Send us a Text Message.

On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the evidence supporting exercise as an effective treatment option for mild to moderate depression. They explore how exercise might be used effectively and the challenges involved in implementing it for patients.

Dr. Nicholas Fabiano, a second-year psychiatry resident at the University of Ottawa, is co-author of the paper "Exercise as treatment for depression." He surveys the evidence showing that exercise can be as effective as antidepressants and psychotherapy for mild to moderate depression. He explains the FITT principle (frequency, intensity, type, and time) for prescribing exercise and stresses the need for setting realistic goals. Dr. Fabiano's article recommends physicians reference a practical guide for exercise for people who have depression, written by Dr. Michelle Fortier and colleagues.

Dr. Fortier, a physical activity psychologist and professor at the University of Ottawa’s School of Human Kinetics, offers her perspective on encouraging patients with depression to include exercise as part of their overall treatment plan. She suggests bringing kinesiologists into primary care to help patients overcome barriers to exercise. Dr. Fortier talks about the importance of small, manageable steps and using motivational interviewing techniques to engage patients. She also discusses the "commit 10" approach, which encourages patients to start with just ten minutes of activity over a two week period.

Throughout the episode, the hosts and guests stress the importance of empathy, realistic goal setting, and systemic support to make exercise a practical treatment option for depression. They highlight the overall benefits of movement for both mental and physical health and advocate for a more integrated approach to patient care.

For more information from our sponsor, go to scotiabank.com/physicians

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

Send us a Text Message.

On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle an unexpected yet urgent topic: the resurgence of measles. With rising cases globally and in Canada, they discuss the implications and necessary actions for healthcare professionals.

Dr. Sarah Wilson, a public health physician at Public Health Ontario, provides a comprehensive overview of the current measles situation. She explains the factors contributing to the increase in cases, including disruptions to immunization services during the COVID-19 pandemic and preexisting trends in declining vaccine acceptance. Dr. Wilson also highlights the severe complications of measles, especially for vulnerable groups such as children under five, pregnant individuals, and those who are immunocompromised.

The conversation shifts to practical steps for healthcare providers. Dr. Wilson details the importance of considering measles in differential diagnoses for patients with fever and rash, particularly those with relevant exposure histories. She emphasizes the need for appropriate diagnostic testing and discusses the public health response, including the administration of immune globulins for high-risk contacts.

The key practical step for controlling measles is, of course, widespread immunization. Dr. Samira Jeimy, an assistant professor and the program director for the division of Clinical Immunology and Allergy at Western University. She offers an overview of the vaccine including its effectiveness and safety, despite persistent misinformation. Dr. Jeimy explains the vaccination schedule for children and the importance of booster doses for adults, especially before travel to areas with active outbreaks. She also details the role of vaccination given within 72 hours of an exposure to reduce the risk of infection or lessen the severity of measles if infected.

Throughout the episode, the hosts and guests emphasize the need for improved communication and trust-building between healthcare providers and patients when addressing vaccine hesitancy.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

Send us a Text Message.

On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the heated debate over proposed updates to the CanMEDS framework. The controversy ignited when an interim report placed principles of equity, social justice, and anti-racism at the heart of the framework, rather than medical expertise.

Dr. Kannin Osei-Tutu, author of a commentary in CMAJ, proposes a new model for CanMEDS that places shared humanity and compassion at the centre. He argues that the current model of medical education and practice needs to be reimagined, as it has resulted in gross systemic inequities in health outcomes that urgently need to be addressed. He calls for expanding and enriching the concept of medical expertise to incorporate principles of inclusive compassion and social justice.

Dr. Philip Berger agrees on the need for healthcare to be free from bias, discrimination, systemic injustice, and racism but criticizes Dr. Osei-Tutu’s model and the interim CanMEDS revisions for not placing medical expertise at the centre of physician competency. Dr. Berger, a Toronto family physician and member of the Canadian Medical Hall of Fame, is noted for his long history of advocacy on behalf of marginalized groups. He argues that failing to place medical expertise at the centre of CanMEDS is a fatal flaw, as it undermines the credibility of physicians, thereby reducing their influence, which is essential for effective social justice advocacy.

Throughout the discussion, the hosts and guests stress the importance of maintaining civil dialogue and prioritizing the improvement of healthcare outcomes for marginalized populations.

For more information from our sponsor, go to medicuspensionplan.com

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions