IM Reasoning

Conversations to inspire critical thinking in clinical medicine and education

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 medical students, trainees and practitioners of clinical medicine, with a special focus on clinical reasoning, the once-mysterious process behind the remarkable abilities of the master clinician.

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  1. Ben Mitchell says:

    Hi Nic and Art,
    It was a pleasure to meet you both at GPTEC in Sydney last week. I only wish I was aware of your podcast prior to meeting you. I have since listened to a few of your episodes and intend to make it a regular habit.

    I would also like to say I’m currently working on how we can incorporate more of your teaching clinical reasoning methods into our GP rotation in our Medical School here in Brisbane. We already to follow your ‘morning report’ style in our tutorials but I’d like to expand on this.

    Many thanks again and keep up the good work. I will endeavour to spread the word about your podcast!


    1. Nicolas Szecket says:

      Thanks Ben. We appreciate the feedback and support. Maybe we’ll see you at GPTEC 2018!


    Hello Nic and Art

    I’m a pediatrician and pediatric dermatologist-skin surgeon at Mexico City. Also, I teach “clinical integration seminar” for 4th year medical students at the University that I work for and at a public hospital in my town.
    Your podcast has been very important in this teaching endeavor. In order to prepare to teach this seminar I searched for several resources in books and through the internet and then I found you.
    I listen to your podcast as I commute and I’ve suggested my students to listen to you and other podcasts and videocasts: EMCases for example. I love your humor and the way you’ve promoted methodological clinical thinking through STC, as well as your interviews with Dr. Larry Weed (he is certainly missed), and your references to the Society to Improve Diagnosis.
    You’re doing a very good work!, Thank you very much.

    1. Diana says:

      Nic nació en Argentina y habla en español muy bien

  3. Nick Hummel says:

    Dear Art and Nic
    I am a medical educator at James Cook university,involved with training GPs for most of regional Queensland. Your stuff is inspirational ; just the right balance of medicine,brain food and humour.I can’t make it to Melbourne next week,not sure about GPTEC,but am hoping you contact me if you are interested in coming to Cairns +/- Townsville sometime to talk to an audience of GP Medical educators and supervisors.

    1. Nicolas Szecket says:

      Dear Nick,
      Thanks for your comments. I am sure Art and I would love to make it out to your part of the world for a talk or workshop. Its all about finding time. Is there a forum you had in mind that happens at a particular time? Let’s keep the channel open.

  4. Nice work…espec teaming up w my chum Casey Parker

    ….now, you guys on Twitter yet?


  5. Pedro says:

    Hello Art and Nic,
    Here Portuguese medical student studying in the Netherlands. Your podcast is a breeze of fresh air in the medical podcasts community. Love the Stump the Chumps series! It has been one of the most useful podcasts to listen to until now. I have learned a lot. Episode with Gurpreet Dhaliwal was also incredible! Very inspiring person.
    Keep up with the good work.

    1. Nicolas Szecket says:

      Thanks Pedro for you comments. More Stump the Chumps episodes in the works!

  6. Abdul Siddiqui MD says:

    I am an infectious disease consultant in Seattle. I just listened to your podcast about NEJM clinical reasoning case. Loved the lively conversational format.
    Great job.

  7. Caroline Roberts says:

    Hi Art and Nic,

    What a fantastic podcast – thank you!
    I recently discovered your podcast through a network of medical professionals on Facebook and I’m so glad I did.

    I am a Psychiatrist over here in Australia but completed my basic medical training at Otago NZ. Listening to your podcast makes me feel more at home and I like that. So great to hear this important work going on there in Auckland and I hope the field of clinical reasoning is expanding across to other main centres of NZ now too.

    Although not a physician, I cannot tell you how much satisfaction and fascination rediscovering general medicine has brought me as I listen to your podcast on my drive to and from work. I can tell you, the art (and science!) of clinical reasoning (especially differential diagnosis generation) has really starting to wane in the field of Psychiatry too. This is I think often-times, as you highlight in one of your episodes, due to the system-driven necessity to record a singular diagnosis for coding purposes so as to meet KPI targets and, in turn, secure funding. This however can be at the expense of carefully considered differential diagnosis generation so important to understanding the complexities of the presentations we see in Mental Health.

    I have already found many ways of applying principles learned (and re-learned) in your episodes to my everyday practice, teaching and supervision, and cannot thank you again enough.

    Cheers guys and keep up the great work!


  8. Martin Schönemann-Lund says:

    Hi Art and Nic. Thank you for an interesting and engaging podcast which I recently discovered when the word of it reached twitter and the FOAMed community there. I was especially pleased about the episode “Myths of the Clinical” exam as I had been thinking that a presentation of Bayesian statistics was missing in the podcast. When doing more rounds of Stump the Chumps an idea could be to more openly mention your gestalt probabilities for the Dx and discuss the likehood ratios for the different tests ordered to improve the reasoning about why this particular test is ordered. Too often in medicine I find that tests and investigations are ordered without considering these aspects and it commonly leads to overdiagnosis and incidental findings that in my mind is an equally large problem in modern medicine as mis- and underdiagnosis.

  9. Hanna says:

    Hi Art and Nic,

    I have been listening to your podcast recently and I really love it. I am a last year medical student in Sweden and I am learning a lot and have gotten many new perspectives by listening to your episodes, which I am sure will help me become a better clinician in the future. I especially think your Stump the Chumps episodes are fantastic, it is so helpful to hear how experienced physicians reason about a case.

    I also find your interviews really great and interesting, I am just curious as to why you haven’t interviewed any female physicians yet, is there no female expert in the field of clinical reasoning and education?

    Thanks again for a great podcast!

    1. Nicolas Szecket says:

      Hi Hanna,

      Thanks for writing to us. You brought up a great point that neither of us had ever noticed. We have not yet had any female physicians on the show! not a conscious decision, just a coincidence. So glad you are enjoying the podcast.
      Art and Nic

  10. Nick Gowen says:

    Love the show guys. I listen to about 15 or 20 podcasts on a semi-regular basis, and you are one of my favorites (and easily my favorite medical one). I’ll be passing the word on to my colleagues/residents/students to listen.

    Nick Gowen, M.D.
    Internal Medicine and Pediatrics
    Little Rock, AR USA

    1. Nicolas Szecket says:

      Thanks for the feedback Nick. Glad you find the podcast helpful and we hope those you recommend us to will as well!

      Art and Nic

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