Core IM | Internal Medicine Podcast

If your patient asks you about a left atrial appendage closure device, what should you tell them?  
 In the latest episode of the Beyond Journal Club podcast from CORE IM and NEJM Group, the hosts will help you: 
Understand the trade-offs: stroke prevention, bleeding, procedural risks, and medications afterward. 
Build clinical judgment: weigh which approach may better serve the individual patient, beyond the trial’s headline. 
Learn from thoughtful counseling: hear how you might discuss the evidence, acknowledge uncertainty, and explore what matters to your patients.

🔹Sponsor: ACP MKSAP Oakstone CME
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP7​

🔹Transcript and Show Notes  
01:09 | What the Watchman is, and why it should work?
05:58 | The checkered history: PROTECT-AF and PREVAIL
09:06 | The plot continues: PRAGUE-17, OPTION, OCEAN, and CLOSURE-AF
12:35 | CHAMPION-AF: the biggest test yet
15:03 | Reading the fine print
19:23 | A local solution to a systemic problem
22:45 | How patients hear about it
25:44 | So what do we tell our patients?
29:52 | Takeaways

Tags: IMCore, Internal Medicine, Medical Education, WATCHMAN device, Atrial Fibrillation, Cardiology, DOAC Anticoagulation, Primary Care, Hospital Medicine

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“Should you stop screening for colorectal cancer (CRC) at 75?” 
This episode explores how to individualize screening decisions based on life expectancy, prior colonoscopy findings, and procedural risks. Learn how to navigate these nuanced conversations, avoid age-based assumptions, and use strategies like mailed FIT kits and offering screening choices to help more patients get screened.

🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here!

🔹Transcript and Show Notes
01:18 | Screening >75 yo?
10:06 | Takeaways on Colorectal Cancer Screening After 75 
10:37 | Systems thinking: How do we get to an 80% screening rate

Tags: Core IM, Internal Medicine, Colorectal Cancer Screening, Gastroenterology, Cancer Screening 

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“What’s the best way to screen?” This episode breaks down the pros, limitations, and follow-up needs of FIT, Cologuard, CT colonography, and colonoscopy to help you choose the right CRC screening option for your patients. Also learn practical colonoscopy surveillance intervals based on polyp size, number, and pathology.

🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here!

🔹Transcript and Show Notes
01:24 | Screening Options Besides Colonoscopy
11:22 | How FIT, FIT-DNA, and CT colonography differ and when each makes sense.
12:52 | Colonoscopy and Frequency
19:29 | How adenoma number, size, and histology guide surveillance intervals. 

Tags: Core IM, Internal Medicine, Colorectal Cancer Screening, Gastroenterology, Cancer Screening 

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“The triglycerides are high. Now what?” This episode breaks down a practical approach to elevated TGs, from knowing when to check ApoB or non-HDL-C to choosing lifestyle changes, lipid-lowering medications, and when to suspect an underlying genetic disorder. 

🔹Transcript and Show Notes
02:17 | Check a non-HDL-C or ApoB if TGs are ≥150 mg/dL 
07:18 | Address waist circumference and lifestyle before meds for high TGs
10:52 | Dr. Watson’s 3-day carbohydrate responsiveness trial 
17:07 | Order a fasting or nonfasting lipid panel?
19:00 | When do you reach for TG-lowering medications? 
25:26 | Familial chylomicronemia syndrome (FCS)

Tags: CoreIM, Medical Education, Hypertriglyceridemia, ACC AHA lipid guidelines, lipid guidelines 2026, cardiovascular risk 

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“Too young for colon cancer.” This episode unpacks the red flags of early-onset colorectal cancer (CRC), from blood in the stool and iron deficiency anemia to persistent abdominal pain and changes in bowel habits, and offers practical pearls for closing the clinical loop. Also learn why a “negative” family history may need a yearly refresh.

🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here!

🔹Transcript and Show Notes

01:45 | Colorectal cancer rising in younger adults 
06:42 | Why screening starts at age 45
08:15 | What may be driving early-onset colorectal cancer 
13:37| Key takeaways: symptoms, follow-up, and family history 

Tags: Colorectal Cancer Screening, Internal Medicine, Gastroenterology, Cancer Screening, Oncology

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