Cmaj Podcasts

Transformative therapies for sickle cell disease are redefining what is possible for patients, offering the potential for cure alongside substantial risks. In CMAJ, the article Transformative therapies for sickle cell disease outlines how stem cell transplant and emerging gene therapies are changing the trajectory of a condition long defined by recurrent crises, shortened life expectancy, and inequities in care.Dr. Kareem Jamani, a haematologist and clinical associate professor at the University of Calgary, explains how stem cell transplant replaces a patient’s blood-forming system to eliminate sickling haemoglobin, offering what can reasonably be considered a cure. Outcomes are generally favourable, particularly with matched sibling donors, but risks remain, including graft-versus-host disease, infertility, rejection, and mortality that can reach 5–7% with less well-matched donors. He also outlines the role of gene therapy, which modifies a patient’s own stem cells to increase fetal haemoglobin production, r

Two research articles in CMAJ examine gaps in how maternal risk is captured and how it varies across populations in Canada. One study shows that extending surveillance beyond delivery reveals a higher burden of severe maternal morbidity, particularly in the postpartum period. A second examines obstetric trauma, identifying differences across racial and immigration groups and pointing to structural and sociocultural factors that shape risk during delivery.Dr. Giulia Muraca, an obstetrician-gynecologist at McMaster University and principal investigator on the first study, explains that extending surveillance beyond delivery increases estimated rates of severe maternal morbidity from 1.7% to 2.7%, representing nearly 10 000 affected pregnancies annually in Canada. Maya Rajasingham, a perinatal epidemiologist at McMaster and co-author, notes that 29% of these events occur postpartum, with sepsis emerging as a key contributor. Muraca adds that postpartum sepsis rates are substantially higher than previously report

New prescriptions for stimulant medications used to treat attention-deficit/hyperactivity disorder (ADHD) doubled during the COVID-19 pandemic compared with the years before it, with the largest increases among adults aged 18 to 34 and among women.Dr. Tara Gomes, a professor at the University of Toronto and principal investigator of the Ontario Drug Policy Research Network, discusses findings from the CMAJ research article Patterns of prescription stimulant initiation before and during the COVID-19 pandemic. Her team found that the number of Ontarian adults newly starting stimulants rose rapidly after an initial drop early in the pandemic. The interval between a first ADHD-related health care encounter and a stimulant prescription also fell from about seven years before the pandemic to less than one year during it. Gomes suggests the increase likely reflects both improved recognition of ADHD in adults and easier access through virtual care, which may be shortening the pathway from first expression of concern

Ontario’s expansion of online gambling and legalization of single-event sports betting were followed by a sharp rise in help-seeking for gambling problems, particularly among young men. A new CMAJ study, Help seeking for gambling problems following expansion of Ontario's online gambling market and legalization of single event sports betting, analyzes calls to Ontario's 24-hour mental health and addiction hotline before and after the 2022 policy changes. The findings suggest that increased accessibility, private-sector expansion, and in-play betting may be amplifying gambling-related harm.Dr. Daniel Myran, a family physician, research chair in family and community medicine at North York General Hospital, and co-author of the study, reports that hotline contacts among males aged 15 to 24 tripled after the market opened to private operators. By the end of the study period, more than 70% of callers cited online gambling. He describes how legalization of single-event sports betting and in-play betting re

Child physical abuse often presents first with injuries that appear minor, but missing these early warning signs can have devastating consequences. Two recent CMAJ papers examine how sentinel injuries in infants may signal escalating risk and how patterns of severe maltreatment shifted during the COVID-19 pandemic. Together, they offer practical guidance on when clinicians should escalate concerns and highlight system factors that shape risk for vulnerable children.Dr. Megan Cooney, a child maltreatment pediatrician at Health Sciences Centre Winnipeg and co-author of “Five things to know about sentinel injuries and indicators of child physical abuse”, explains why medically minor injuries in pre-cruising infants require careful scrutiny. She notes that more than one quarter of children who experience catastrophic abuse had previously been seen for minor injuries. Any unexplained or poorly explained injury in a non-cruising infant should raise concern. She also reviews the validated TEN-4-FACESp clinical decis

On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore new evidence suggesting that rates of psychotic disorders are increasing in younger generations in Canada. Drawing on population-level data and broader psychiatric research, the episode examines how generational trends in psychosis intersect with substance use, social change, and the ongoing youth mental health crisis.Dr. Daniel Myran, a family physician and public health researcher at North York General Hospital, discusses findings from his CMAJ study, Incidence of psychotic disorders by birth cohort: a population-based cohort study in Ontario, Canada. He explains how overall rates of psychosis appear stable when populations are viewed as a whole, but mask a substantial rise among people born in the 1980s, 1990s, and early 2000s. Dr. Myran outlines possible contributors, including substance exposure, changes in diagnostic practices, and social determinants, and emphasizes the implications for early intervention psychosis progr

On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham examine how large-scale events expose weaknesses in Canada’s health care capacity. The discussion draws on the CMAJ editorial Mass gathering events underscore serious vulnerabilities in health care capacity in Canada, which argues that Canada’s hospitals lack the flexibility to absorb even modest surges in demand. With the FIFA World Cup approaching, the episode asks how prepared the system really is.Dr. Catherine Varner, deputy editor of CMAJ and an emergency physician, explains why she wrote the editorial now. Drawing on her frontline experience during major events in Toronto, she describes hospitals that routinely operate over capacity, with little ability to create space when demand rises. She distinguishes between mass casualty events and mass gatherings, noting that while catastrophic incidents are rare, sustained influxes of visitors predictably increase emergency department use. Varner also describes how prolonged overcrowding

On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham examine the issues raised in a recent CMAJ commentary on Alberta’s Compassionate Intervention Act, which explores the ethical and clinical implications of this approach to involuntary treatment. As governments across Canada turn to coercive measures in response to the overdose crisis, the episode considers what these policies mean for patient autonomy, clinical practice, and the role of physicians in enforcing care.Dr. Bonnie Larson, a family physician and addictions medicine specialist at the University of Calgary, joins the conversation to unpack the legislation. She explains how the Act allows individuals to be detained and treated even when they are deemed capable of making their own medical decisions. Dr. Larson describes how this represents a substantial departure from established principles of consent and autonomy, placing physicians in ethically complex positions and reshaping their role in care.The discussion then turns to Mas

On this ENCORE of our most popular episode of 2025, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with two authors of the latest “Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care”The discussion reflects a shared urgency: despite past successes, Canada’s hypertension control rates are declining. The new guidelines aim to reverse this trend by simplifying diagnosis and treatment for frontline clinicians.Dr. Rémi Goupil, a nephrologist and clinician researcher at Sacré-Cœur Hospital in Montreal, and Dr. Greg Hundemer, a nephrologist and clinician scientist at The Ottawa Hospital, explain that the updated guideline is deliberately designed for primary care providers. They highlight key shifts: lowering the diagnostic threshold for hypertension to  ≥ 130/80 mm Hg, simplifying blood pressure targets, and emphasizing accurate, standardized measurement techniques both in clinic and at home. The guidelines were created with input from a majority-primary care c

Despite a range of effective prevention tools, HIV incidence continues to rise in Canada, with stark disparities across ethnicity, gender, Indigeneity and geography. Updated Canadian guidelines on HIV pre- and post-exposure prophylaxis reflect scientific advances since 2017 and address both new formulations and persistent barriers to equitable access.Dr. Darrell Tan, lead author and clinician scientist at St. Michael’s Hospital, outlines several prophylaxis options now available. Daily oral tenofovir disoproxil fumarate with emtricitabine is close to 100 per cent effective with perfect adherence and remains forgiving of occasional missed doses. Long-acting injectable cabotegravir, administered every two months, shows even greater effectiveness in trials largely because it reduces the adherence challenges associated with daily pills, though cost and availability continue to limit uptake.Natasha Lawrence, a community health worker at Women’s Health in Women’s Hands Community Health Centre in Toronto, reports th

Celiac disease affects between one and two percent of Canadians, yet many patients wait years before receiving a clear diagnosis. On this episode of the CMAJ Podcast, the hosts speak with two contributors to the CMAJ review article Diagnosis and management of celiac disease about the condition’s diverse clinical presentations, appropriate testing strategies, and the practical realities of long-term dietary management.Jedid-Jah Blom, a registered dietitian at the McMaster Celiac Disease Clinic and researcher at the Farncombe Family Digestive Health Research Unit at McMaster University, shares her own experience being diagnosed and living with celiac. She explains how patients must identify hidden gluten sources in ingredients like dextrin and malt, and why cornmeal or corn flour products may be contaminated. Blom outlines the risks of cross-contamination and dining out challenges, emphasizing whole gluten-free grains over processed products that lack fortification.Dr. Maria Ines Pinto-Sánchez, a gastroenterolo

This episode of the CMAJ Podcast explores how physician identity can influence patient expectations, and how those expectations may contribute to gender, race, and immigration status pay gaps. The discussion builds on the CMAJ article “Family physician pay inequality: a qualitative study exploring how physician responses to perceived patient expectations may explain gender, race, and immigration status pay differences”.Dr. Monika Dutt, a family physician, public health and preventive medicine specialist, and PhD candidate in health policy at McMaster University, explains how the study’s interviews with 55 family physicians across Ontario revealed patterns linking patient expectations to physician identity. She describes how gender and cultural background influence the types of visits physicians are asked to provide, and how these interactions may affect their earnings under fee-for-service models.Dr. Meredith Vanstone, professor in the Department of Family Medicine at McMaster University, outlines how physici

A recent article in CMAJ, Mental health service use among Black adolescents in Ontario by sex and stress level: a cross-sectional study, reveals how patterns of mental health service use among Black youth shift with the level of psychological distress. Lead author Mercedes Sobers, a PhD candidate in epidemiology at the Dalla Lana School of Public Health and research coordinator at the Centre for Addiction and Mental Health, joins the podcast to unpack the findings and their implications.The study found that Black male youth had higher odds of accessing services than white male youth when at low levels of distress but lower odds of accessing services at high levels. Black female youth had lower odds of service use than white female youth at both low and high distress levels. Mercedes explains how these patterns may reflect how behaviour is interpreted: Black boys may be referred to services more often at lower distress levels but steered toward more punitive responses when distress rises. For Black girls, she

Rates of depression in Canada are rising, but a new CMAJ guideline advises against universal screening in primary care. The Canadian Task Force on Preventive Health Care found no evidence that routinely administering depression questionnaires to all adults improves outcomes and raised concerns about false positives, overdiagnosis, and strain on limited mental health resources.Dr. Eddy Lang, lead author of the guideline and professor of emergency medicine at the Cumming School of Medicine, University of Calgary, explains the rationale behind the Task Force’s recommendation. He describes how the review found no benefit from universal screening in improving depressive symptoms or quality of life and that commonly used questionnaires frequently misidentify patients, generating false positives and false negatives. Lang emphasizes that while physicians should remain attentive to patients’ mental health, questionnaires are not the answer to identifying depression in the general population.Dr. Jennifer Young, a famil

Evidence is mounting that cannabis use can trigger first episode psychosis, particularly among young people. On this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with researchers and a patient with lived experience about what the data show, who is most at risk, and how clinicians should respond.Bailey Peterson, a 26-year-old student from Mississauga, Ontario, describes how her cannabis consumption progressed from casual use to daily, all-day use of high-potency products. She recounts her experience with psychosis, the challenges of her hospitalization, and what she wishes she and her clinicians had known earlier.Sophie Li, a fourth-year medical student at the University of Ottawa and an author of the CMAJ article Cannabis and psychosis, explains how rates of schizophrenia associated with cannabis use disorder have risen sharply in recent years and notes that young men in their late teens and early 20s are most at risk. For women, the highest risk tends to occur later, in thei

Spinal and bulbar muscular atrophy (SBMA), also known as Kennedy’s disease, is a rare, progressive neuromuscular disorder that is often misdiagnosed and diagnosed late. A new CMAJ guideline offers Canadian-specific recommendations for its recognition and management.On this episode we hear from Richard Paul, a former bus driver from Saskatoon, who recalls how his symptoms began suddenly with an inability to bite into a sandwich and, over the years, progressed so gradually he barely noticed the loss of strength. His experience captures both the slow, inexorable progression of SBMA and the uncertainty of living without a diagnosis for decades.Mr. Paul was finally diagnosed by Dr. Kerri Schellenberg, a neuromuscular neurologist at the University of Saskatchewan and lead author of the guideline. She explains the clinical hallmarks of SBMA, its overlap with conditions such as ALS, and the non-motor manifestations that require attention. She also discusses the higher prevalence among Indigenous populations in Canada

Homelessness among pregnant and parenting people in Canada is rising, with grave consequences for both parents and children. On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore the scope of the problem and the supports that can improve outcomes for parents and children.Dr. Stéphanie Manoni-Millar, co-author of the CMAJ commentary Tackling the crisis of homelessness amongst pregnant and parenting people in Canada, explains who is most affected and what risks they face. She describes a predominantly young population, many of whom are homeless or experiencing precarious housing. She highlights the health consequences for children, including developmental delays, infections, and increased rates of anxiety and depression, and stresses the importance of affordable housing and integrated services to support families.Nerina Chiodo, a social worker in Toronto with MotherCraft Breaking the Cycle, shares insights from more than two decades of supporting pregnant people who are homeless. Sh

Smoking remains the leading cause of preventable disease and death in Canada. A new clinical practice guideline published in CMAJ on tobacco smoking cessation outlines evidence-based behavioural and pharmacological interventions to help patients quit. On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham speak with Dr. Eddy Lang, co-author of the guideline, and Dr. Andrew Pipe, a pioneer in smoking cessation research and practice, about how clinicians can better support patients ready to stop smoking.Dr. Eddy Lang, an emergency physician and professor at the Cumming School of Medicine, describes how the Canadian Task Force on Preventive Health  assessed a wide range of interventions to make sense of a complex evidence base. He outlines the strong recommendations in favour of pharmacological therapies such as nicotine replacement therapy, bupropion, varenicline, and cytosine, as well as behavioural interventions including counselling, group therapy, and quit lines. He also explains the con

Send us a text—This is an encore presentation of an episode previously published June 30—On this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with two authors of the latest “Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care”The discussion reflects a shared urgency: despite past successes, Canada’s hypertension control rates are declining. The new guidelines aim to reverse this trend by simplifying diagnosis and treatment for frontline clinicians.Dr. Rémi Goupil, a nephrologist and clinician researcher at Sacré-Cœur Hospital in Montreal, and Dr. Greg Hundemer, a nephrologist and clinician scientist at The Ottawa Hospital, explain that the updated guideline is deliberately designed for primary care providers. They highlight key shifts: lowering the diagnostic threshold for hypertension to  ≥ 130/80 mm Hg, simplifying blood pressure targets, and emphasizing accurate, standardized measurement techniques both in clinic and at h

Send us a textIron deficiency affects as many as 40% of women of reproductive age, yet the problem often goes undetected—even when patients have symptoms and complications. On this episode, Dr. Blair Bigham and Dr. Mojola Omole speak with hematologists Dr. Michelle Scholzberg and Dr. Rita Selby about their structural solution to this pervasive problem: a province-wide change to how laboratories flag ferritin results. Their article, “Diagnosis and management of iron deficiency in females”, is published in CMAJ.Dr. Michelle Scholzberg, a hematologist and clinician scientist at St. Michael’s Hospital and division director of Hematology at the University of Toronto, explains why iron deficiency without anemia is clinically important, how flawed reference standards and stigma around menstruation have contributed to underdiagnosis, why screening based on hemoglobin alone misses many patients and how structural barriers within medicine have long impeded timely detection and treatment. She outlines the evidence that