Clinical Conversations

In this episode Professor Tom Fardon returns to Clinical Conversations to discuss updates in asthma diagnosis and management from the joint BTS/SIGN/NICE guideline on Asthma. Prof Fardon and Dr Ben Warner discuss the changes to practice since the guidelines were released and the evolving role of biologics in asthma treatment.

Professor Fardon is a Consultant Respiratory Physician at NHS Tayside and Honorary Professor at the University of Dundee. They are also the chair of the Scottish Severe Asthma Group within the Centre for Sustainable Delivery.

Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals with the University of Glasgow.

Recording Date: 9 December 2025

--Links--
BTS/SIGN/NICE guideline on Asthma - https://www.nice.org.uk/guidance/ng245
Asthma Pathway - https://www.nice.org.uk/guidance/ng244
Algorithm A: Objective tests for diagnosing asthma in adults and young people (aged over 16 years) - https://www.nice.org.uk/guidance/ng245/resources/bts-nice-and-sign-algorithm-a-summary-of-objective-tests-for-diagnosing-asthma-pdf-13556516365
Algorithm C: Pharmacological management of asthma in people aged 12 years and over - https://www.nice.org.uk/guidance/ng245/resources/algorithm-c-pharmacological-management-of-asthma-in-people-aged-12-years-and-over-bts-nice-pdf-13556516367
‘Optimising inhaled therapy for patients with asthma’- https://doi.org/10.1136/bmj-2024-080353
Asthma+Lung UK website Inhalers resource - https://www.asthmaandlung.org.uk/living-with/inhaler-videos
‘Greener Practice’ asthma care toolkit (free registration required)- https://www.greenerpractice.co.uk/asthma-toolkit/
'Greener Practice' Device Choice video - https://www.youtube.com/watch?v=YRJGD48bryI
Asthma Guidelines (Plain Language Version) - https://www.sign.ac.uk/patient-public-involvement/plain-language-versions-of-guidelines/asthma/

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

This is a co-release with our sister podcast, Career Conversations.

In this episode, Dr Marilena Giannoudi talks with Dr Manav Sharma about the specialty, Aerospace Medicine. They discuss the pathways which lead to the specialty and some interesting cases.

Dr Manav Dutt Sharma is an aerospace medicine physician, former Indian Air Force flight surgeon and human factors specialist with over 23 years of experience at the intersection of aviation and healthcare. He has led an award‑winning primary healthcare centre in the Air Force, works on safety, service quality and systems improvement in hospitals, and has authored a forthcoming book, From Runways to Recovery Rooms, on what healthcare can learn from aviation.

Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members & Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.

Recording Date: 12 December 2025

--Links--
JRCPTB Specialty - https://www.thefederation.uk/training/specialties/aviation-and-space-medicine

Physician Higher Specialty Training Recruitment - https://www.phstrecruitment.org.uk/

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Aoife Duignan speaks with Dr Mireia Moragas about how to treat headaches in a pregnant person. They discuss what questions physicians should ask themselves when a pregnant person attends the acute ward with headaches, the green and red flags for headaches as well as the medications that are safe during pregnancy.

Dr Mireia Moragas is a Consultant Neurologist in Edinburgh where she also runs the Headache Clinic, as well as participating in the acute care of patients with stroke. She has participated in the local and Scottish national headache guidelines as well as the local protocols for management of headache and stroke during pregnancy.

Dr Aoife Duignan is a specialist trainee in geriatric and general medicine in South East Scotland. She is also Co-Chair & Vice Chair - Representation for the Trainees and Members' Committee (T&MC).

Recording date: 10 November 2025

--Useful Links--
Bumps (Best Use of Medicines in Pregnancy) - https://www.medicinesinpregnancy.org/

Maternity pathway and schedule of care - https://www.gov.scot/publications/maternity-pathway-schedule-care-clinical-guidance-schedule/

National Maternity Network, Management of Headache in Pregnancy Guidance - https://www.perinatalnetwork.nhs.scot/wp-content/uploads/2023/02/2023-02-21-Headache-in-Pregnancy.pdf

NHS Scotland Centre for Sustainable Delivery - https://www.nhscfsd.co.uk/media/nswenkmf/national-headache-pathway-migraine-during-pregnancy-and-following-childbirth.pdf

RefHelp NHS Lothian - https://apps.nhslothian.scot/refhelp/

RefHelf Migraine/Chronic Headache in pregnancy - https://apps.nhslothian.scot/refhelp/guidelines/neurology/headache/migraine-chronic-headache-in-pregnancy/

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode of Clinical Conversations, Dr Marilena Giannoudi discusses cardiorenal metabolic disease with Dr Andrew Frankel. Their discussion provides an overview of this common cause of chronic kidney disease (CKD) and they focus on the management of cardiorenal metabolic disease, with Dr Frankel highlighting the importance of lifestyle management and patient education and engagement, and the pharmacotherapy 'four pillars' of RAAS inhibition, SGLT2 inhibition, blood pressure control, and MR antagonism. Explore this and more in this episode.

Dr Andrew Frankel has been working as a consultant nephrologist at Imperial College Healthcare NHS trust since 1995 and works at the Imperial Renal and Transplant Centre, which is one of the largest kidney units in Europe catering for a population base of over three million. He has experience in managing all aspects of kidney disease but has a particular interest in relation to the management of kidney disease in the context of diabetes, cardiac disease and obesity.

Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of RCPE's Trainees and Members' Committee.

-- Links --

NICE Guideline (NG203) - Chronic kidney disease: assessment and management
https://www.nice.org.uk/guidance/ng203

2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes
https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines

For Kidneys Sake Podcast - By Dr Andrew Frankel and colleagues
https://www.forkidneyssake.com/

Recording date: 24 November 2025

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Kat Ralston speaks to Professor Edwin Jesudason about how his experience of whistleblowing as a paediatric surgeon changed his practice. They reflect on the importance of listening and creating a shared dialogue with patients, discuss how experiencing moral injury can help clinicians better understand and navigate patient suffering and explore the art of being human in medicine.

Professor Edwin Jesudason is a Consultant in Rehabilitation Medicine in NHS Lothian.

Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC).

Recording date: 24 July 2025

-- Useful Links --
Jesudason, 'The 4D Model: Rehabilitating Unrealistic Medicine', BJHM (2025) https://doi.org/10.12968/hmed.2024.084

Jesudason, 'Manufacturing safer medics', J Med Ethics (2022) https://doi.org/10.1136/jme-2022-108581

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