Core IM | Internal Medicine Podcast
Core Internal Medicine via following series: 5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do? Gray Matters || Management Reasoning Hoofbeats || Dissecting clinical reasoning At the Bedside || Explore everyday challenges
Episodes
Baby alligators 
- those betrayals of purpose 
, or, death by a thousand paper cuts 
!
Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with:
Regulated curiosity
Strategic empa...
Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?
When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.
🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Grou...
We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.
🔹 Sponsor: Oakstone CME
Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP
(1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life
(10:28) | How Dr. Carol Ward Created the Horn Awa...
Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t?
🔹 Sponsor: Oakstone CME
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Timestamp
(02:...
How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when?
(03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast
(05:27) | Triglycerides as a Cardiovascular Risk Marker
(09:28) | Acute Management For Pancreatit...
Why is venous congestion not the same as volume overload? How can looking at IVC as well as doppler on the hepatic vein, portal vein, and/or intrarenal vein help? Can venous congestion explain someone's delirium? Or be at play in septic shock? What are the limitations of the VEXUS score?
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(0...
SGLT-2i vs. GLP-1? vs Metformin? How do you balance the cost and coverage of first-line options like metformin, SGLT-2, and GLP-1s? How do you choose between SGLT-2 and GLP-1s for comorbidities like CAD or CKD? And how do you weigh their side effects and practical use?
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Timestamps:
(01:43) | Case 1: Managing Uncontrolle...
What really works when treating HRS? Vasoconstrictors like terlipressin vs. norepinephrine vs. midodrine: how do we decide which to use? Do you give albumin? When do you give Lasix or another diuretic? When is the better choice transplant, dialysis, or even palliative care?
🔹 Sponsor: Oakstone CME
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Timestamps:
(00:12) | Introdu...
HRS-AKI vs. other causes of AKI in cirrhosis: What do serum or urine sodium clues, albumin challenges, and shifting diagnostic criteria actually reveal about getting the diagnosis right?
🔹 Sponsor: Oakstone CME
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP
Timestamps:
(00:57) | Understanding the Pathophysiology of HRS
(03:42) | How Portal Hypertension Traps the Kidneys
(1...
Who’s really at risk for fractures, and how should we be treating them?
Most fragility fractures occur in patients without osteoporosis. Should we rethink who gets treated? And could just one or two IV infusions (spread years apart) of zoledronate prevent fractures for years? Have the concerns about bisphosphonates been overblown?
Find out all the nuances on this episode of Beyond Journal Club, a series brought to you by Core IM in ...
Medications for orthostatic hypotension! When to initiate treatment, how to use them safely, and what to do when new issues arise during treatment. How do those change if someone has autonomic failure? What do you do when your patient has hypertension AND also has orthostatic hypotension?
🔹 Sponsor: Oakstone CME’
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP
Timestamps ...
Learn specific, practical ways to counsel patients on non-pharmacologic interventions. What is our goal with OH treatment? Is it the blood pressure number that matters? How do we avoid missing neurogenic causes of orthostatic hypotension (OH)?
🔹 Sponsor: Oakstone CME’
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Timestamps:
(00:05) | Cas...
Next time you’re squinting at a chest tube, feel confident you know exactly what to look for and why. Hear it explained in a way that really sticks!
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP
Timestamps:
(02:50) | Xray vs. POCUS vs. CT for Pneumothorax Diagnosis
(07:29) | Do All PTXs Ne...
How do you work up neutropenia? When is neutropenia benign? When do neutrophils recover? How can you diagnose neutropenic fever in the first 15 minutes and start antibiotics in the first 60 minutes? Do you always add MRSA coverages? Only Pseudomonas coverage? When do you add fungal coverage?
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.co...
Have a good laugh and reflect deeply with these three stories that hit the feels in different ways.
If you'd love to hear more stories from Dr. Maria Rosasco, check out some of her other appearances on the podcast: July Stories and Handoffs & Contingency Planning.
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/M...
What went wrong? What were the reasoning or contextual missteps that led us astray?
🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025
🔹 Transcript and Show Notes
Timestamps:
(00:02) | Case Presentation and Initial Diagnosis
(02:47) | Tachycardia and Early Impressions
(04:10) | Clinical Deterioration and New Clues
(07:19) | Problem Representation and Reflection
(21:45) | Lessons on Reasoning and Bi...
- Imaging Pearls | (01:12)
- Deciding on Thoracentesis | (04:00)
- Light’s Criteria and Pseudoexudates | (07:00)
- Pleural Fluid Studies: pH and Cell Differential | (16:56)
- Diagnosing and Treating Parapneumonic Effusions | (23:32)
- Malignant Pleural Effusions: Diagnosis and Management | (30:39)
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www....
Listen for some good laughs and relatable stories!
In this episode, we share raw and real stories from July — from rapid responses to unexpected kindness — and reflect on the emotional weight of starting out in medicine.
🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025
Prior July Stories:
July Stories 2.0 (2023)
July Stories (2019)
Timestamps:
(00:32) | Dr. Ali Trainor...
How much do beta blockers help after a heart attack, even when the heart’s pumping well? In this episode, we revisit the origins of beta blockers in post-MI care, examine how evidence evolved, and explore the REDUCE-AMI trial, which questions whether beta blockers are still needed for all.
Listen to this latest episode of Beyond Journal Club, a collaboration between Core IM and NEJM Group, where we put research into context tracing ...
🔹 What is invasive fungal disease, and who is most at risk for developing invasive fungal disease? (~ 02:46)
🔹 What are the main classes of fungi? (~11:35)
🔹 What are the pros and cons of B-D Glucan and Galactomannan (~19:16)
🔹 How to increase the yield of blood cultures? How to interpret yeast growth in sputum/BAL and urine cultures? (~ 30:42)
🔹 How is invasive fungal disease treated? (~ 35:14)
📌 Sponsor: Oakstone CME’s ACP MKS...
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