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In this episode of Clinical Conversations, Dr Sebastian Spencer and Dr Dan Harman discuss how community and frailty medicine is evolving to deliver proactive, person-centred care closer to home; why frailty matters across all specialties; and how clinicians and healthcare systems can better identify, manage and support people living with frailty. Dr Dan Harman is a consultant geriatrician and clinical lead at the Jean Bishop Integrated Care Centre in Hull. He is an expert in frailty, hospital-at-home and community-based care. He has over 20 years of medical, executive management, academic and policy experience. Dr Sebastian Spencer is a member of RCPE's Trainees and Members' Committee and an academic renal registrar. -- Useful Links -- Taher, A.S.M., Slavova-Boneva, V. & Battisti, N.M.L. Polypharmacy, Medicine Optimisation, and Medication Adherence in Older Cancer Patients. Curr Oncol Rep 28, 43 (2026). https://doi.org/10.1007/s11912-026-01780-9 Age UK. The Longest Wait to Leave: Tackling the delayed discharges that help to drive corridor care - https://www.ageuk.org.uk/bristol/about-us/news/the-longest-wait-to-leave-report/ British Geriatrics Society - Be proactive: Delivering proactive care - https://www.bgs.org.uk/be-proactive-proactive-care-for-older-people-with-frailty British Geriatrics Society - Pragmatic prescribing to reduce harm for older people with moderate to severe frailty - https://www.bgs.org.uk/PragmaticPrescribing Crocker TF, et al. Community based complex interventions to sustain independence in older people: systematic review and network meta-analysis. BMJ. 2024. - https://doi.org/10.1136/bmj-2023-077764 Recording Date: 29 July 2026 -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Heather Kennedy is joined by Dr Ailie Young, Consultant in Acute Medicine with special skill in Obstetric Medicine. They discuss breathlessness in pregnancy, covering the approach to initial assessment and investigations in the AMU, the management of acute exacerbation of asthma in pregnancy, and the investigation/management of PE in pregnancy. Dr Ailie Young is a Consultant in Acute and General medicine with a specialist skill in Obstetric Medicine. She is particularly interested in the investigation and management of the acutely unwell pregnant patient that is admitted to the Acute Admissions unit with a medical problem. Dr Heather Kennedy is an ST4 in Acute Internal Medicine in Southeast Scotland and a member of the Trainees and Members' Committee. -- Useful Links -- UK Teratology Information Service - https://uktis.org Best Use of Medicines in Pregnancy (BUMPS) - https://www.medicinesinpregnancy.org The Maternal Care Bundle (See Element 1 VTE) - https://www.england.nhs.uk/long-read/the-maternal-care-bundle/#element-1-venous-thromboembolism-vte Green-top guideline Thrombosis and Embolism during Pregnancy and the Puerperium - https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/thrombosis-and-embolism-during-pregnancy-and-the-puerperium-acute-management-green-top-guideline-no-37b/ Recording Date: 16 July 2026 -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode of Clinical Conversations, Dr Emma Spencer discusses the importance of digital health literacy - the ability to access, understand and use digital health tools - with Professor Mahmood Adil, RCPE's outgoing Clinical Data & Digital Health Lead. Prof Adil provides insights into the evolution of digital health and clinical informatics over his career and how doctors can enhance their digital health literacy. The introductory resource on clinical data and digital health can be accessed on RCPE's Education Portal: https://learning.rcpe.ac.uk/data-digitalhealth Professor Mahmood Adil was RCPE's Clinical Data & Digital Health Lead. He is a global expert in clinical data, digital health & innovation fields. He has over 25 years of medical, public health, executive management, academic and policy experience and has delivered on key senior positions in the UK, USA & Middle East. Dr Emma Spencer is Co-Vice Chair - Education of RCPE's Trainees and Members' Committee and resident doctor in internal medicine. RCPE would like to thank Professor Adil for his contributions and service as our Clinical Data & Digital Health Lead. Recording date: 17 April 2026 An extended version of this episode will be released on our sister podcast, Career Conversations, later this year: https://podcasts.rcpe.ac.uk/show/career-conversations/ -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Heather Kennedy hears about a case that was challenging but rewarding for Dr Neil Watson, which he had presented at the recent RCPE Medical Trainees Conference. They discuss multi-system disease, and the challenge of connecting the dots between different symptoms and presentations, highlighting the importance of combining specialism and generalism. Dr Neil Watson is a neurology registrar in NHS Lothian. His research background is in human prion disease, and he completed an MD with the University of Edinburgh in which he led an international study validating the current diagnostic criteria for sporadic Creutzfeldt-Jakob disease. Dr Heather Kennedy has completed IMT and is currently working as a locum in NHS Fife. She is a member of the Trainees and Members' Committee (T&MC). Recording Date: 31 March 2026 -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode Dr Marilena Giannoudi discusses all things heart failure with Dr Sam McClure. They begin with how to diagnose and classify heart failure with reduced ejection fraction and heart failure with preserved ejection fraction before moving onto treatment and when to refer to the Heart Failure Team. Dr Sam McClure is a Consultant Interventional Cardiologist and Clinical Lead for Heart Failure in Sunderland. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members & Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. Recording Date: 30 March 2026 -- Useful Links -- ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2023 Update) - https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/focused-update-on-heart-failure-guidelines/ European Heart Journal, Volume 44, Issue 37, 1 October 2023, Pages 3627–3639 - https://academic.oup.com/eurheartj/article/44/37/3627/7246292?login=false Chronic heart failure in adults: diagnosis and management (NICE Guideline) - https://www.nice.org.uk/guidance/ng106 H2FPEF Score for Heart Failure with Preserved Ejection Fraction - https://www.mdcalc.com/calc/10105/h2fpef-score-for-heart-failure-with-preserved-ejection-fraction -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Angus Sinclair speaks with Dr Jonathan Malo about dyslipidaemias. They discuss the different types of dyslipidaemias, the treatments (including some new ones) and the types of cases that should be referred. Dr Jonathan Malo is a consultant chemical pathologist at the Department of Clinical Biochemistry in NHS Lothian. And is the clinical lead for the Lipid Clinic at the Royal Infirmary of Edinburgh. He currently chairs a Scottish network of lipid clinic specialists, and is involved in a Scottish government group tasked with improving CVD prevention. Dr Angus Sinclair is an Internal Medical Trainee in the East of Scotland. He graduated from the University of Edinburgh in 2018 and since then has worked across Scotland and as a medical registrar in a rural district general hospital in New Zealand. He has been actively involved in undergraduate and postgraduate teaching, as well as in clinical governance and resident doctor leadership. Recording date: 20 March 2026 --Links-- Assessment of adverse effects attributed to statin therapy in product labels: a meta-analysis of double-blind randomised controlled trials, The Lancet, 2026; 407, 689-703. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials, The Lancet, 2022; 400, 832-845. N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects, NEJM, 2020;383:2182-2184. DOI: 10.1056/NEJMc2031173. Statin treatment and muscle symptoms: series of randomised, placebo-controlled n-of-1 trials. BMJ, 2021;372:n135. https://doi.org/10.1136/bmj.n135 SIGN 149: Risk estimation and the prevention of cardiovascular disease (2017) - https://www.sign.ac.uk/assets/qrg149.pdf NICE Guideline 238: Cardiovascular disease: risk assessment and reduction, including lipid modification (2023) - https://www.nice.org.uk/guidance/ng238/resources/cardiovascular-disease-risk-assessment-and-reduction-including-lipid-modification-pdf-66143902851781) AHA guideline - https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423 ASSIGN/QRISK score calculators - https://www.heartuk.org.uk/educational-content/risk-calculators -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Marilena Giannoudi talks with Rebecca Howard and Bruce Cruickshank from Guide Dogs UK, one of the UK's leading sight loss charities. They discuss some of the small acts and considerations that medical professionals can practice to help their patients with sight loss. Rebecca Howard is a Sighted Guide Trainer with Guide Dogs UK. Bruce Cruickshank is a volunteer with Guide Dogs UK and is a guide dog owner. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members & Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. Recording date: 9 March 2026 -- Links -- Guide Dogs UK - https://www.guidedogs.org.uk/ Guide line services - https://www.guidedogs.org.uk/contact-us/#guide-line-services-support-and-dog-related-queries Sighted guide training - https://www.guidedogs.org.uk/how-you-can-help/sighted-guide-training/ -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Marilena Giannoudi chats with Dr Heeraj Bulluck about preventive cardiology. They discuss the little habits that can make a big difference in preventing heart disease and the importance of taking care of yourself as a doctor as well as the patients you see. Dr Heeraj Bulluck is a UK-based interventional cardiologist with a keen academic interest. Alongside his clinical work, he recently developed an interest in cardiovascular prevention - helping individuals understand and act on risk long before disease develops. He is the author of Heart Reset 40, where he translates clinical insights into practical, sustainable changes for long-term heart health, particularly for busy professionals. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members & Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. Recording date: 2 February 2026 --Links-- Heeraj Bulluck, Heart Reset 40 - https://www.amazon.co.uk/Heart-Reset-40-Cardiologists-Science-Backed-ebook/dp/B0G8N4YBPC The Royal College of Physicians of Edinburgh (RCPE) has not quality checked Heart Reset 40 and is not endorsing this resource. A link is provided for reference only. 2025 Update on ESC/EAS Guidelines for management of dyslipidaemias - https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/dyslipidaemias/ ESC Essential Resources for Preventive Cardiologists - https://www.escardio.org/topics/risk-factors-and-prevention/ -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode Professor Tom Fardon returns to Clinical Conversations to discuss updates in asthma diagnosis and management from the joint BTS/SIGN/NICE guideline on Asthma. Prof Fardon and Dr Ben Warner discuss the changes to practice since the guidelines were released and the evolving role of biologics in asthma treatment. Professor Fardon is a Consultant Respiratory Physician at NHS Tayside and Honorary Professor at the University of Dundee. They are also the chair of the Scottish Severe Asthma Group within the Centre for Sustainable Delivery. Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals with the University of Glasgow. Recording Date: 9 December 2025 --Links-- BTS/SIGN/NICE guideline on Asthma - https://www.nice.org.uk/guidance/ng245 Asthma Pathway - https://www.nice.org.uk/guidance/ng244 Algorithm A: Objective tests for diagnosing asthma in adults and young people (aged over 16 years) - https://www.nice.org.uk/guidance/ng245/resources/bts-nice-and-sign-algorithm-a-summary-of-objective-tests-for-diagnosing-asthma-pdf-13556516365 Algorithm C: Pharmacological management of asthma in people aged 12 years and over - https://www.nice.org.uk/guidance/ng245/resources/algorithm-c-pharmacological-management-of-asthma-in-people-aged-12-years-and-over-bts-nice-pdf-13556516367 ‘Optimising inhaled therapy for patients with asthma’- https://doi.org/10.1136/bmj-2024-080353 Asthma+Lung UK website Inhalers resource - https://www.asthmaandlung.org.uk/living-with/inhaler-videos ‘Greener Practice’ asthma care toolkit (free registration required)- https://www.greenerpractice.co.uk/asthma-toolkit/ 'Greener Practice' Device Choice video - https://www.youtube.com/watch?v=YRJGD48bryI Asthma Guidelines (Plain Language Version) - https://www.sign.ac.uk/patient-public-involvement/plain-language-versions-of-guidelines/asthma/ -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

This is a co-release with our sister podcast, Career Conversations. In this episode, Dr Marilena Giannoudi talks with Dr Manav Sharma about the specialty, Aerospace Medicine. They discuss the pathways which lead to the specialty and some interesting cases. Dr Manav Dutt Sharma is an aerospace medicine physician, former Indian Air Force flight surgeon and human factors specialist with over 23 years of experience at the intersection of aviation and healthcare. He has led an award‑winning primary healthcare centre in the Air Force, works on safety, service quality and systems improvement in hospitals, and has authored a forthcoming book, From Runways to Recovery Rooms, on what healthcare can learn from aviation. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members & Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. Recording Date: 12 December 2025 --Links-- JRCPTB Specialty - https://www.thefederation.uk/training/specialties/aviation-and-space-medicine Physician Higher Specialty Training Recruitment - https://www.phstrecruitment.org.uk/ -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Aoife Duignan speaks with Dr Mireia Moragas about how to treat headaches in a pregnant person. They discuss what questions physicians should ask themselves when a pregnant person attends the acute ward with headaches, the green and red flags for headaches as well as the medications that are safe during pregnancy. Dr Mireia Moragas is a Consultant Neurologist in Edinburgh where she also runs the Headache Clinic, as well as participating in the acute care of patients with stroke. She has participated in the local and Scottish national headache guidelines as well as the local protocols for management of headache and stroke during pregnancy. Dr Aoife Duignan is a specialist trainee in geriatric and general medicine in South East Scotland. She is also Co-Chair & Vice Chair - Representation for the Trainees and Members' Committee (T&MC). Recording date: 10 November 2025 --Useful Links-- Bumps (Best Use of Medicines in Pregnancy) - https://www.medicinesinpregnancy.org/ Maternity pathway and schedule of care - https://www.gov.scot/publications/maternity-pathway-schedule-care-clinical-guidance-schedule/ National Maternity Network, Management of Headache in Pregnancy Guidance - https://www.perinatalnetwork.nhs.scot/wp-content/uploads/2023/02/2023-02-21-Headache-in-Pregnancy.pdf NHS Scotland Centre for Sustainable Delivery - https://www.nhscfsd.co.uk/media/nswenkmf/national-headache-pathway-migraine-during-pregnancy-and-following-childbirth.pdf RefHelp NHS Lothian - https://apps.nhslothian.scot/refhelp/ RefHelf Migraine/Chronic Headache in pregnancy - https://apps.nhslothian.scot/refhelp/guidelines/neurology/headache/migraine-chronic-headache-in-pregnancy/ -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode of Clinical Conversations, Dr Marilena Giannoudi discusses cardiorenal metabolic disease with Dr Andrew Frankel. Their discussion provides an overview of this common cause of chronic kidney disease (CKD) and they focus on the management of cardiorenal metabolic disease, with Dr Frankel highlighting the importance of lifestyle management and patient education and engagement, and the pharmacotherapy 'four pillars' of RAAS inhibition, SGLT2 inhibition, blood pressure control, and MR antagonism. Explore this and more in this episode. Dr Andrew Frankel has been working as a consultant nephrologist at Imperial College Healthcare NHS trust since 1995 and works at the Imperial Renal and Transplant Centre, which is one of the largest kidney units in Europe catering for a population base of over three million. He has experience in managing all aspects of kidney disease but has a particular interest in relation to the management of kidney disease in the context of diabetes, cardiac disease and obesity. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of RCPE's Trainees and Members' Committee. -- Links -- NICE Guideline (NG203) - Chronic kidney disease: assessment and management https://www.nice.org.uk/guidance/ng203 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines For Kidneys Sake Podcast - By Dr Andrew Frankel and colleagues https://www.forkidneyssake.com/ Recording date: 24 November 2025 -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Kat Ralston speaks to Professor Edwin Jesudason about how his experience of whistleblowing as a paediatric surgeon changed his practice. They reflect on the importance of listening and creating a shared dialogue with patients, discuss how experiencing moral injury can help clinicians better understand and navigate patient suffering and explore the art of being human in medicine. Professor Edwin Jesudason is a Consultant in Rehabilitation Medicine in NHS Lothian. Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC). Recording date: 24 July 2025 -- Useful Links -- Jesudason, 'The 4D Model: Rehabilitating Unrealistic Medicine', BJHM (2025) https://doi.org/10.12968/hmed.2024.084 Jesudason, 'Manufacturing safer medics', J Med Ethics (2022) https://doi.org/10.1136/jme-2022-108581 -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Kat Ralston speaks to Dr Jane Rimer about a challenging clinical case which had an unexpected outcome. They discuss the importance of reflection with trusted colleagues and consider systems to help us cover the basics well. They explore how we can reduce the sense of isolation and vulnerability that is often encountered when we have to navigate complaints, adverse event reviews and legal processes, as illustrated by the title 'Defence against The Dark Arts'. Dr Jane Rimer is a Consultant Physician and Geriatrician in NHS Lothian. She is also Associate Postgraduate Dean for Medical Training in South East Scotland. Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC). Recording Date: 29 July 2025 -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Marilena Giannoudi hears about a case that changed the practice of Professor James Dear. They discuss the challenges of caring for a patient without a diagnosis, who to talk to if you are feeling uncertain in how to treat a patient, and how you can own up to and move on from mistakes you may make. Professor James Dear is a Consultant in Clinical Pharmacology at the Royal Infirmary of Edinburgh and Personal Chair of Clinical Pharmacology at the Centre for Cardiovascular Science at the University of Edinburgh. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members & Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. Recording date: 9 June 2025 -- Follow us -- https://www.instagram.com/rcpedintrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).