We cannot put this off any longer.  IMreasoning has reached the end of its road.  We had a great 5 years.  We both learned so much, about medicine, about cognition, about the art of teaching, about each other, and about ourselves. Thank you once again to all of you, our listeners, for sticking with us.  Thank you especially to those who got in touch, and gave us encouragement to continue this project over the past 5 years. Thank you as well to all of you who appeared and participated in the podcast, to present stump the chumps cases, or to share your expertise in conversation with us. A special thank you to Steve and Madi who navigated the tech and the socials for us in the final leg of this adventure.  We couldn't have done this without you.

We cannot put this off any longer.  IMreasoning has reached the end of its road.  We had a great 5 years.  We both learned so much, about medicine, about cognition, about the art of teaching, about each other, and about ourselves. Thank you once again to all of you, our listeners, for sticking with us.  Thank you especially to those who got in touch, and gave us encouragement to continue this project over the past 5 years. Thank you as well to all of you who appeared and participated in the podcast, to present stump the chumps cases, or to share your expertise in conversation with us. A special thank you to Steve and Madi who navigated the tech and the socials for us in the final leg of this adventure.  We couldn't have done this without you.

Our final episode

Join us for another instalment of Stump the Chumps. This time our case comes from Baylor University presented by Alec Rezigh, a friend of the podcast. Enjoy!

Join us for another instalment of Stump the Chumps. This time our case comes from Baylor University presented by Alec Rezigh, a friend of the podcast. Enjoy!

69: STC with Alec Rezigh

Just a quick inbetweenisode to let you all know we will be back with another instalment of STC in early February.  Enjoy a Southern Hemisphere summer, wherever you are.

Just a quick inbetweenisode to let you all know we will be back with another instalment of STC in early February.  Enjoy a Southern Hemisphere summer, wherever you are.

Epilette January 2021

Join us for another installation of STC (technically international) with Ramey Bajwa.  Play along and see if you can guess the diagnosis any earlier than we did (or did not).

Join us for another installation of STC (technically international) with Ramey Bajwa.  Play along and see if you can guess the diagnosis any earlier than we did (or did not).

68: STC with Ramey Bajwa

Stefanie Green

Join us for our conversation with Stefanie Green, the director of CAMAP (Canadian Association of MAID Assessors and Providers) where we hear about the lessons learned from the Canadian experience over the past four years since it has been legal for doctors to provide medical assistance in dying.

Join us for our conversation with Stefanie Green, the director of CAMAP (Canadian Association of MAID Assessors and Providers) where we hear about the lessons learned from the Canadian experience over the past four years since it has been legal for doctors to provide medical assistance in dying.

67: MAID with Stefanie Green

Join us for another instalment of STC (Stump the Chumps) where we tackle another case from HumanDx Global Morning Report. But first, try your hand at solving a case that Art brought along from his recent ward round.  Good luck!

Join us for another instalment of STC (Stump the Chumps) where we tackle another case from HumanDx Global Morning Report. But first, try your hand at solving a case that Art brought along from his recent ward round.  Good luck!

66: STC with Human Dx and reverse STC

Join us for another instalment of STC, presented at grand rounds at the Royal Adelaide Hospital. Unfortunately we had to stay at home in Auckland and do it over Zoom... (because COVID). Josh Inglis and Toby Gilbert gave us a real challenge.

Join us for another instalment of STC, presented at grand rounds at the Royal Adelaide Hospital. Unfortunately we had to stay at home in Auckland and do it over Zoom... (because COVID). Josh Inglis and Toby Gilbert gave us a real challenge.

65: STC at the Royal Adelaide with Josh and Toby

Daniel Kilov

Join us for a fascinating conversation with Daniel Kilov, philosopher and memory athlete, about memory.  Find out about techniques that we can each learn to help us to memorise...anything. Click on Daniel Kilov TedX talk to here more And if you're interested here is the link to  Joshua Foer Ted Talk, author of "Moonwalking with Einstein":

Join us for a fascinating conversation with Daniel Kilov, philosopher and memory athlete, about memory.  Find out about techniques that we can each learn to help us to memorise...anything. Click on <a href="https://youtu.be/dn0bMqCwHBQ" rel="nofollow" target="_blank">Daniel Kilov TedX talk</a> to here more And if you're interested here is the link to <a href="https://www.ted.com/talks/joshua_foer_feats_of_memory_anyone_can_do?utm_campaign=tedspread&amp;utm_medium=referral&amp;utm_source=tedcomshare" rel="nofollow" target="_blank"> Joshua Foer Ted Talk</a>, author of "Moonwalking with Einstein":

64: Memory - Daniel Kilov

We are thrilled to launch our 1st collaboration with HumanDx. "a worldwide effort, created with and led by the global medical community, to build an open intelligence system that maps the steps to help any patient" There is a key image associated with the case which you should inspect before starting.  Go to our website IMreasoning.com. You can try to solve thousands of interesting cases at HumanDx in an interactive, engaging platform, and can add your own cases too.

We are thrilled to launch our 1st collaboration with HumanDx. "a worldwide effort, created with and led by the global medical community, to build an open intelligence system that maps the steps to help any patient" There is a key image associated with the case which you should inspect before starting.  Go to our website <a href="http://IMreasoning.com" rel="nofollow" target="_blank">IMreasoning.com</a>. You can try to solve thousands of interesting cases at HumanDx in an interactive, engaging platform, and can add your own cases too.

63: STC with Human Dx

Chang is back people.  Hope you enjoy our conversation over a pint at Galbraith's in Auckland.  Chang helps us understand what machine learning actually means.  It's all about matrices apparently.  Easy...

Chang is back people.  Hope you enjoy our conversation over a pint at Galbraith's in Auckland.  Chang helps us understand what machine learning actually means.  It's all about matrices apparently.  Easy...

62: The Chang, and musings on Artificial Intelligence

Welcome to IM Reasoning with your hosts Dr. Art Nahill and Dr. Nic Szecket, two general internists with a passion for teaching clinical reasoning. Join us for case discussions, conversations and interviews that explore issues important to clinicians and students, with a special focus on clinical reasoning, the once-mysterious process behind the remarkable abilities of the master clinician.

I have listened to this podcasts throughout medical school. I love the two hosts; they play off one another very well. They have interesting guest interviews about the art of medicine and how to improve diagnostic accuracy. Stump the chump cases are well presented and I learn so much by hearing them talk through their thought process. They are the OG clinical problem solvers!!

Great insight into clinical decision-making

Insightful and well done. Looking forward to more episodes!

What a great podcast

IMreasoning - Clinical reasoning for Doctors and Students

We chat once again with Gurpreet Dhaliwal, this time about what it takes to become a master diagnostician.  We discuss the main strategies; seeing many cases, deliberate training, getting feedback, closing the loop, and others.

We chat once again with Gurpreet Dhaliwal, this time about what it takes to become a master diagnostician.  We discuss the main strategies; seeing many cases, deliberate training, getting feedback, closing the loop, and others.

42: Becoming an Expert Diagnostician

The differential diagnosis is at the heart of analytic thinking for the diagnostician.  Dr. Mark Graber agrees.  As the founder of the Society to Improve Diagnosis in Medicine, he should know.  It can overcome many of the biases we are prone to when we limit ourselves only to diagnosis by pattern recognition.  We discuss some simple approaches to generating a differential diagnosis and developing a problem representation.

The differential diagnosis is at the heart of analytic thinking for the diagnostician.  Dr. Mark Graber agrees.  As the founder of the Society to Improve Diagnosis in Medicine, he should know.  It can overcome many of the biases we are prone to when we limit ourselves only to diagnosis by pattern recognition.  We discuss some simple approaches to generating a differential diagnosis and developing a problem representation.

3: Differential Diagnosis and Problem Representation

Transillumination of the sinuses? shifting dullness? the puddle sign? In this episode we poke fun and debunk our favourite "useless" physical exam manoeuvres that we continue to teach our medical students.  We couldn't cover all of them in one go, so stay tuned for more... Try the app DxLogic on the iPhone to have a quick reference to the utility of many studied history features and physical exam manoeuvres. Also, check out JAMA's series of articles entitled "The Rational Clinical Exam".

Transillumination of the sinuses? shifting dullness? the puddle sign? In this episode we poke fun and debunk our favourite "useless" physical exam manoeuvres that we continue to teach our medical students.  We couldn't cover all of them in one go, so stay tuned for more... Try the app DxLogic on the iPhone to have a quick reference to the utility of many studied history features and physical exam manoeuvres. Also, check out JAMA's series of articles entitled "The Rational Clinical Exam".

23: Myths of the Physical Exam part 1

Rahul Gandhi

It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.

It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.

40: Stump the Chumps International - Rahul Gandhi

We continue laying the foundations of type 1 and type 2 thinking with a discussion about biases.  Once again we hear from Prof. Gurpreet Dhaliwal and some of his thoughts on the utility of studying metacognition.

We continue laying the foundations of type 1 and type 2 thinking with a discussion about biases.  Once again we hear from Prof. Gurpreet Dhaliwal and some of his thoughts on the utility of studying metacognition.

2: Biases

Gurpreet Dhaliwal

Dr. Gurpreet Dhaliwal is professor of clinical medicine at UCSF and has written many articles in the realm of clinical reasoning.  Although you have already heard snippets of our conversation on prior episodes, we thought we would share the entire interview with all of you.  Gurpreet has an enlightening way of explaining how we think, and how we move from good clinicians to expert clinicians, through extended problem-solving and feedback.

Dr. Gurpreet Dhaliwal is professor of clinical medicine at UCSF and has written many articles in the realm of clinical reasoning.  Although you have already heard snippets of our conversation on prior episodes, we thought we would share the entire interview with all of you.  Gurpreet has an enlightening way of explaining how we think, and how we move from good clinicians to expert clinicians, through extended problem-solving and feedback.

4: Wise Words from Gurpreet Dhaliwal

Finally, our much awaited third try with Stump the Chumps.  This time one of our registrars Dr. Brian Grainger challenges us with a case of a young patient.  This is a longer episode, which I guess reflects the fact that sometimes, when the diagnosis is not obvious, you just have to take your time.  Enjoy!

Finally, our much awaited third try with Stump the Chumps.  This time one of our registrars Dr. Brian Grainger challenges us with a case of a young patient.  This is a longer episode, which I guess reflects the fact that sometimes, when the diagnosis is not obvious, you just have to take your time.  Enjoy!

13: Stump the Chumps - take 3

Enjoy an episode of STC.  This time WE weren't in the hot seat!  Humbling to see an excellent trainee in action.

Enjoy an episode of STC.  This time WE weren't in the hot seat!  Humbling to see an excellent trainee in action.

32: STC with Chang

We discuss the importance of the words that we choose to use in our medical documentation.  Words matter! They can generate stigma, and they can bias the decisions we subsequently make as practitioners.

We discuss the importance of the words that we choose to use in our medical documentation.  Words matter! They can generate stigma, and they can bias the decisions we subsequently make as practitioners.

41: Words

We're back after a long summer break.  Enjoy this episode on uncertainty in medicine.  We talk to Arabella Simpkin, an English paediatrician, working in Boston, who spends a lot of time thinking and writing about uncertainty and our need to embrace it, or at the very least, tolerate it graciously.

We're back after a long summer break.  Enjoy this episode on uncertainty in medicine.  We talk to Arabella Simpkin, an English paediatrician, working in Boston, who spends a lot of time thinking and writing about uncertainty and our need to embrace it, or at the very least, tolerate it graciously.

38: Uncertainty in Medicine

Bob Trowbridge

In this episode we get tips on how to teach clinical reasoning from Bob Trowbridge, an expert clinical educator at Maine Medical Centre. Go to our website www.imreasoning.com for links to Bob's new book, and other resources we discuss with Bob. Visit us at https://www.facebook.com/IMreasoning to comment on the episode and to give us your thoughts on this topic.

In this episode we get tips on how to teach clinical reasoning from Bob Trowbridge, an expert clinical educator at Maine Medical Centre. Go to our website <a href="http://www.imreasoning.com" rel="nofollow" target="_blank">www.imreasoning.com</a> for links to Bob's new book, and other resources we discuss with Bob. Visit us at <a href="https://www.facebook.com/IMreasoning/" rel="nofollow" target="_blank">https://www.facebook.com/IMreasoning</a> to comment on the episode and to give us your thoughts on this topic.

17: Teaching Clinical Reasoning - Bob Trowbridge

While waiting for another of our home-grown cases we decided to do a STC using a published case from the Clinical Problem-Solving series of the New England Journal of Medicine. Let us know what you think of this format! www.imreasoning.com www.facebook.com/imreasoning or now you can make noise at us on Twitter.  Our handle is @IMreasoning

While waiting for another of our home-grown cases we decided to do a STC using a published case from the Clinical Problem-Solving series of the New England Journal of Medicine. Let us know what you think of this format! <a href="http://www.imreasoning.com" rel="nofollow" target="_blank">www.imreasoning.com</a> <a href="http://www.facebook.com/imreasoning" rel="nofollow" target="_blank">www.facebook.com/imreasoning</a> or now you can make noise at us on Twitter.  Our handle is @IMreasoning

26: STC from the Clinical Problem-Solving series in NEJM

Some of you may have heard of the double tragedy involving Jack Adcock, a six year old who died from sepsis and Dr. Bawa-Garba, a pediatric trainee in the UK convicted of manslaughter in relation to his death and prevented from ever working again. Justice or a clear case of scapegoating? Listen as we discuss this troubling case and its far-reaching implications for transparency, honest reflection, and patient safety.

Some of you may have heard of the double tragedy involving Jack Adcock, a six year old who died from sepsis and Dr. Bawa-Garba, a pediatric trainee in the UK convicted of manslaughter in relation to his death and prevented from ever working again. Justice or a clear case of scapegoating? Listen as we discuss this troubling case and its far-reaching implications for transparency, honest reflection, and patient safety.

39: The Case of Dr. Hadiza Bawa-Garba

Becky Lane

Enjoy another instalment of Stump the Chumps.  Our good friend and colleague Becky Lane challenged us with a very interesting presentation of a young man. Don't forget to leave feedback on our Facebook page www.facebook.com/imreasoning

Enjoy another instalment of Stump the Chumps.  Our good friend and colleague Becky Lane challenged us with a very interesting presentation of a young man. Don't forget to leave feedback on our Facebook page <a href="http://www.facebook.com/imreasoning" rel="nofollow" target="_blank">www.facebook.com/imreasoning</a>

18: STC 4 with Becky Lane

As promised, we bring you our first attempt at "stump the chumps".  This is where we are presented with a challenging diagnostic case and we think out loud as we reason our way through it.  You can play along as you hear the case unfold.

As promised, we bring you our first attempt at "stump the chumps".  This is where we are presented with a challenging diagnostic case and we think out loud as we reason our way through it.  You can play along as you hear the case unfold.

5: Stump the Chumps

Apologies for the delay in getting this next episode out to you.  Play along with us on this very challenging case. Schadenfreude (/ˈʃɑːdənfrɔɪdə/; German: [ˈʃaːdn̩ˌfʁɔʏ̯də] (listen); lit. 'harm-joy') is the experience of pleasure, joy, or self-satisfaction that comes from learning of or witnessing the troubles, failures, or humiliation of another.

Apologies for the delay in getting this next episode out to you.  Play along with us on this very challenging case. Schadenfreude (<a href="https://en.wikipedia.org/wiki/Help:IPA/English" rel="nofollow" target="_blank">/ˈʃɑːdənfrɔɪdə/</a>; German: <a href="https://en.wikipedia.org/wiki/Help:IPA/Standard_German" rel="nofollow" target="_blank">[ˈʃaːdn̩ˌfʁɔʏ̯də]</a> (<a href="https://en.wikipedia.org/wiki/File:Schadenfreude-native-german.flac" rel="nofollow" target="_blank"></a><a href="https://upload.wikimedia.org/wikipedia/commons/e/e6/Schadenfreude-native-german.flac" rel="nofollow" target="_blank">listen</a>); <a href="https://en.wikipedia.org/wiki/Literal_translation" rel="nofollow" target="_blank">lit.</a> 'harm-joy') is the experience of pleasure, joy, or self-satisfaction that comes from learning of or witnessing the troubles, failures, or humiliation of another.

55: STC live at AusDEM 2019 - Melbourne

After a season 1 that has dragged on for 4 years, we've decided to have a publishing break so we can work on more episodes.  Thanks to all our listeners for your feedback and encouragement.  We will be back soon!

After a season 1 that has dragged on for 4 years, we've decided to have a publishing break so we can work on more episodes.  Thanks to all our listeners for your feedback and encouragement.  We will be back soon!

We'll be back soon!

Enjoy our live Stump the Chumps at Main Medical Centre.  We were honoured to be invited by Bob Trowbridge and it was a pleasure to visit Portland, Maine.

Enjoy our live Stump the Chumps at Main Medical Centre.  We were honoured to be invited by Bob Trowbridge and it was a pleasure to visit Portland, Maine.

36: Live STC at MMC

We bring you our second attempt at "stump the chumps".  Our friend and colleague Oliver Menzies brought an interesting case.  We think this case was not quite as enigmatic as our first one (episode 5) but we hope it illustrates sound clinical reasoning as we work our way through the clinical information.  Enjoy.

We bring you our second attempt at "stump the chumps".  Our friend and colleague Oliver Menzies brought an interesting case.  We think this case was not quite as enigmatic as our first one (episode 5) but we hope it illustrates sound clinical reasoning as we work our way through the clinical information.  Enjoy.

11: Stump the Chumps - take 2

Doctors should always strive to present themselves as unbreakable to their patients...  All doctors are smart...  All patients have a definitive diagnosis... Believe it or not, versions of these ideas, and many others, are pervasive in our medical education institutions, and to varying degrees are believed and practiced by doctors everywhere. In this episode, we debunk and discuss our favourite myths. Enjoy! Don't forget to write us with feedback on our Facebook page at https://www.facebook.com/IMreasoning or on our webpage at www.imreasoning.com and write to us with your STC cases to imreasoning@gmail.com

Doctors should always strive to present themselves as unbreakable to their patients...  All doctors are smart...  All patients have a definitive diagnosis... Believe it or not, versions of these ideas, and many others, are pervasive in our medical education institutions, and to varying degrees are believed and practiced by doctors everywhere. In this episode, we debunk and discuss our favourite myths. Enjoy! Don't forget to write us with feedback on our Facebook page at <a href="https://www.facebook.com/IMreasoning" rel="nofollow" target="_blank">https://www.facebook.com/IMreasoning</a> or on our webpage at <a href="http://www.imreasoning.com" rel="nofollow" target="_blank">www.imreasoning.com</a> and write to us with your STC cases to <a href="mailto:imreasoning@gmail.com">imreasoning@gmail.com</a>

24: Myths part 2

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