Medicine and Science from The BMJ

In this magazine episode, we talk about the forever chemicals in our blood, how to protect patients from cosmetic procedures gone wrong, and the long-standing dearth of LGBTQ+ data.

 

Per- and poly-fluoro-alkyl substances, also called PFAS or "forever chemicals", have become ubiquitous in our environment over the last 70 years. As the UK government launches a new epidemiological study into human exposure, we discuss the persistent biological effects of PFAS and what this means for long-term health outcomes.

 

Also this week, we turn our attention to the up-and-coming new restrictions in England targeting non-surgical cosmetic procedures. But will these proposed changes actually protect the public from unscrupulous providers? We discuss the problems with regulation in a profit driven market, and what it means for patient safety.

 

Finally, while health outcomes for LGBTQ+ people are known to be worse than the general population, the extent of that gap, and what’s causing it, are still difficult to study. Basic data collection is shockingly poor. We hear why that is, and what’s needed to fill the gap.

 

Guest List:
Tony Fletcher – Honorary associate professor at the London School of Hygiene & Tropical Medicine

Alexandra Mullock – Senior lecturer in medical law at the University of Manchester

Joel Bates – Research assistant at King’s College London

 

Reading:
PFAS: the persistent problem of forever chemicals and health

Delayed regulation of non-surgical cosmetic procedures threatens patient safety

The NHS doesn’t routinely collect data on LGBTQ+ health, even though meaningful improvements can’t happen without it

In this episode of the Medicine and Science podcast, we dive into a cross-border public health mystery and hear about the loneliness of the resident doctor.

Canada recently lost its measles elimination status following a major outbreak of over 2,000 cases that began in late 2024. It's essential that public health agencies can track the virus as it moves through a population - but how do they do it? Two public health physicians from Ontario join us to explain how they went into full investigatory mode. We discuss how genomic sequencing, contact tracing, and vaccination data came together to form a detective story that exposes the vulnerability of under-vaccinated populations, the porous nature of international borders, and what it will take to regain elimination status.

Then, we turn to the ongoing retention and morale crisis among resident doctors in the UK. A new BMJ opinion piece points to a possible different fuel for the discontent: workplace loneliness. We explore how rotational placements are stripping away crucial support networks, isolating young doctors on the wards, and what must be done to restore vital connectedness to the profession.

Guest List:

Dr. Sarah E. Wilson – Public Health Physician in Toronto, Ontario.

Dr. Miriam Klassen – Medical Officer of Health in Stratford, Ontario.

Alex Mafi – Resident doctor in London 

Reading List:

Impact of a large measles outbreak associated with transmission in the Americas and Canada’s loss of measles elimination status: descriptive cohort study 

Loneliness at work: We need to restore connectedness for resident doctors

In this podcast, we explore one of 2026's key issues - the way in which climate and conflict are interacting to endanger human health. 

Neta Crawford, professor of international relations at the University of St Andrews has been studying how war contributes to climate change, despite the difficulty in obtaining clear information - as most military emissions are exempt from reporting under Kyoto-era rules, She explains why mandatory transparency, reduced reliance on military solutions, and a change to defense doctrines are necessary.

Mohammed Aba Aji, post-doctoral research associate at Washington University argues that rising spending on the military - nearly $3 trillion and increasing for 11 years, is diverting resources from health, education, and climate adaptation. He explains why the only way to tackle this is to redefine defence away from property and infrastructure to human flourishing.

Reading list

War and military mobilisation are drivers of climate change

Increasing defence expenditure may cost us our security

Countering the arms industry as a commercial determinant of health

 

 

*This episode was republished on 24th of October, to correct the final mp3

In this episode of podcast we explore two clinical dilemmas - unrecognised drug side effects, and the outcomes from hip and knee replacements.

When an unrecognised adverse drug effect is mistaken for a new symptom, the resulting prescribing cascade can end in polypharmacy and potentially preventable patient harm. New research on nearly 2.3 million adults in Ontario, has found 24 high-priority, potentially inappropriate prescribing cascades—including laxatives after iron, pain relievers following statins, and sedatives after cholinesterase inhibitors. Paula Rochon, Jerry Gurwitz, and Antonio Cherubini, three of the study's authors join us to discuss.

Over 100,000 hip and, 100,000 knee replacements are performed annually in the NHS, and health systems are investing hundreds of millions to rapidly scale robot-assisted surgery, but is this expensive new tech delivering better patient outcomes? Two target trial emulation papers, using the UK's National Joint registry aim to find out if robots are better at join replacement. Hassan Mohammad, one of the papers' authors shares their findings, and Teppo Järvinen joins the conversation to discuss challenging orthopaedic surgery standard practice.

Guest List
Prescribing Cascades Discussion

Paula Rochon, Geriatrician, senior scientist, and professor at Sinai Health and the University of Toronto.

Jerry Gurwitz, Geriatrician, researcher, and professor of Medicine at UMass Chan Medical School.

Antonio Cherubini, Geriatrician and clinical eesearcher at Università Politecnica delle Marche and INRCA (Istituto Nazionale di Riposo e Cura per Anziani) 

Robotic Hip & Knee Arthroplasty Discussion

Hassan Mohammad, academic clinical lecturer in orthopaedics at Barts and The London School of Medicine and Dentistry

Teppo Järvinen, orthopaedic surgeon and professor at the University of Helsinki, and Head of the Finnish Centre for Evidence-Based Orthopaedics (FICEBO) in Finland.

BMJ.com Reading List
Research Papers

Exploring high priority potentially inappropriate prescribing cascades in older adults: population level retrospective cohort study

Early national comparison of robotic versus conventional knee replacements for arthritis using National Joint Registry data: target trial emulation study

Early national comparison of robotic versus conventional hip replacements for arthritis using National Joint Registry data: target trial emulation study

Robot assisted hip and knee arthroplasty: It is high tech, but is it better?

Referrals for ADHD and autism assessments have reached unprecedented levels, leaving NHS waiting lists stretched into years and families struggling to access support. But is the rise driven by a genuine increase in neurodevelopmental conditions, increased awareness, or systemic overdiagnosis?

This prompted the government to commission the Independent Review into Mental Health Conditions, ADHD, and Autism; and we're joined by vice Chair of that review, Professor Sir Simon Wessely, Regis chair of psychiatry at King’s College London.

In this episode, we discuss: Community prevalence vs. administrative prevalence, the roles of underdiagnosis, misdiagnosis and overdiagnosis. Why the current focus on diagnosis is a mistake, and why environmental factors are really key to the changes we're seeing. We also cover thecore recommendations of the report.

 

Read the full report:

https://www.gov.uk/government/publications/independent-review-into-mental-health-conditions-adhd-and-autism-final-report