Humanitarian crises from around the world, attributed to various causes such as war and climate change, have resulted in the displacement of millions of people worldwide. Some of these displaced individuals journey to other countries, such as Canada, to settle and start new lives. However, a refugee’s journey doesn’t end once they arrive in their new home, they must navigate a new system to access housing, healthcare, and education, while potentially facing numerous barriers along the way. In this episode of Raw Talk, we interview experts to gain a Canadian perspective on the unique health experience of refugees, and the resettlement process for refugees living in Canada. Steve Meagher discusses who refugees are and the barriers they face to accessing healthcare services in Canada. Dr. Praseedha Janakiram sheds light on the diversity of refugees and their journeys from leaving their homeland to settling into a new life. Dr. Meb Rashid speaks to the routine health issues that refugee families face and how primary and community healthcare is tailored to those needs. Centre for Refugee Children Women’s College Hospital Crossroads Clinic The Toronto Addis Ababa Academic Collaboration (TAAAC) The Canadian Collaborative Mental Health Care Conference - Dr. Janakiram speaking Christie Refugee Welcome Centre Canadian Centre for Victims of Torture

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#99 Refugee Healthcare in Canada

Have you ever wondered how the World Anti-Doping Agency (WADA) decides what substances are banned in professional sport? Or what it’s like to get tested for prohibited substances? In this episode of Raw Talk, we interview experts on anti-doping and the use of performance enhancing drugs. James Fitzgerald explains the many tools that WADA uses to combat doping in sport, from dried blood spot analysis to machine learning. We also speak to two Canadian Olympic athletes, Evan Dunfee and Maddy Kelly, about their experiences getting tested, what kinds of pressures they felt to perform, and the tainted beef controversy. Lastly, Dr. Dean St. Mart tells us about the health risks of steroids - in the context of bodybuilding - from androgen receptors to “blasting and cruising”, and explores whether its possible to use such performance enhancing drugs safely. We hope you enjoy the expertise and diverse perspectives our fascinating guests shared with us on this week’s episode. World Anti-Doping Agency (WADA) Global Drug Reference Online (Global DRO) Yes, Evan Dunfee is the Kraft Dinner guy Supplement Needs

#98: Podium Pills: Fame or Folly?

Post-graduate education. This is where students learn the joy and importance of scientific discoveries and advancement firsthand. This is also where students face realities of research and of adulthood all at once. In today’s episode, we have a roundtable discussion to exchange views on our hopes and struggles as a graduate student. From sharing our unique stories, we see common themes such as building a healthy relationship with our supervisor, networking with peers, managing stress from the recent COVID-19 pandemic, and coping with failure to prevent burnout. Our fellow graduate student Samantha Ing-Esteves, the founder of the Graduate Representation Committee (GRC) in the Temerty Faculty of Medicine at University of Toronto, also joins us and speaks to the data collected by GRC representing our financial struggles. Sam also explains to us how GRC strives to advocate for domestic and international graduate students. From the good, the bad, and the ugly, we gain rich learning experiences as a graduate student and continue to contribute to science the best we can. The struggle is real, but so is the adventure. We have fun together, we support each other, and we grow stronger. And most importantly, we keep it raw. GRC Student Finance and Living Survey 2021-2022 GRC Student Finance and Living Report 2019 U of T Community of Support Tips and Secrets to Choosing your IMS Courses 100 Reasons Not to Go to Graduate School

#97: Let‘s Talk Grad School

The Human Genome Project -- to sequence all genes in human DNA -- took over a decade and about $5 billion dollars to complete. Today, we can get the same results in 2 months for about $5000, or even over a weekend if we really need it. As a result, more and more people have access to genetic testing. For many families affected by inheritable conditions, these tests can be invaluable. But is this the precision medicine revolution we've been promised? In this episode of Raw Talk Podcast, we gather experts in genetic testing and genetic counselling to find out. We'll explore what genetic testing really looks like, what the results can mean for families, and learn about the growing field of genetic counselling. First, we spoke with Dr. Raymond Kim, medical geneticist at the University Health Network, who told us about the history and future trajectory of medical genetics. We also sat down with genetic counsellors Stacy Hewson and Laura Zahavich, who direct and lecture for the genetic counselling master's program here at the University of Toronto; they shared with us their challenging but rewarding experiences supporting families to order, interpret, and process genetic tests. Finally, we heard from Huntington's Disease researcher and carrier Dr. Jeff Carroll, who shared his story with genetic testing personally and while family planning. We hope to shed a light on the exciting fields of medical genetics and genetic counselling, and the growing number of genetic tools that might truly revolutionize healthcare as we know it. Dr. Raymond Kim - Webpage Stacy Hewson - Webpage Laura Zahavich - Webpage Jeff Carroll - Webpage University of Toronto MSc in Genetic Counselling Program Article - Prioritizing diversity in human genomics research gnomAD: Genome Aggregation Database Raw Talk Podcast - Season 5 Listener Survey

#96: Genetic Testing: What it Means for Families and the Future

Medical Assistance in Dying (MAiD) was legalized in Canada in 2016 under Bill C-14 after decades of public dialogue and debate. This episode takes a deep dive into MAiD, the death and dying experience, and what these mean to patients, families, care providers, and others involved in the health system. We had the pleasure to sit down with and learn from Sally Bean, Director of Policy and Ethics at Sunnybrook Hospital; Dr. Madeline Li, Psychiatrist and Lead of the Psycho-social Oncology Division, Princess Margaret Cancer Centre; Dr. Ahmed Al-Awamer, Palliative Care Physician and Director of Postgraduate Medical Education, University Health Network; and Steve Legere, a patient diagnosed with incurable cancer who has been approved for MAiD, and his partner, Christine Legere. Each of these individuals takes us through a different aspect of living and dying at the end of life and how MAiD has impacted their respective lives and professional roles. Please note, this podcast discusses topics of death and dying and may be triggering for some listeners. Canada’s new medical assistance in dying (MAID) law Madeline Li’s Maclean’s article Article: Medical Assistance in Dying — Implementing a Hospital-Based Program in Canada

#95: Live or Be Alive: Medical Assistance in Dying

Medical Assistance in Dying (MAiD) was legalized in Canada in 2016 under Bill C-14 after decades of public dialogue and debate. This episode takes a deep dive into MAiD, the death and dying experience, and what these mean to patients, families, care providers, and others involved in the health system. We had the pleasure to sit down with and learn from Sally Bean, Director of Policy and Ethics at Sunnybrook Hospital; Dr. Madeline Li, Psychiatrist and Lead of the Psychosocial Oncology Division, Princess Margaret Cancer Centre; Dr. Ahmed Al-Awamer, Palliative Care Physician and Director of Postgraduate Medical Education, University Health Network; and Steve Legere, a patient diagnosed with incurable cancer who has been approved for MAiD, and his partner, Christine Legere. Each of these individuals takes us through a different aspect of living and dying at the end of life and how MAiD has impacted their respective lives and professional roles. Please note, this podcast discusses topics of death and dying and may be triggering for some listeners. Canada’s new medical assistance in dying (MAID) law Madeline Li’s Maclean’s article Article: Medical Assistance in Dying — Implementing a Hospital-Based Program in Canada

For many people, childhood memories hold a special place in our hearts. Childhood experiences also impact our journey through life, shaping our personality, relationships, and conceptions of right and wrong. But not all childhood memories are bright, and many children suffer significant trauma through maltreatment by family members or other trusted adults. In this episode, we explore the difficult topic of child maltreatment with the help of our esteemed guests. First, Dr. Tracie Afifi, a Professor in Community Health Sciences at the University of Manitoba, describes the scope of child maltreatment in Canada, and describes intervention and prevention strategies. Next, Dr. Robert T. Muller, a Clinical Psychologist, Professor of Psychology at York University, and bestselling author on trauma therapy, tells us about the goals, pitfalls, and successful strategies in psychotherapy for patients with childhood trauma. Finally, Dr. Katreena Scott, an Associate Professor and Clinical Psychologist at the University of Toronto, explores the complex familial contexts in which child maltreatment can arise, and describes the unique intervention program she and her team have pioneered to help break the cycle. Local Children's Aid Societies (Ontario) Profile - Dr. Tracie Afifi Profile - Dr. Robert T. Muller Profile - Dr. Katreena Scott Book - Trauma and the Struggle to Open Up: From Avoidance to Recovery and Growth Book - Trauma and the Avoidant Client: Attachment-Based Strategies for Healing Caring Dads Adverse Childhood Experiences Global look at Child Maltreatment (WHO) Child Maltreatment in Canada Indigenous people and Child Maltreatment

#94: Child Maltreatment: Healing and Breaking the Cycle

Since their discovery in the 1920’s, antibiotics have allowed the field of medicine to make leaps and bounds in innovation. The ability to treat bacterial infections reliably and effectively have made transplant surgeries, cancer chemotherapy, and treating what were once considered deadly infections- like diarrhea- a routine part of our health care. However, antibiotic resistance can occur when the bacteria being targeted change in response and render the antibiotic ineffective. Antibiotic resistance is a global threat and there are concerns that by the year 2050, antibiotic resistant infections could cause more than 10 million deaths annually. In this episode, we explore the drivers of antibiotic resistance around the world and speak to researchers tackling this issue through their research on innovative therapies and solutions. First, Dr. Thomas Van Boeckel explains the major driving forces and global trends in development of antibiotic resistance. system wide policy level changes required to tackle the threat. Dr. Erin Duffy takes us through the innovative work being done at CARB-X, a non-profit initiative to accelerate research in the field globally. Finally, Chidozie Ojobor from the University of Toronto, talks to us about his research on tailocins, a promising new technology he is researching for combating antibiotic resistant bacteria. CDC antibiotic resistance threat report, 2.8 million AR cases each year in the USAGlobal trends in antimicrobial resistance in animals in low- and middle-income countriesDr. Van Boeckel’s university profile page Antimicrobial Resistance: Tackling a crisis for the health and wealth of nationsCARB-X portfolioDavidson Lab at UofT

#93: The Future of Antibiotics

Since their discovery in the 1920’s, antibiotics have allowed the field of medicine to make leaps and bounds in innovation. The ability to treat bacterial infections reliably and effectively have made transplant surgeries, cancer chemotherapy, and treating what were once considered deadly infections, like pneumonia, a routine part of our health care. However, antibiotic resistance can occur when the bacteria being targeted change in response and render the antibiotic ineffective. Antibiotic resistance is a global threat and there are concerns that by the year 2050, antibiotic resistant infections could cause more than 10 million deaths annually. In this episode, we explore the drivers of antibiotic resistance around the world and speak to researchers tackling this issue through their research on innovative therapies and solutions. First, Dr. Thomas Van Boeckel explains the major driving forces and global trends in development of antibiotic resistance and system wide policy level changes required to tackle the threat. Dr. Erin Duffy takes us through the innovative work being done at CARB-X, a non-profit initiative to accelerate research in the field globally. Finally, Chidozie Ojobor from the University of Toronto, talks to us about his research on tailocins, a promising new technology he is researching for combating antibiotic resistant bacteria. CDC antibiotic resistance threat report, 2.8 million AR cases each year in the USA Global trends in antimicrobial resistance in animals in low- and middle-income countries Dr. Van Boeckel’s university profile page Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations CARB-X portfolio Davidson Lab at UofT

Pharmaceutical drugs are a pillar of modern healthcare - from preventative medicines to life-saving therapies. We therefore rely on pharmaceutical companies to discover, develop, and deliver new drugs to patients in need. We know that this process is both risky and expensive, but does that justify the drug prices we see in Canada today? Who decides what’s a fair drug price anyways? And what is the role of academic science in this whole operation? Join us as we answer these questions and more, with our expert guests: Dr Alison Symington, consultant with Life Sciences Ontario, describes the process of drug discovery and the relationships between academia and industry. Dr. Wong-Rieger, President and CEO of Canadian Organization for Rare Disorders, describes the challenges faced by individuals with rare diseases. Dr. Nigel Rawson, Senior Fellow with the Fraser Institute, introduces us to the Patented Medicine Prices Review Board and their upcoming changes. Finally, Dr. Joel Lexchin, Emergency physician at the University Health Network and Canadian drug policy expert, explains some of the challenges to setting fair drug prices in Canada. Profile - Dr. Alison Symington Profile - Dr. Durhane Wong-Rieger Profile - Dr. Nigel Rawson Profile - Dr. Joel Lexchin Patented Medicine Prices Review Board (PMPRB) Proposed PMPRB changes Canada Pharmacare Act (Bill C-213) Canadian Organization for Rare Disorders (CORD) Innovative Medicines Canada Article - academic vs industry for drug discovery Drug Discovery @ U of T

#92: Producing and Pricing Drugs in Canada

Many factors including income, food security, or housing can have a huge contribution to our health. These are known as the social determinants of health (SDoH). In this episode, we discuss some common SDoH, how they impact our health, and what some leading physicians are doing to tackle the issue. Our guests, Dr. Andrew Boozary, Dr. Andrew Pinto, and Dr. Kate Mulligan discuss topics such as, the  teaching of SDoH in the medical curriculum, how the SDoH have been exacerbated with the COVID-19 pandemic, as well as current and future efforts to address the SDoH and decrease the associated health disparities. All of our guests are actively working to change our health system and the way we provide care to improve the health disparities we see in Toronto, Ontario, Canada, and beyond. Dr. Andrew Boozary’s Twitter Dr. Kate Mulligan’s Twitter Dr. Andrew Pinto’s Twitter Upstream Lab Social Medicine at UHN as reported by Toronto Star Public Health Ontario’s report on SDoH in COVID19

#91: Social Determinants of Health: Care beyond the Clinic

Like so many institutions, anti-Black racism continues to pervade the healthcare system—rarely in overt, obvious ways, but in ways that undeniably lead to worse health outcomes for Black communities. In this episode, we discuss the uncomfortable truths of anti-Black racism in healthcare, and what we can do about it. We hear from Dr. Sean Wharton, Medical Director of the Wharton Medical Clinic, Internist, and Adjunct Professor at McMaster University and York University, about his experiences in the hblealthcare system, as a trainee, physician, and researcher. He discusses the roots of racist systems, and the impacts of subconscious biases on both the provision and receipt of patient care. As the founder of the Black Medical Students’ Association, he describes how the unique needs of different trainee and patient populations must be recognized and addressed if we hope to provide equitable care. We also spoke with Jessica Goncalves, a nursing student and the first Black President of the Nursing Undergraduate Society at the University of Toronto. She tells us about the labelling that begins long before members of the Black community enter health professions, and the importance of diverse representation within such professions. We hope that you are inspired—as we are—by our guests, to continue conversations, advocacy, and actions in the pursuit of health equity. Dr. Wharton - Wharton Medical Clinic Dr. Wharton - Feature UofT Temerty Faculty of Medicine Dr. Wharton - Inaugural Lecture in Black Health for City-Wide Medical Grand Rounds Jessica Gonclaves - President of the Nursing Undergraduate Society Resource - The Implicit Project Article - The Effect of Race and Sex on Physicians' Recommendations for Cardiac Catheterization Resource - Anti-Racism Resources Article - For our White Friends Desiring to be Allies Book - So You Want to Talk About Race by Ijeoma Oluo Book - How to be an Antiracist by Ibram X. Kendi Book - Black and Blue: The Origins and Consequences of Medical Racism by John Hoberman Event - Black Physicians Association of Ontario Annual Health Symposium (Feb 27, 2021) Organization - Black Physicians of Canada Organization - U of T Black Medical Students Association

#90: Anti-Black Racism in Healthcare

Vaccine technology has come a long way in terms of safety and understanding the underlying immunological principles. The first vaccine that was made was against smallpox in the late 18th century. Since then, vaccines have become the key tool in fighting against infectious diseases that have affected humans for centuries, including chickenpox, measles, and polio. But as the world prepares for the largest mass vaccination campaign in history with the COVID19 vaccines, there are many people that are somewhat hesitant about the vaccination process but are curious to learn more. The emergence of mRNA vaccines has allowed for the fastest development of a vaccine in history and could be a sign of what’s to come in the future. In this episode, we talk about the COVID19 mRNA vaccine with the co-founder of Moderna, Dr. Derrick Rossi and about how mRNA can be used in personalized cancer vaccines with Providence Therapeutics’ Chief Development officer, Dr. Natalia Martin Orozco. We look back at the history of vaccine development with Dr. Christopher Rutty. Finally, We also speak with Dr. Nicole Charles to explore the complexity of vaccine hesitancy in marginalized communities. Connaught labs at UofT History of Vaccination virtual exhibit Dr. Charles’ book - Suspicion. Vaccines, Hesitancy, and the Affective Politics of Protection in Barbados Seminal paper from the Rossi lab about Modified RNAs Providence Therapeutics

#89: Vaccines: Making History

Tuberculosis (TB) is a bacterial infectious disease that affects millions of people globally every year. Despite being one of the oldest infectious diseases in humans, control of the epidemic through treatment and vaccination has remained out of reach. In today’s episode, we learned about what makes TB so difficult to control, from immunology to stigma. First, Dr. Jun Liu, a Professor in the Department of Molecular Genetics at University of Toronto, guides us through current knowledge on TB and discusses the difficulties and advances in developing TB vaccines. Next, Dr. Amrita Daftary, a Professor in the Department of Global Health at York University, explains the process of diagnosing and treating TB, and later highlights challenges that patients with TB may face while accessing care. Finally, Dr. Sarah Fortune, the Director of TB Research Program at Harvard T. H. Chan School of Public Health, helps us understand how TB drug resistance can arise, and why TB-HIV co-infection poses such a challenge. The fight against TB continues every day, by millions of patients, healthcare providers, and researchers alike. Join us as we learn about this forgotten pandemic. Dr. Jun Liu - profile Dr. Amrita Daftary - profile Dr. Sarah Fortune - profile What is DOTS? - report Paul Farmer on Partners in Health, Harvard-Haiti, and making the lives of the poor the fight of his life TB Personal Stories Vaccine Preventable Diseases

#88: Tuberculosis: The Forgotten Pandemic

Bimonthly conversations with scientists and students from the University of Toronto Faculty of Medicine.

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