. Raymond Barnhill on Melanocytic Lesions

    Dr. Raymond Barnhill on Diagnostic Drift, Uncertainty, and the MPATH-Dx V2.0 Approach to Melanocytic Lesions In this episode of The Girl Doc Survival Guide, Christine interviews Dr. Raymond Barnhill, a world-recognized dermatopathology expert known for work on diagnostically challenging melanocytic lesions, melanoma pathology references, and contributions to WHO skin tumor classification and AJCC melanoma staging. Dr. Barnhill shares career anecdotes and key communities at Yale and in Boston, collaborations with numerous melanoma leaders, and the founding of the North American Melanoma Pathology Study Group and the International Melanoma Pathology Study Group, as well as participation in the NIH-funded MPATH Study Group. The discussion focuses on overdiagnosis, underdiagnosis, and diagnostic discordance in melanocytic lesions, including evidence of diagnostic drift toward calling more lesions melanoma over time and the overlap between melanoma criteria and atypical/dysplastic nevi. He describes MPATH research, explains the revised MPATH-Dx V2.0 schema, explicitly recognizing uncertainty along a continuum rather than a strict benign/malignant threshold. He emphasizes practical diagnostic approaches including measuring lesion size (noting a 4 mm threshold associated with conventional dysplastic nevi and increasing concern at larger sizes), focusing on key architectural features (junctional nest variation/disarray and lentiginous proliferation), using nuclear size relative to keratinocyte nuclei (including a 1.5× threshold and counting atypical cells per high-power field) while accounting for site-specific pitfalls such as scalp nevi. The conversation also covers “gestalt” versus systematic review, the importance of due diligence using full clinical and morphologic information before ancillary testing, and cautions against overreliance on immunohistochemistry or molecular tests. Dr. Barnhill closes with career advice ends with a message that setbacks can be opportunities for growth. 00:00 Welcome + Meet Dr. Raymond Barnhill (Dermatopathology Legend) 01:51 Career Origins & Melanoma Pathology Mentors (Yale → Boston) 03:59 Building Melanoma Pathology Study Groups (North American & International) 05:57 Overdiagnosis, Diagnostic Drift & Why Discordance Happens 09:43 Inside the MPATH Study: Measuring Interobserver & Intraobserver Agreement 11:39 MPATH-Dx V2.0 Explained: Standardized Classes & Treatment Guidance 13:59 Redefining “Low-Risk” Melanoma: Stringent pT1a Criteria + Embracing Uncertainty 18:47 Practical Grading Tips: Lesion Size, Architecture & Nuclear Atypia Thresholds 22:42 Gestalt vs Due Diligence: Avoiding Traps + Using IHC/Molecular Wisely (PRAME) 28:39 Career Advice: Passion, Mentors, Community + Final Reflections

    31 min

  5. FEB 11

    EP205: Lessons in Leadership and Legacy with Dr. Thomas Helm

    Balancing Careers and Family: Insights from Dr. Thomas Helm In this episode of The Girl Doc Survival Guide, Christine invites Dr. Thomas Helm, MD, for his second appearance on the podcast. Dr. Helm, former Head of Dermatology and Director of Dermatopathology at Buffalo Medical Group, now working at Penn State Hershey Medical Center, shares his extensive experience and personal anecdotes. They discuss generational changes in the medical field, challenges faced by women in medicine, and the importance of work-life balance. Dr. Helm emphasizes the significance of understanding work culture, making intentional career decisions, and maintaining work-family harmony. He reflects on his career transition to academia and the rewarding relationships he has built along the way. The conversation delves into the importance of community, mentoring, and the profound impact of prioritizing meaningful relationships over individual autonomy. 00:00 Introduction and Guest Welcome 00:45 Personal Anecdotes and Family Influence 01:22 Changes in Medical Field Demographics 02:10 Challenges for Women in Medicine 02:39 Balancing Career and Family 04:50 Mentorship and Career Advice 06:46 Prioritizing Relationships and Community 10:53 Transition to Academia and Personal Growth 18:52 Final Thoughts and Gratitude

    20 min

  6. FEB 4

    EP204: Overcoming Decision Paralysis with Dr. Mary Steffel

    Overcoming Decision Paralysis: Insights from Dr. Mary Steffel In this episode of The Girl Doc Survival Guide, we welcome Dr. Mary Steffel, an Associate Professor of Marketing at Northeastern University. Dr. Steffel delves into the phenomenon of decision paralysis, drawing from her extensive research on consumer judgment and decision making. She shares personal anecdotes, including her illustrative experience playing Cinderella, and discusses practical strategies for managing complex decisions. Key solutions include delegating decision-making to others and simplifying choices. Dr. Steffel also offers advice for healthcare providers to help patients navigate medical decisions. The conversation covers the importance of recognizing decision fatigue and planning decision-making for optimal times. 00:00 Introduction and Guest Welcome 00:56 Personal Anecdote: Cinderella and Decision Paralysis 02:15 Understanding Decision Paralysis 03:54 Real-World Example: Medicare Drug Plans 05:25 Delegating Decisions: A Practical Approach 09:58 Medical Decision Making: Simplifying Choices 14:07 Overcoming Decision Fatigue 15:49 Conclusion and Farewell

    16 min

  7. JAN 28

    EP203: Decoding Overdiagnosis: A Deep Dive with Dr. Wolfie Weyers

    In Conversation with Dr. Wolfgang Weyers: The Complexities of Dermatopathology Diagnosis In this episode of The Girl Doc Survival Guide, Christine welcomes Dr. Wolfgang Weyers, a highly respected dermatopathologist and author, to discuss his experience and perspectives on medical diagnosis. Dr. Weyers shares a personal anecdote about his influential mentor, Dr. Bernie Ackerman, and dives into a critical discussion on overdiagnosis, the importance of specific diagnosis in dermatopathology, problems caused by partial samples, and the criteria for diagnosing melanoma. He emphasizes the importance of experience, proper training, and the need to biopsy adequately developed lesions. The conversation also touches on the complexity of biological classification and the role of behavior and molecular studies in understanding diseases.  00:00 Introduction to Dr. Wolfgang Weyers 00:46 Personal Anecdotes and Influences 02:05 Discussion on Overdiagnosis 05:04 Criteria for Melanoma Diagnosis 08:34 Challenges in Diagnosis and Solutions 16:48 Final Thoughts and Conclusion

    17 min

  8. JAN 21

    EP202: Understanding Cancer Diagnosis: An Expert Discussion with Dr. Kathleen Kerr

    Overdiagnosis and Medical Decision Making with Dr. Kathleen Kerr In this episode of The Girl Doc Survival Guide, Dr. Kathleen Kerr, a Professor of Biostatistics at the University of Washington, discusses overdiagnosis and medical decision making. Dr. Kerr delves into how patients perceive mammogram results, the difference between overdiagnosis and overcalling, and the challenges pathologists face in diagnosing cancer. She also shares findings from her research on the influence of prior opinions on second diagnoses and the cognitive processes involved in interpreting pathology images. The discussion highlights the complexities and subjectivity in pathology diagnoses and the implications for patient care. 00:00 Introduction and Guest Welcome 00:33 Personal Anecdote on Mammograms 01:25 Understanding Screening and Its Limitations 02:24 Exploring Overdiagnosis 05:59 Research on Dermatopathologists' Perceptions 08:20 Second Opinions in Medical Decision Making 12:26 Pathologists' Diagnostic Process 15:42 Final Thoughts on Diagnostic Criteria

    18 min
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4.8
out of 5
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About

Young doctors are increasingly in ‘survival’ mode.    Far from flourishing, the relentless pressure of working in medicine means that ‘balance’ is harder than ever to achieve.   On the Girl Doc Survival Guide, Yale professor and dermatologist Dr Christine J Ko sits down with doctors, psychologists and mental health experts to dig into the real challenges and rewards of life in medicine.    From dealing with daily stressors and burnout to designing a career that doesn’t sacrifice your personal life, this podcast is all about giving you the tools to not just survive...    But to be present in the journey.

Information

  • Creator
    Christine J Ko, MD
  • Years Active
    2022 - 2026
  • Episodes
    217
  • Rating
    Clean
  • Copyright
    © 2026 Girl Doc Survival Guide
  • Show Website
    Girl Doc Survival Guide

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