9 episodes

The External Medicine Podcast is a podcast exploring some of the most exciting ideas in medicine. Medical students Daniel Belkin and Mitch Belkin interview physicians, scientists, and outside-the-box thinkers for evidence-based, practice-changing knowledge.

The External Medicine Podcast The External Medicine Podcast

    • Health & Fitness
    • 4.7 • 24 Ratings

The External Medicine Podcast is a podcast exploring some of the most exciting ideas in medicine. Medical students Daniel Belkin and Mitch Belkin interview physicians, scientists, and outside-the-box thinkers for evidence-based, practice-changing knowledge.

    Fructose and Fat Storage: An Evolutionary Perspective with Rick Johnson, MD

    Fructose and Fat Storage: An Evolutionary Perspective with Rick Johnson, MD

    This conversation was recorded on June 24th, 2021. In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Johnson about fructose and its relationship to fat storage. They discuss uric acid as a cause of kidney inflammation and essential hypertension, how glucose intake can trigger endogenous fructose production, and the relationship between salt and obesity. Finally, they touch on the evolutionary history of uric acid metabolism and the potential role for fructokinase inhibitors in treating metabolic disease.

    Who is Rick Johnson?
    Dr. Johnson is a Professor of Nephrology at the University of Colorado School of Medicine. He is one of the world’s leading experts on fructose. His research focuses on the role of fructose and uric acid in obesity, diabetes, hypertension, and kidney disease. He has over 700 publications, in journals including JAMA and the NEJM. He is also the author of two books for a general audience, The Fat Switch and The Sugar Fix.

    References
    Uric Acid levels predicts future hypertension
    Uric acid and its relationship with pediatric hypertension 
    Randomized Trial - Allopurinol on hypertensive adolescents 
    Endogenous fructose production and kidney inflammation
    High salt diet and endogenous fructose production in mice
    How osmolality of soup increases blood pressure 
    Fructose, Uricase, and the Back-to-Africa Hypothesis 
    Books:
    1. The Fat Switch
    2. The Sugar Fix
     ______________________

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    Daniel Belkin and Mitch Belkin  are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 
     

    • 1 hr 6 min
    Medical Conservatism, Myocarditis, and Physician Advocacy with John Mandrola, MD

    Medical Conservatism, Myocarditis, and Physician Advocacy with John Mandrola, MD

    This conversation with Dr. John Mandrola was recorded on July 11th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Mandrola about a 2019 article he co-authored entitled The Case for Being a Medical Conservative. They discuss concerns about vaccine-induced myocarditis in children, vaccine mandates, and whether the AMA and other physician organizations should take sides on controversial political issues. 
    Who is John Mandrola?
    Dr. John Mandrola is a practicing cardiac electrophysiologist and a regular columnist for theheart.org on Medscape. He hosts the fantastic “This Week in Cardiology” podcast and is a blogger at drjohnm.org. He completed his medical training in Internal Medicine, Cardiology and Electrophysiology at Indiana University. 
    References:
    The CAST trial 
    RECOVERY Trial
    Medscape – Cardiology
    Medscape – General Medicine
    Blog
    Substack
    This Week In Cardiology Podcast
    Twitter: @drjohnm

    ______________________

    Follow us @ExMedPod, and sign up for our newsletter at www.externalmedicinepodcast.com/subscribe

    Daniel Belkin and Mitch Belkin  are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 

    • 53 min
    The Epigenetics of Aging & Dispelling mRNA Vaccine Myths with Yuri Deigin

    The Epigenetics of Aging & Dispelling mRNA Vaccine Myths with Yuri Deigin

    This conversation with Yuri Deigin was recorded on June 25th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Yuri about aging, which he argues is fundamentally an epigenetic phenomenon. We discuss partial reprogramming using Yamanaka factors, evolutionary explanations of aging, and recent in vivo experiments which suggest that aging is partially reversible. We also touch on mRNA vaccines, specifically to address allegations about the cytotoxicity of the spike protein and concerns about infertility discussed on Bret Weinstein’s Dark Horse Podcast with Steve Kirsch and Robert Malone, MD, recorded on June 11th 2021.
    Who is Yuri Deigin?
    Yuri Deigin is a biotech entrepreneur with a background in pharmaceutical development. He received degrees in computer science and mathematics from the University of Toronto and an MBA from Columbia University. He is the CEO of Youthereum Genetics, a company which aims to translate epigenetic rejuvenation therapies to humans. 
    Yuri was an early proponent of the SARS-CoV-2 lab leak hypothesis, the idea that the virus may have inadvertently escaped from a lab. In April 2020, he published a detailed genomic analysis of SARS-CoV-2. In that article, Yuri discusses the virus’s furin cleavage site, genetic similarities and differences with its closest relative (RaTG13), and the similarities between the virus’s receptor binding motif and that of a pangolin respiratory virus. He also explores the gain-of-function research program at the Wuhan Institute of Virology. Unfortunately, we did not have time in this conversation to delve into this hotly debated topic.
    References:
    Universal methylation age across mammalian species
    Partial reprogramming of Progeria mice
    David Sinclair paper on restoring vision in mice
    Uri Manor Lab spike protein paper 
    Large doses of Spike Protein Induce Acute Lung Injury in Mice
    Pfizer ADME study (translated from Japanese) 
    Vaccine Adverse Event Reporting System (VAERS) FAQ re: requirement to report deaths, other serious adverse events
    How frequently are side effects reported to VAERS?
    More on Yuri:
    Medium article on SARS-CoV-2 Origins
    Yuri’s twitter: @ydeigin

    • 55 min
    The Case for Medical Education Reform with Bryan Carmody, MD

    The Case for Medical Education Reform with Bryan Carmody, MD

    This conversation with Dr. Bryan Carmody was recorded on June 21st, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Carmody about the history of the USMLEs, the value of standardized test scores, and the arms race in the residency admissions process. They touch on conflict of interest in medical education and the rising cost of medical schools among other topics.

    If you enjoy this episode, please follow us on twitter @ExMedPod and subscribe to our newsletter.
    Who is Bryan Carmody?
    Dr. Bryan Carmody is a pediatric nephrologist at Eastern Virginia Medical School. He has made a name for himself as a critic of certain aspects of medical education and the residency application process. For years, he has argued that USMLE Step 1 should go pass-fail and that Step 2 CS should be eliminated — both of these events happened in the last year and a half. 
    Campbell’s law:
    Campbell’s law comes from Donald Campbell, a psychologist and social scientist from the mid-20th century.
    In 1976, Campbell wrote: “Achievement tests may well be valuable indicators of general school achievement under conditions of normal teaching aimed at general competence. But when test scores become the goal of the teaching process, they both lose their value as indicators of educational status and distort the educational process in undesirable ways.” 
    For instance, there are now entire school curricula devoted to improving test scores. This obviously wasn’t the original intention. 
    References:
    Radiology Journal Article: “Do residency selection factors predict radiology resident performance?” This article finds a fairly modest association between USMLE score and discordance rates between preliminary resident reads of radiologic findings and the final attending interpretation. This was for residents at UPMC. https://pubmed.ncbi.nlm.nih.gov/29239834/
    Paul Graham: The podcast references his essay, The Lesson to Unlearn.
    More on Dr. Carmody:
    Youtube video on capping residency applications: 
    Dr. Carmody’s Youtube channel
    Twitter link: @jbcarmody 
    Sheriff of Sodium blog

    • 1 hr 8 min
    Diagnostic Reasoning and Medical Overuse with Deborah Korenstein, MD

    Diagnostic Reasoning and Medical Overuse with Deborah Korenstein, MD

    This conversation was recorded on June 7th, 2021. In this interview, we talk with Deborah Korenstein, MD, about medical overuse and overdiagnosis. We discuss her April 2021 publication in JAMA Internal Medicine, the Accuracy of Practitioner Estimates of Probability of Diagnosis Before and After Testing as well as the diagnostic process, the teachability of diagnostic reasoning, cognitive biases, and other topics.

    Who is Deborah Korenstein?
    Dr. Deborah Korenstein is Chief of the General Internal Medicine Service at Memorial Sloan Kettering Cancer Center in New York. Her clinical work focuses on care to adult survivors of childhood and other high-risk cancers. As a researcher and an educator of physicians in training, she is interested in improving the value of care while minimizing unnecessary and potentially harmful tests and treatments. 
    To learn more about mitigating medical overuse, check out the ABIM Foundation's Choosing Wisely campaign and Dr. Korenstein's project Testing Wisely.

    Factoids:

    In this week's episode, we list some factoids on the overprescription of antibiotics for viral URIs, the incidence of incidentalomas, and the detection of PE with high resolution CTA. If you'd like to read the articles from which these factoids were taken, check them out below:
    1. 2019 Update on Medical Overuse: A Review in JAMA Internal Medicine
    Highlights: 
    Procalcitonin does not affect antibiotic duration in patients with lower respiratory tract infection (4.2 vs 4.3 days)Incidentalomas are present in 22% to 38% of common magnetic resonance imaging or computed tomography studies9% of women dying of stage IV cancer are still screened with mammographyClinics commonly overprescribe antibiotics (in 39% of all visits, patients received antibiotics)State medical liability reform was associated with reduced invasive testing for coronary artery disease, including 24% fewer angiograms2. Overdiagnosis in primary care: framing the problem and finding solutions in BMJ (2018)
    Highlights:
    Overdiagnosis is defined as the diagnosis of a condition that, if unrecognized, would not cause symptoms or harm a patient during his or her lifetimeOverdiagnosis can harm patients by leading to overtreatment (with associated potential toxicities), diagnosis related anxiety or depression, and labeling, or through financial burden.Many entrenched factors facilitate overdiagnosis, including the growing use of advanced diagnostic technology, financial incentives, a medical culture that encourages greater use of tests and treatments, limitations in the evidence that obscure the understanding of diagnostic utility, use of non-beneficial screening tests, and the broadening of disease definitions. 

    • 1 hr 4 min
    The Invisible Graveyard: A Conversation with Economist Alex Tabarrok

    The Invisible Graveyard: A Conversation with Economist Alex Tabarrok

    In this interview, we talk with Professor Alex Tabarrok about what economists can bring to discussions of the pandemic, the US government’s response to COVID-19, the performance of the FDA and the CDC, regulatory nationalism, the first doses first campaign, and why America should vaccinate the world. This conversation was recorded on May 2nd, 2021. 
    Who is Alex Tabarrok?
    Professor Alex Tabarrok is the Bartley J. Madden Chair in Economics at the Mercatus Center and a professor of economics at George Mason University. He is the co-author of the popular economics blog Marginal Revolution and co-founder of Marginal Revolution University. He is the author of numerous academic papers in the fields of law and economics, criminology, regulatory policy, voting theory and other areas in political economy. His articles have appeared in the New York Times, the Washington Post, the Wall Street Journal, and many other publications.

    • 1 hr 1 min

Customer Reviews

4.7 out of 5
24 Ratings

24 Ratings

Ari Sadi ,

Informative

Informative and helpful. Thank you very much!

MelliousBellious ,

Cool discussion

I’d love to hear more!! Love It!

JulieGeeee ,

🩺

illuminating + insightful

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