Clinical Conversations

In this episode, Dr Otite Akpovona speaks with Dr Pamela Brown about some of the ethical sides of heart failure, especially in the care of heart failure in the older population. They discuss treatments to offer, how this treatment should be offered, and a reminder to trainees that the patient should always remain at the centre of care at all times. Dr Pamela Brown,is a Consultant Cardiologist at James Cook University Hospital in Middlesbrough. Her subspeciality interests are Cardiac MRI, echocardiography and heart disease in pregnancy, heart failure and heart valve disease. She trained at the University of Newcastle and completed speciality training in the Northern Deanery. She completed her MD in 2020 at the University of Manchester with her thesis titled: Cardiac MRI based risk stratification in dilated cardiomyopathy. Dr Otite Akpovona is an Internal Medicine trainee at James Cook University Hospital and is a member of the Trainees and Members' Committee (T&MC) at the RCPE. -- Useful Links -- Felker, et al, 'Diuretic Strategies in Patients with Acute Decompensated Heart Failure', NEJM (2011), https://www.nejm.org/doi/full/10.1056/NEJMoa1005419. Recording date: 14 August 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).

Dr Marilena Giannoudi interviews Professor Arjun Ghosh on what cardio-oncology is: cardiac care for cancer patients pre-treatment, during therapy, and in survivors with late effects. They discuss various cardiotoxicities, from heart failure, to hypertension, to arrhythmias and more, including emergencies such as pericardial effusion and 'triple M'. Training routes and opportunities are highlighted. Professor Arjun Ghosh is a Professor of Cardiology and Consultant Cardiologist at Barts Heart Centre and University College London Hospital. He is the first Consultant Cardiologist in the UK to be appointed specifically in cardio-oncology and helped establish and grow cardio-oncology services at BHC and UCLH. Dr Marilena Giannoudi is a cardiology registrar based in Leeds, and a member of the Trainees and Members' Committee. Recording date: 9 October 2026 -- Links -- 2022 ESC Guidelines on cardio-oncology: https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/cardio-oncology/ Position statement: Echo surveillance for childhood, teenage and young adult cancer survivors: https://www.bsecho.org/Public/Resources/Clinical-guidance/PUG001.aspx British Society for Echocardiography and British Cardio-Oncology Society guideline for transthoracic echocardiographic assessment of adult cancer patients receiving anthracyclines and/or trastuzumab: https://doi.org/10.1530/ERP-21-0001 BC-OS: https://www.bc-os.org/ BCS/BCOS/UCLH Cancer Academy Cardio-Oncology Course 2026: https://bcs-bcsbcosuclh-cancer-academy-cardio-oncology-course-2026.eventsairsite.com/ 'All Things Cardio-Oncology' Podcast: https://open.spotify.com/show/1y2sUJqr1khd4Fga6qxaBP [Please note RCPE has not quality checked external training or educational resources and inclusion here does not signify endorsement] -- 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 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).