Med School Minutes

Med School Minutes - Ep. 52 | Mountains, Medicine & Mentorship: Dr. Patel’s Unconventional Path

• Kaushik Guha

Share episode

Join us on the shores of sunny St. Vincent as Dr. Paryus Patel, Corporate Chief Medical Officer of Prime Health, shares his inspiring journey from Africa to the U.S., how he climbed both literal and professional mountains, and what it takes to succeed as an international medical graduate.

In this episode, Dr. Patel talks about:
✅ Building one of the largest community-based residency networks in the U.S.
✅ How his passion for pulmonary research took him to the world’s highest peaks
✅ Insights on balancing work, research, leadership, and life
✅ His perspective on AI in medicine and his advice for future doctors

Whether you are a future doctor, an IMG, or simply love an inspiring story of resilience and mentorship, this is one you will not want to miss.

Speaker 1:

Hello and welcome to another episode of the Med School Minutes podcast, where we discuss what it takes to attend and successfully complete a medical program. This show is brought to you by St James School of Medicine. Here is your host, kaushik Guha.

Speaker 2:

Thank you so much for joining us for another episode of Med School Minutes. Today we decided to mix it up a little bit and we're filming from the shores of sunny St Vincent. Our very special guest is Dr Paras Patel. He is the Corporate Chief Medical Officer of Prime Health, which is a chain of 53 hospitals, and he personally oversees nearly 250 residency slots. We're going to talk to him about his journey and how he became as successful as he is being an IMG. So, without further ado, let's welcome Dr Paras Patel. Welcome, dr Patel to sunny St Vincent. It's wonderful being here. Yes, this is a unique. This is not our usual studio, so it's a breath of fresh air air. But I just really wanted to start the whole interview by really asking you and tell us why don't you tell us a little bit about yourself and your background?

Speaker 3:

so I have a very interesting and a fascinating life that I have led so far. I started as born and raised in Africa, spent my high school. Always was intrigued by the art of medicine. Doctor's office was my fascinating places to go. That was my driving passion. Over time, as I evolved into I actually diversified because of the change in condition, climate and political environment in Africa.

Speaker 3:

I moved to India okay, where I act, finished the medical school earlier phases, which was a unique and a very astonishing experience that you can never get. It was bland, cultural, plan, diversity of disease, so it actually got me more even interested into pursuing that field. I shifted from there to UK, finished my clerkship portion in UK, southampton, and where I learned a different part, though it was all traditional British medicine but it was hands-on clinical science, clinical fundamental medicine. I finished at a very young, early age. At that time I did not feel that I wanted to kind of go into practice and it was a funny story that my first day I was identified as a little kid and not as a doctor. So it made me change to go ahead and do research. I went into research for WHO and those areas back in the early 70s they were coming up with tuberculosis medication and treatment. So I worked with WHO on TB trials and TB and that somehow got me interested in pulmonary medicine. Subsequently, back in 85, I moved to United States In 85, after that I continued and pursued my passion for research.

Speaker 3:

I signed up with UC Irvine in Southern California, did some research while I was getting ready for reciprocating exams that I had to take as a foreign grad. Unfortunately I wasn't grandfathered into anything, so at that time the exams were different, but it was similar to step one, step two and step three. So while I was doing that it took me about two and a half years in the same time period to take those tests. I continued my research and that established a strong fundamental understanding of what United States research protocols are, started my residency as an emergency room physician After a year. I actually loved the medicine part, but what was missing was the follow-ups. I mean you treat, you did. I was at least curious of what happens to this patient. So to satisfy my drive, I shifted over from emergency room to internal medicine, which gave me the fulfillment I wanted to pursue After internal medicine. Doing two years of internal medicine, one year of it I was appointed as the first foreign graduate chief resident in history of USC Okay of USC.

Speaker 3:

Usc being academic high academic center, used to have about 180 to 190 intermedicine slots. When I became the chief resident I decided to expand the program. I kind of came with a curriculum and didactics, the core that trained them to be a fundamental, better clinician. So we grew the program from almost double it to 260, which included primary, intermedicine, med-ped and optional of transitional medicines for certain graduates who did not know whether the intermedicine was the right way. So transitional year allowed them to actually decide where they want to be and transition into that Ended up doing pursuing that education, ended up doing the Pomeroy fellowship, critical care fellowship, trauma fellowship, sleep fellowship and transplant fellowship. So that was my eternal large academic career. So it transitioned to me a fundamental knowledge.

Speaker 3:

At the time I was very interested in looking at the efficiency and cost of doing this test of medicine. That's where I transitioned into looking into options and I subsequently went into private practice model in Westside of Los Angeles where Senella was one of the hospitals that had gone through a lot of changes back in 2007. Prime came and bought it over, where I always had played a leadership role, where I was appointed to become, help them manage the clinical aspects as a title called CMO, where it all normally regulated the help with the emergency rooms, help with the clinical protocols, standardization of care. How do we deliver high level of care, how do we optimize the best care at the least possible cost and efficiency in expediting care. So that's kind of a role that I started with. Subsequently, as the Prime grew, I've grown with time and now Prime owns 53 hospitals that I'm appropriate CMO. I directly supervise almost 36 of them. The rest I indirectly assist. Also, my second role was education right.

Speaker 3:

So when Prime started this program we all pushed and Dr Reddy, who's the chairman and and CEO, had the same vision. So we started expanding into internal medicine bread and butter residency programs. Initially I was the PD but given the time, circumstances and my schedule, we appointed different PDs. So now what we do is started development. So from 12 programs we went to 24 programs. We went to 24 programs governing almost 250 plus residents in the medicine slots and our ambition is to even take it larger as we acquire more hospitals.

Speaker 3:

Not all hospitals are capable of residency because you have to provide certain level of care, certain volume, certain clinics, some outpatient rotation, so our larger hospitals, or bringing a cluster of three hospitals and adapting. So we have started doing that. Last year, within the last two years, we opened up six programs right. So it is an ambitious goal, but that's what we want to do is pursue more further education. Going back to the second piece of it, as a program director there's a huge amount of responsibility, not just the item of selecting candidates and other, but giving them the right amount of education, and that takes infrastructure. So we are creating that infrastructure with a community-based medicine. The difference between a university teaching setup and a community-based setup is, even though universities participate in a great amount of research, they have a very structured organization, but 70 to 80 percent of patients are treated in the community hospital. So it is important that we establish this community-based teaching programs where majority of the physicians who are trained well will end up serving the community.

Speaker 2:

So I just want to quickly summarize. Can you just tell us how many residencies and how many fellowships you have?

Speaker 3:

again. So I actually did residency-wise I did emergency room and I did intermedicine and I did fellowship in pulmonary critical care, trauma transplant, sleep so that's four fellowships and two residences.

Speaker 2:

My god, that's. That definitely speaks volumes of the passion, right, absolutely. And then you moved from England and you were a physician, practicing physician in England, that's correct. And then you moved to the United States. What drew you to the United States?

Speaker 3:

So a couple of things. One was most of my family had lived in some part of the family, but my immediate family had all migrated to the United States. So my brother was here, my sisters were here, so it was more of a family attraction. But at the same token I wanted to establish a different style. I wanted to learn. What I heard was a different way of practicing medicine, because British medicine was traditional medicine, which is nothing wrong. I think they delivered a great level of care. But I think the family bond and my pursuit to have a higher level of education was the reason I moved to the United States.

Speaker 2:

So this is something I always ask people, especially people, and there are very, very few people like you who've literally seen both aspects of nationalized medicine and privatized medicine privatized being in the United States. What were your biggest culture shocks, if you will, when you came to the United States?

Speaker 3:

So the impression was nationalized medicine evolved with serving everybody, serving every population. But they had to be conservative on the resources. So the question is first, how do you select? That that becomes an ethical and a medical dilemma of who gets what, and one suit doesn't fit everyone. So it's a challenge. Not necessarily it has worked for them. It has a different way of looking at it.

Speaker 3:

But when I moved to the United States, privatized medicine was a whole different way To some extent. I thought it was probably over expensive, even though the resources and things were available. The ultimate product is, besides the expense, you want to look at the outcomes and that definition of a good medical care is morbidity, mortality, care, outcomes, preventive medicine which preventive medicine was a missing gap in this country when I came here. It's become a lot more better. We have done, but how we educated we were.

Speaker 3:

What I noticed was the difference culturally was here. We were tempted to treat rather than prevent. Initially, even though the concept was there, it was not very well reinforced, but it has evolved. Now it's changing the fields as we have learned over time. The second part of cultural was understanding privatization. Privatization means understanding the business aspect of medicine, business aspect being where the peer sources? Who funds for that? What is covered, what is not covered? What resources are you limited? How do you appeal for those resources? So that was learning at different resources rather than in a medicine where you were in nationalized services. You were given a set of toolboxes where you utilize. So that evolved me into the business aspect of understanding and self-learning medicine.

Speaker 2:

And now, in your current role as a CMO, obviously you've mentioned that this is a lot more administrative. Is there certain aspects of being more academic that you actually miss?

Speaker 3:

So fortunately I had the luxury and I think at the prime we don't have a schedule that you are purely become a patchwork or a pencil pusher. I still have an active medical practice, that I practice Pongwei medicine, so I've left that academic part going. I still love teaching so I do incorporate rotations. Even though it's subspecialty, intermedicine, I do encourage them to rotate to the ICUs, advanced teaching and the same in the pulmonary clinic. So that passion of teaching hasn't gone yet. Okay, awesome.

Speaker 2:

So I do want to let our audiences know about some of your research. Over the last couple of days, you've told us about the endeavors that your research has actually taken you, or literally the summits that you had to skip to fulfill your research. Can you tell us a little bit about your pulmonary research?

Speaker 3:

so, um, the research in the pulmonary medicine, uh, what I wanted and originally started with the tb trials and when I came, so that was in the uk, uk, yeah, um, when I came to this country, tuberculosis was not a major rampant disease or something that it existed, but it was never that. So At the time the way United States was focusing more on was more core, what we call as fundamental basic research. That was driven by academic basic science driven reason. Clinical research is required, a clinical orientation.

Speaker 3:

Lung disease, heart disease were very prevalent in my passion for lung disease. So I participated in a research study that talked about delivery of medicine into the lung. How does it get into the lung? What's the right size of the particle, what's? There are tons of inhalers and how do we deliver? That goes to the maximum efficiency of treating the lung properly. So that kind of was my fascination, though it was a bensize. Over the time I rewound into more of a microbiological research of lung particles and other things that are complex sciences but talks about how does lung heal, how does lung regenerate, how does lung damage get repaired, how does smoking affect lung. So those are the different aspects that actually enticed me to learn into the extensive research part of pulmonary medicine and this research.

Speaker 2:

you obviously melded it very well with your passion, which is mountaineering Right.

Speaker 3:

So as I was already an outdoor person, I wanted to establish and accomplish what we want to do. So in one of my fellowship research was at high altitude, effects of hypoxia, low oxygen and climbers Right, and that actually made me start kind of climbing mountains. So events like there are mountains that are 14 to 15 000 feet in los angeles in california that I climbed eight or ten years just to do pomeroy research, that drove me. But even before that, as a kid I always loved the nature and outdoor and mountains. I liked it to test myself, so started climbing k2, went to the base of Everest, did part of Nanga Parbat.

Speaker 3:

Then I shifted to United States where I count McKinley I was counting the same winds Then I ended up in Machu Picchu and Havana Picchu ended up in Patagonia. So my avid passion for outdoors, mountains, is always done, a passion that I love to do. It gives me the zen, the moment, but it also blends in a calmness, a serenity, as we work in this world of medicine and stress. It ties in of understanding what the outdoors is for you.

Speaker 2:

So, with two residencies, four fellowships, so much of research, you've still managed to maintain a passion that needs a fair bit of preparation, time and time investment, which is modern plan. I mean, obviously, when I talk to a lot of students, they keep saying that this is a very demanding field. I don't have time to do this, I don't have time to do this, I don't have time to do that. How did you manage to do all of this? And you still do. You're here with us in St Vincent. You're CMO of a really large hospital chain. How do you make time?

Speaker 3:

So time waits for no one. There's a split amount of time in the thing. How you time manage becomes very crucial, and you have to manage time with efficiency. The most people that actually push their limits and boundaries are very efficient at time management. How do you decide what takes priority, prioritizing the time. At the same token, never forget that unless you have the time that drives that passion, you will never succeed in anything. So it is not just a balance of pursuing a career or career oriented. You have to balance that out with lifestyle. What we look now towards is what are the things that gives you motivation? Climbing a mountain gives that ecstatic joy and probably adrenaline rush, but that rush creates a creative mind. That when you are even back in your office working away, that rush and that energy drives that passion to accomplish more. And time is something you make of it. Time is not going to wait for you. That means there is always a time. You just have to figure out when, where and why.

Speaker 2:

Right, right, right. So what are your thoughts on? Like, especially a lot of youngsters spending so much time on social media and short videos. Basically, right. What's your view?

Speaker 3:

on that. So there may be some part of it where there's a way I call it a communication channel. It's a part of it, and I think it should not be your entire communication channel, because what I call it is a glorified chit-chat box and it's a personal opinion. So what it misses out is, yes, you may be able to drive the content or exchange some ideas, but then we are humans. We miss out on the human to human interaction. There is a kind of emotion, there's a feel, there's a touch, there is kind of high expression, there's language which gets masked by the social media. You cannot.

Speaker 3:

So to some extent it has extensive communication system, but then, as I look over the social media, what is a meaningful conversation is missing out. It becomes basically more of a gossip, chit-chat he said, she said, kind of thing. So part of it may be good to communicate, but when you're looking at higher education or some more of a education that is established to help you build your career or growth or something, there has to be a human-to-human interface. Right, you get to a small group, get together, have some probably nice food, probably drinks here and there enough to socialize and chill out and understand each other in a different environment. That, I think, is crucial for your growth.

Speaker 2:

So this is a good segue into the next section that I'd like to talk about. Obviously, I feel like we're in the middle of an information technology revolution and, from the academic standpoint, I can tell you, academics generally across the board, moves at a glacial pace, whether it's the LCME, whether it's our accreditation board, whether it's general the trend of education, however, it seems like hospitals are far more adept and I feel like almost the residency programs through the program directors are focusing a lot more on efficiency for the student, not necessarily from an academic level. How do you think AI has changed your profession and generally residents in education as you see it, and how do you think it will?

Speaker 3:

continue to change. So AI is a big umbrella. It inclusive of multiple segments, the most commonly AI. We put it in a simple basket, but there's machine learning, natural language processing, large language model and then gen AI. These are all four major concepts we talk about. Each one has a different aspect of how we look at AI, how we use AI in medicine.

Speaker 3:

Ai is not something that has just evolved because there are some other issues that will come up as we perfect this medicine. Ai definitely is helpful in providing a large amount of data source in a very comprehensive package, because human brain, over looking at three, four hundred years of our time, learning medicine and research and a lot of things that come out humanly possible to read and reach out to that data information is practically impossible. But how do we implement the key salient features? So the comprehensive data of time? How do you come past that information used to betterment of patient or patient care? So that is a great aspect of AI. It has started. There are technologies of how we reduce our mundane manpower and use them for a betterment. I'll give you a perfect example. If I'm sitting in an office and seeing a patient, I'm asking questions, I'm directing questions. How do I use that as a tool that actually I don't have to go finish and go back and then either dictate or type that thing, the technologies that are medically driven technologies. You leave your cell phone or device open, it will translate into what you're talking into, generates a note for them. If I'm prescribing certain medication, it will actually prescribe while I'm actually doing so. I don't have to go out and re-prescribe. So there is some optimization or machine processes that AI can use. At the same time, it makes me more efficient that I'm not going out and typing another. Second set of note. It allows me to treat more patients, probably even with a better advancement. Also, when I'm out and I actually did say I prescribe patient a Marxism though it says it will counteract and says patient's allergic, even though I forgot, I don't have to look it up it will allow me to self correct. So it makes me more efficient. So that's kind of a basic AI Efficiency-wise. So it improves your time and efficiency.

Speaker 3:

The second piece of it is if I am looking for something or there's a complex patient complaints, how do I assemble them into a multi-database with his understanding, or how do I encompass that? He has seen five different doctors and each one has prescribed anything, unless the patient brings it over. How do I encompass this? That he has seen five different doctors and each one has prescribed anything, unless the patient brings it over? How do I encompass all the detail and say, hey, this is most likely, this is happening, so it allows you to better communicate? So I think AI may change how we practice medicine, how we actually assemble data, how we actually will evolve into diagnosing disease or using AI as what's the best possible option.

Speaker 3:

Even precision medicine, which is an individual patient to twins with asthma or both have asthma. What works for one, what doesn't work for one, right, they may be genetically same but doesn't mean they have some changes in their genome or other things that we understand. And then also ai to do precision medicine of what? What precision medicine? That dna or gene technology or other things that will ring up.

Speaker 3:

So we are in this infancy but it will evolve very rapidly and it is coming okay so, uh, what?

Speaker 2:

what if a lot of students come and tell me oh, you know, anesthesiologists are going away, radiologists are going away because of AI. Is that founded on anything?

Speaker 3:

I think it's just misunderstanding what human capabilities are Talk about when internet came in and we said we'll be actually communicating everything by there. There'll be less paper wastage, we'll be cutting down less trees, we'll be doing less more We'll be doing less, more. We'll be postal communication and UPS will go away and other things. Well, they've grown bigger. Right, we're using more paper, more printers, more cutting down more trees. We are using that. Give birth to Amazon. Right Now we are able to do so. Not necessarily.

Speaker 3:

Human brain is a very evolving brain. It will figure out. So I don't think. Yeah, even if radiologists are a certain spill, but they'll be doing something different. Progress to medicine never stops, right. Disease will are always there. No disease we have erratic. It may have suppressed some, but we have never got rid of any disease. It will same thing. Disease will evolve and change, and how we treat and address them in different field will evolve. What we are traditionally doing for 50 years may change how we approach it, but I don't think anything's going away right, right, awesome, and what is your view on?

Speaker 2:

so, again, from the education standpoint, if you go talk to a professor, a vast majority of them, or an overwhelming majority of them, despise AI. They don't want students to use AI. They don't want students using AI because you know essentially, and you know in all likelihood, a lot of students use it as a shortcut, not necessarily to increase efficiency. Now, keeping that in mind, during, you know, since you run so many residency practices, do you have tools in place that are constantly policing incoming students that hey, did they write their personal statement through AI and all of that? Or is this something that you know will flesh itself out during the interview process?

Speaker 3:

so there are three ways of looking in the interview process. Right, one is if I'm the pd or if I'm the evaluation committee, the things that I'm going to look into, starting with um. But I was giving an example of, for 12 residency or 15 residences part, I may get 3 000. How am I going to stream that out? Right? So the screening tool typically looks at their scores. So what my advice to most of the residents would be focus on clinical medicine. Forget all this other issues that are evolving around technology. Focus primarily on first step. Usmle is now pass or fail, so that's become okay, but the visibility of Belker or the institution side still exists. And then, if you particularly are focusing currently what we look into, scores of 240 or plus tells you that you have enough fundamental core clinical knowledge that you grasp the subject, that you understood enough basic sciences to be forthcoming Because the reason we look at this core clinical knowledge, that you grasp the subject, that you understood enough basic sciences to be forthcoming. Because the reason we look at this is it's not because three years span in an intermedicine residence is not enough to train a good doctor. So you have to have a strong fundamental core to grasp things that come to you.

Speaker 3:

The second thing we look into is if they have some advancement, that they have looked into their passion, their drive of what they want, why they want to be a doc, why they will actually really have done, besides being a doc, of affiliated thing, voluntary services, that affiliated medicine, that their dedication to community or they've done some other things that are not just purely medicine but in the pursue that they are not just one box shop kind of students. Other things that we look is that probably creative skill of whether it's an AI generated letter. It is a well framed letter, may avoid some grammatical errors and correct strangers, but you see some of the reputations, you see patterns. That actually tells you that this is not a heart-driven or soul-driven letter. Right, it will take us a while to be that creative enough, but it tells you that we look for the drive. What are the birds' stories of what they? It may be a little lengthy but it tells you that what led them to be a doctor as a passion, not just because they want to serve the community.

Speaker 3:

That is a generic statement. We look at the uniqueness of individual examples. So those are the patterns, how we filter out, because ultimately for 15 slots. I'm at the ability to interview maybe 60 or 70. So the immense task is what we look as creative abilities of that. So AI, when you start looking at the trend, if everybody uses JetGPT or other for JAMA or any other things, there's a common repetitive thing that you pick up so that I would strongly discourage. You can take that as advice, but still drive your own labs, right, right, right.

Speaker 2:

Okay, that's good. And what about students using AI for study tools? Do you feel that that's effective? Like I know, a lot of students are using AI for mnemonics. Create something for me that helps me remember it. Do you wholeheartedly think that that's a better way? I personally think that that's pretty ingenious.

Speaker 3:

I think everyone has their own understanding. We used to make mnemonics in the good old days of medicine, paper and pencil, how to remember this right For diseases or sick days, and some of them we kind of linked it with some foods and other colors and other things. That's how we used to remember it right. So using AI to create your personal mnemonics if that helps you to remember or understand things better, I don't see any problem with that.

Speaker 2:

All right, awesome.

Speaker 2:

Well, one thing that I've always a lot of students ask me is you know I want to be a physician, but I don't really want to necessarily see patients on a day-to-day basis, want to change the system, and you know you were telling me a little bit about how this position of a cmo is a relatively new position, at least as compared to a ceo.

Speaker 2:

Um, what do you think a student should really do to become a cmo? And I genuinely think that you know, in hospital settings, having a ceo who is not a physician is a disservice, in my opinion, which is the vast majority of hospitals that is the case. But I think, looking at prime as an example and looking at some of the other hospitals that don't necessarily have, uh, the, the structure that prime has end up struggling. And we read it in the newspaper all the time hospitals going bust, hospitals being taken over, um, what are your thoughts on physicians going into medicine, going into residency, something it may even be family or, uh, something more generic and then coming out and becoming CMOs, maybe even CEOs? Is this a trend, do you think?

Speaker 3:

So interestingly so nobody will probably understand medicine as good as a physician, right? So the traditional medicine, where the CEO is nothing wrong with them, it was a structure that was designed but now it's an evolving field that physician leadership are getting into leadership that are getting more into management, understanding the complexity of disease and rather than some non-physician who has a difficulty understanding the physician flow. So that field is definitely evolving and as you see more and more to be a CMO. There's a couple of things there's no course. There's nothing that's going to teach you they Be a CMO. There's a couple of things there's no course. There is nothing that's going to teach you. They'll give you some principles.

Speaker 3:

You can do Sigma 6 and other things which allow you the efficiency models, but you have to learn. It boots on the ground. You have to be a good clinician. You have to understand, you have to be a people person. You have to be a team player. You have to understand the other specialties. You have to understand and team with them. How do you actually? Because ultimately you'll have to grow into that position. There is no didactic course that will make you.

Speaker 3:

Even if you did MBA in health management, you may understand the concept. But you're dealing with a group of individuals who are highly educated, highly trained, highly sophisticated. How do you have them come in? Make sure that they buy in. That respect has to be earned. You cannot learn by a book. So if they want to go, yes, you can take para courses while you're doing your residency, you can do some health administration management courses or you can do MBAs after you're done, but unless you understand the clinical bread and butter medicine. But unless you understand the clinical bread and butter medicine essentially of a good CMO. Most of the CMOs in this country have done that. Some of them have now grandfathered later on but relinquished their practices and now gone to. But each one has worked and put their blood and sweat as a doctor.

Speaker 2:

Okay. So basically, if a student comes and asks me I want to be an administrator essentially a CMO Right the advice should be stick to your residency, get your residency. Student comes and asks me I want to be an administrator essentially cmo right the advice should be stick to your residency, get your residency, be a good clinician right, and then the path will right itself absolutely on its own. All right, well, but thank you so much, dr patel, for your time pleasure it was, uh, amazing having you here in st vincent.

Speaker 2:

I hope you enjoyed yourself while you were here. I hope you got a chance to see our school and see what our school is all about, and we had a blast having you and we hope you can come back and talk to our students periodically.

Speaker 3:

Pleasure. It was wonderful seeing St James. I love the mission that you are driving through. I love the passion that you have created, growing into 25 years, how you have encouraged a good education within a small community, involving the community, and I think you have leaps and bounds to come forward and I will be happy to support that cause.

Speaker 2:

Thank you so much, dr Patil. I really appreciate it. Thank you so much, dr Paras Patil, for giving us such valuable insights into your journey and especially your time management skills, where you've managed to maintain some hobbies that are really demanding of time. I hope our audience is as inspired as I have been, and thank you so much for your time and visiting us in sunny St Vincent, and remember there is no shortcut to becoming an MD.

Speaker 1:

Thank you so much for tuning into our show. We hope you enjoyed another episode of Med School Minutes. If you like our content, please follow us and receive notification when a new show is posted. This podcast is brought to you by St James School of Medicine. For a video version of this podcast, please check us out on sjsmorg slash video.