The Intern at Work is a Canadian internal medicine podcast created by residents for residents. Launched in 2018, it offers concise, evidence-based episodes designed to support learners on the wards and on call. Each episode focuses on a specific clinical topic, providing practical approaches to diagnosis and management. The podcast also features discussions on medical education, ethics, and the art of medicine, aiming to foster a deeper understanding of internal medicine practice.
Proteinuria assessment requires more than a urine dipstick: transient causes, historical results, quantitative albumin or total-protein measurement, serum creatinine and urine microscopy help distinguish glomerular, tubular and overflow protein loss.
Recurrent oral ulceration becomes more concerning when accompanied by genital ulcers, skin lesions, uveitis, neurological symptoms or thrombosis. Behçet disease remains a clinical diagnosis; urgent organ-specific investigation and specialist immunosuppression are needed when vision, the central nervous system or major vessels are threatened.
Rapidly escalating oxygen requirements after sepsis, aspiration, trauma or pancreatitis should prompt assessment for acute respiratory distress syndrome. Diagnosis links an acute trigger, bilateral pulmonary abnormalities and hypoxaemia not fully explained by cardiac failure or fluid overload, followed by lung-protective ventilation and severity-based escalation.
Acute medicine, gastroenterology, neurology and haematology clinicians get a practical approach to severe unexplained abdominal pain, autonomic disturbance, neuropsychiatric symptoms and hyponatraemia. Random urine ALA and PBG testing, precipitating medicines or fasting, porphyria-safe prescribing, carbohydrate support and intravenous haemin for severe attacks shape recognition and treatment.
Acute medicine, emergency and respiratory clinicians get a practical framework for rapidly evolving allergic reactions. Multisystem symptoms, absent skin findings, intramuscular adrenaline, repeat dosing, beta-blocker use, adjunctive treatment, biphasic reactions and safe discharge planning are kept together.
General practice, endocrinology, geriatrics and orthopaedic teams get a practical osteoporosis framework. Fragility fractures, vertebral compression, FRAX, bone mineral density, secondary-cause testing, calcium and vitamin D replacement, anti-resorptive therapy, denosumab timing and anabolic treatment for very high fracture risk are covered.
Clinic-facing internal medicine, rheumatology and ophthalmology learners get a pattern-recognition approach to recurrent mouth ulcers, genital ulceration, painful red eye and swollen leg. Clinical diagnosis connects with organ-directed investigation, mimic exclusion and escalation for ocular, neurological, vascular or gastrointestinal disease.
Severe limb, back or chest pain in sickle cell disease needs early analgesia and an active complication screen. Fever, respiratory symptoms, abdominal pain, neurological symptoms or a haemoglobin drop should change the assessment before the pain is treated as uncomplicated crisis.
New hypoxaemia with cough, fever and ground-glass change should trigger a careful medicine review. This teaching walks through drug-induced interstitial lung disease, linking timing of exposure, HRCT abnormalities and exclusion of infection, heart failure, autoimmune disease and other ILD causes.
Early-onset COPD, fixed adult-onset asthma or unexplained liver disease should make alpha-1 antitrypsin deficiency visible. Serum levels can reassure falsely during infection or inflammation, so high suspicion may need SERPINA1 sequencing and liver assessment.
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