S1 E6: Fertility in Primary Care w/ Dr. Jason Hitkari

S1 E6: Fertility in Primary Care w/ Dr. Jason Hitkari

Guest: Dr. Jason Hitkari Host: Dr. Chris Morrow Producer: Craig Ferguson Music: "Stand With Me" by Adrian Walther licensed via SoundStripe Episode Timestamps [00:00] – Introduction and episode overview [00:29] – Guest introduction: Dr. Jason Hitkari [01:05] – Declining fertility rates in Canada and BC [03:54] – The rise of egg freezing and its exponential uptake [05:20] – Elective vs. medical egg freezing (oncofertility) [05:51] – Cost of egg freezing and lack of MSP coverage [06:44] – CFAS guidelines on egg freezing: who and when [07:32] – The primary care provider's role in egg freezing counselling [08:05] – When to investigate infertility: age-dependent timelines [09:46] – The basic infertility workup in primary care [10:51] – AMH testing: what it is and how to interpret it [11:53] – Pelvic ultrasound and tube assessment (HSG) [13:44] – Who should be referred to a fertility specialist [14:17] – Approaching the "fertility assessment" request in primary care [15:44] – Overview of fertility treatments: IUI, IVF, and ICSI [17:43] – Male fertility: lifestyle factors and semen analysis [21:21] – BC's new MSP IVF funding: eligibility and coverage [23:00] – The IVF waitlist and what patients can expect [23:39] – How patients access the funded IVF program [24:03] – Equity and access: financial, LGBTQ+, and legal barriers [25:21] – Rural access to fertility care in BC [27:05] – Key takeaways for primary care providers [28:24] – Knowledge nugget: a brief history of fertility [30:18] – Credits and CME information Studies & Research Mentioned Janecka M, Mill J, Basson MA, et al. Advanced paternal age effects in neurodevelopmental disorders—review of potential underlying mechanisms. Transl Psychiatry. 2017;7:e1019. doi:10.1038/tp.2016.294 Janecka M, Haworth CMA, Ronald A, et al. Paternal age alters social development in offspring. J Am Acad Child Adolesc Psychiatry. 2017;56(5):383–390. doi:10.1016/j.jaac.2017.02.006 Grossman DC, Curry SJ, Owens DK, et al. Screening for Ovarian Cancer: US Preventive Services Task Force Recommendation Statement. In: StatPearls. Rockville, MD: Agency for Healthcare Research and Quality; 2018. https://www.ncbi.nlm.nih.gov/books/NBK442158/ [https://www.ncbi.nlm.nih.gov/books/NBK442158/] Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. 2021;116(5):1255–1265. https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/ [https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/] © UBC Faculty of Medicine All Rights Reserved Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

S1 E5: Alcohol Use Disorder Part 2: Treatment, Medications, and Managing Withdrawal w/Dr. Randal Mason

Guest: Dr. Randal Mason Host: Dr. Chris Morrow Producer: Craig Ferguson Music: "Stand With Me" by Adrian Walther licensed via SoundStripe Episode Timestamps [00:00] – Introduction and episode overview [00:58] – Rethinking the abstinence-only model: harm reduction and patient-defined goals [03:04] – How reduced drinking can meaningfully lower health risks [04:08] – When abstinence remains the right goal [05:04] – Pharmacological approaches: naltrexone and acamprosate [06:37] – Choosing between naltrexone and acamprosate [07:24] – Are anti-craving medications underutilized in primary care? [09:28] – Other options: gabapentin, topiramate, and psychosocial supports [10:36] – Multimodal treatment: combining pharmacotherapy with motivational interviewing [11:04] – Effectiveness of anti-craving medications and reasons for hope [12:38] – Addressing clinician nihilism and burnout around AUD [14:13] – Alcohol withdrawal: identifying risk and using the PAWSS score [15:35] – Outpatient vs. inpatient withdrawal management [17:37] – Gabapentin as a withdrawal management tool [18:37] – Detox: common misconceptions and finite resources in BC [20:06] – Personalizing the withdrawal and detox plan to patient goals [21:44] – A difficult scenario: rural ED, no detox beds, patient wants to go home [24:13] – Practical middle-ground approaches for harm reduction [25:02] – Closing reflections and final thoughts from Dr. Mason [26:50] – Knowledge nugget: animals and alcohol [27:51] – Credits and CME information Studies & Research Mentioned Province of British Columbia. High-Risk Drinking and Alcohol Use Disorder. BC Guidelines; 2024. Accessed January 29, 2026. https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/high-risk-drinking-and-alcohol-use-disorder [https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/high-risk-drinking-and-alcohol-use-disorder] Wood E, Bright J, Hsu K, et al; Canadian Alcohol Use Disorder Guideline Committee. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. CMAJ. 2023;195(40):E1364–E1379. doi:10.1503/cmaj.230715. https://www.cmaj.ca/content/195/40/E1364 [https://www.cmaj.ca/content/195/40/E1364] Canadian Centre on Substance Use and Addiction (CCSA). Canada's Guidance on Alcohol and Health. 2023. Accessed January 29, 2026. https://www.ccsa.ca/en/guidance-tools-resources/substance-use-and-addiction/alcohol/canadas-guidance-alcohol-and-health [https://www.ccsa.ca/en/guidance-tools-resources/substance-use-and-addiction/alcohol/canadas-guidance-alcohol-and-health] BC Centre on Substance Use; Canadian Institute for Substance Use Research. Canadian Operational Guidance: Managed Alcohol Programs. Appendix 9: Alcohol Use Disorder Screening and Assessment Tools. BCCSU; 2023. Accessed January 29, 2026. https://www.bccsu.ca/wp-content/uploads/2023/07/Resource-Alcohol-Use-Disorder-Screening-and-Assessment-Tools.pdf [https://www.bccsu.ca/wp-content/uploads/2023/07/Resource-Alcohol-Use-Disorder-Screening-and-Assessment-Tools.pdf] UBC Continuing Professional Development. Alcohol Use: Screening, Determining Risk, and Evidence-Based Treatment. Accessed January 29, 2026. https://ubccpd.ca/learn/learning-activities/course?eventtemplate=724-alcohol-use-screening-determining-risk-and-evidencebased-treatment [https://ubccpd.ca/learn/learning-activities/course?eventtemplate=724-alcohol-use-screening-determining-risk-and-evidencebased-treatment] © UBC Faculty of Medicine All Rights Reserved Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

S1 E4: Alcohol Use Disorder Part 1: Practical Tools for a Complex Condition w/Dr. Randal Mason

Guest: Dr. Randal Mason Host: Dr. Chris Morrow Producer: Craig Ferguson Music: "Stand With Me" by Adrian Walther licensed via SoundStripe Episode Timestamps [00:00] – Introduction and episode overview [01:09] – The scale of alcohol-related harms in BC and Canada [02:21] – Why screening remains inconsistent in clinical practice [04:10] – Screening at every point of care [04:32] – Clinician discomfort and workflow barriers [05:42] – New guidance on alcohol-related risk [07:36] – Understanding risk thresholds: cancer and cardiovascular disease [08:16] – Patient reactions and clarifying misconceptions [09:03] – BC guidelines compared with Canadian guidelines [10:28] – Screening tools: SASQ, AUDIT, AUDIT-C, DSM-5 criteria [12:30] – Treatment approaches for high-risk drinking vs. diagnosed AUD [13:21] – Challenges for rural and remote patients and providers [15:13] – Considerations for Indigenous patients and culturally safe care [20:34] – Using frameworks like the Five A's in clinical conversations [21:20] – Closing remarks and preview of Part 2 [21:31] – Knowledge nugget: the history of alcohol and the origin of "toasting" [22:10] – Credits and CME information Studies & Research Mentioned • Province of British Columbia. High‑Risk Drinking and Alcohol Use Disorder. BC Guidelines; 2024. Accessed January 29, 2026. https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/high-risk-drinking-and-alcohol-use-disorder [https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/high-risk-drinking-and-alcohol-use-disorder] • Wood E, Bright J, Hsu K, et al; Canadian Alcohol Use Disorder Guideline Committee. Canadian guideline for the clinical management of high‑risk drinking and alcohol use disorder. CMAJ. 2023;195(40):E1364‑E1379. doi:10.1503/cmaj.230715. https://www.cmaj.ca/content/195/40/E1364 [https://www.cmaj.ca/content/195/40/E1364] • Canadian Centre on Substance Use and Addiction (CCSA). Canada’s Guidance on Alcohol and Health. 2023. Accessed January 29, 2026. https://www.ccsa.ca/en/guidance-tools-resources/substance-use-and-addiction/alcohol/canadas-guidance-alcohol-and-health [https://www.ccsa.ca/en/guidance-tools-resources/substance-use-and-addiction/alcohol/canadas-guidance-alcohol-and-health] [ • World Health Organization. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. 2nd ed. WHO; 2001. https://www.who.int/publications/i/item/WHO-MSD-MSB-01.6a [https://www.who.int/publications/i/item/WHO-MSD-MSB-01.6a] • U.S. Department of Veterans Affairs. Alcohol Use Disorders Identification Test – Consumption (AUDIT‑C). Updated March 2021. Accessed January 29, 2026. https://www.hepatitis.va.gov/alcohol/treatment/audit-c.asp [https://www.hepatitis.va.gov/alcohol/treatment/audit-c.asp] • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed, Text Revision (DSM‑5‑TR). American Psychiatric Association; 2022. Information and updates available at: https://www.psychiatry.org/psychiatrists/practice/dsm [https://www.psychiatry.org/psychiatrists/practice/dsm] • UBC Continuing Professional Development. Alcohol Use: Screening, Determining Risk, and Evidence‑Based Treatment. Accessed January 29, 2026. https://ubccpd.ca/learn/learning-activities/course?eventtemplate=724-alcohol-use-screening-determining-risk-and-evidencebased-treatment [https://ubccpd.ca/learn/learning-activities/course?eventtemplate=724-alcohol-use-screening-determining-risk-and-evidencebased-treatment] © UBC Faculty of Medicine All Rights Reserved Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

S1 E3: ADHD Across Life Transitions: Practical Approaches for Primary Care w/ Dr. Elisabeth Baerg Hall

Guest: Dr. Elizabeth Baerg Hall Host: Dr. Chris Morrow Producer: Craig Ferguson Music: "Stand With Me" by Adrian Walther licensed via SoundStripe Episode Timestamps • [00:00] - Introduction and episode overview • [02:03] - Life transitions and when ADHD becomes visible in adults • [04:14] - How ADHD can be masked by structure and support systems • [05:21] - Red flags for ADHD in primary care settings • [08:54] - Who can diagnose ADHD and what tools are available • [12:05] - The importance of impairment in diagnosis and avoiding overdiagnosis • [16:36] - Common comorbidities: Anxiety, depression, and bipolar disorder • [19:39] - ADHD and substance use disorder • [21:26] - Barriers to diagnosis and treatment: Stigma and misconceptions about stimulants • [24:07] - Inequities in access to care, including Indigenous patients • [26:26] - Challenges for rural patients and older adults with ADHD • [29:00] - Resources and support in BC: CADRA, Shared Care, and Skills for Success • [30:56] - ADHD pathways and UBC CPD educational opportunities • [32:59] - Closing remarks and conference information • [33:52] - Knowledge nugget: The history of psychostimulants Studies & Research Mentioned • CADDRA – Canadian ADHD Resource Alliance. Canadian ADHD Practice Guidelines, 4.1 Edition. Toronto, ON: CADDRA; 2020. Accessed January 13, 2026. https://adhdlearn.caddra.ca/wp-content/uploads/2022/08/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf [https://adhdlearn.caddra.ca/wp-content/uploads/2022/08/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf] • Centers for Disease Control and Prevention. Diagnosing ADHD. Updated 2024. Accessed January 13, 2026. https://www.cdc.gov/adhd/diagnosis/index.html [https://www.cdc.gov/adhd/diagnosis/index.html] • The MTA Cooperative Group: A 14-Month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder (ADHD) . Arch Gen Psychiatry 1999;56:1073-1086. • The MTA Cooperative Group: Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder (ADHD). Arch Gen Psychiatry 1999;56:1088-1096. • Molina BSG, Kipp HL, Joseph HM, et al. Stimulant Diversion Risk Among College Students Treated for ADHD: Primary Care Provider Prevention Training. Acad Pediatr. 2020;20(1):119-127. doi:10.1016/j.acap.2019.06.002 • National Institute of Mental Health. The Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study (MTA): Questions and Answers. Revised November 2009. National Institute of Mental Health website. Accessed January 13, 2026. https://www.nimh.nih.gov/funding/clinical-research/practical/mta/the-multimodal-treatment-of-attention-deficit-hyperactivity-disorder-study-mtaquestions-and-answers [https://www.nimh.nih.gov/funding/clinical-research/practical/mta/the-multimodal-treatment-of-attention-deficit-hyperactivity-disorder-study-mtaquestions-and-answers] • Ramtekkar UP, Reiersen AM, Todorov AA, Todd RD. Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses: implications for DSM-V and ICD-11. J Am Acad Child Adolesc Psychiatry. 2010;49(3):217-28.e283. (C) 2025 UBC Medicine Learning Network Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

S1 E2: GLP-1s, Weight Bias and the Future of Obesity Care w/Dr. Jordanna Kapeluto

Endocrinologist Dr. Jordanna Kapeluto unpacks the evolving science of obesity and the role of GLP-1 medications like semaglutide. We explore obesity as a complex, chronic disease, the impact of weight bias in health care, and the promise and pitfalls of new treatments. From mechanisms of action to real-world outcomes, this conversation challenges assumptions and highlights the importance of compassionate, evidence-based care.    Host: Dr. Chris Morrow Producer:  Craig Ferguson Music: "Stand With Me" by Adrian Walther licensed via SoundStripe (C) 2025 UBC Medicine Learning Network Episode Timestamps [00:00] - Introduction and episode overview [01:38] - Medical diagnosis of obesity: Why it is important to diagnose and treat [02:27] - Evolution of our understanding of obesity and weight dynamics [04:30] - Stigma surrounding obesity and patient experiences of weight bias affecting access to appropriate care or diagnostics [06:14] - Defining and diagnosing obesity [12:40] - Discussion on GLP-1 agonists [15:45] - GLP-1 agonists and weight loss [18:14] - GLP-1s in diabetes treatment [18:42] - Criteria for using GLP-1s as a weight loss agent [22:05] - GLP-1s: Downsides and barriers [26:50] - Guidance for primary care providers on prescribing GPL-1s [30:27] - Closing thoughts from Dr. Jordanna Kapeluto [31:50] - Closing remarks from Dr. Chris Morrow on GLP-1 agonists Studies & Research Mentioned Rubino F, Bartolomucci A, Buse JB, et al. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 2025;S2213-8587(24)00316-4. doi:10.1016/S2213-8587(24)00316-4 Palmer AB, Roshani R, McCormick JB, Fisher-Hoch SP, Below JE, North KE, Gordon-Larsen P. Excess Adiposity Without Obesity in a High-Risk Population. JAMA Netw Open. 2025 Oct 1;8(10):e2535194. doi: 10.1001/jamanetworkopen.2025.35194. PMID: 41042515; PMCID: PMC12495492.Drucker DJ. The GLP-1 journey: from discovery science to therapeutic impact. J Clin Invest. 2024;134(2):e175634. Published 2024 Jan 16. doi:10.1172/JCI175634  Eng J, Kleinman WA, Singh L, Singh G, Raufman JP. Isolation and characterization of exendin-4, an exendin-3 analogue, from Heloderma suspectum venom. Further evidence for an exendin receptor on dispersed acini from guinea pig pancreas. J Biol Chem. 1992;267(11):7402-7405. Quetelet A. Sur l'homme et le développement de ses facultés, ou Essai de physique sociale [A Treatise on Man and the Development of His Faculties]. Bachelier; 1835. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.