Episodes

  • Rigged or Right? The Residency Match Under Fire

    Rigged or Right? The Residency Match Under Fire
    Apr 16 2026

    The House Judiciary Committee just dropped a 47-page report calling the National Residency Match Program a hiring monopoly that harms patients, doctors, and the public — and the surgical community is talking. In this episode, Dr. Patrick Georgoff is joined by BTK surgical education fellows Dr. Emma Burke and Dr. Agnes Prem Kumar, along with special guest Dr. Brian Carmody (aka the Sheriff of Sodium), a pediatric nephrologist and one of the sharpest analysts of medical education policy working today. Together, they break down the report's central claims: that the NRMP exercises monopolistic control over residency hiring, suppresses resident wages, and strips trainees of bargaining power — and they separate what the report gets right from where its rhetoric badly outruns its evidence. From the history of Section 207 and the antitrust lawsuit that nearly brought down academic medicine, to the real economics of GME funding, resident unionization, and what a match-free world would actually look like — this is the context you need to understand one of the most consequential debates in graduate medical education in years. Don't miss Dr. Carmody's six-part YouTube series on the match, linked in the show notes.

    Congressional Report: https://judiciary.house.gov/media/press-releases/new-report-exposes-how-medical-residency-hiring-monopoly-harms-patients-and
    The Match 6-Part Video Series: https://www.youtube.com/playlist?list=PLc36yFQWkuG1sXk62A3zeRWB8aoK5SISP
    The Sodium Sheriff Blog: https://thesheriffofsodium.com/

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    50 mins
  • Behind the Mask of Shame Part 3 - Internalized Shame and Burnout

    Behind the Mask of Shame Part 3 - Internalized Shame and Burnout
    Apr 15 2026

    A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons' emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.

    In this third episode, we talk with Drs. Sheina Theodore and Tejal Brahmbhatt about their study examining the relationship between internalized shame states and burnout among surgery residents. They make a compelling case that addressing the well-being crisis in surgery requires looking beyond external stressors to the internal experience of shame: the quiet, invisible voice that tells residents they aren't good enough, and ask what role the culture of surgery plays in that internal monologue.

    Host: Steven Thornton

    Guests:
    1. Sheina Theodore (Assistant Professor of Surgery, Boston University)
    2. Tejal Brahmbhatt (Associate Professor of Surgery, Cedars Sinai Medical Center)


    Publications Discussed:

    1. Smith SM, Kobzeva-Herzog A, McGillen P, Castagne-Charlotin M, Davies J, Sanchez SE, Dechert T, Brahmbhatt TS, Theodore S. Internalized Shame Experiences and Burnout in General Surgery Residents. J Surg Educ. 2025 Apr;82(4):103447. doi: 10.1016/j.jsurg.2025.103447. Epub 2025 Feb 6. PMID: 39919584. https://pubmed.ncbi.nlm.nih.gov/39919584/

    ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

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    33 mins
  • Behind the Mask of Shame Part 2 - Grit, Shame, and Burnout

    Behind the Mask of Shame Part 2 - Grit, Shame, and Burnout
    Apr 14 2026
    A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons' emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.

    In this second episode, we talk with Dr. ElAbd and Dr. Zammit about their study examining the relationship between shame-based learning, grit, and burnout across surgical specialties. Their findings highlight how grit may both protect against burnout and mediate whether residents go on to shame others.

    Host: Steven Thornton

    Guests:
    1. Rawan ElAbd (Plastic Surgery Resident, McGill University)
    2. Dino Zammit (Assistant Professor of Plastic Surgery, McGill University)

    Publications Discussed:
    1. ElAbd R, Pu L, Esmonde-White C, ElHawary H, Vorstenbosch J, Zammit D. Association of Grit and Shame Based Learning on Burnout in Surgical Training: A Single Institution Analysis. J Surg Educ. 2025 Sep;82(9):103583. doi: 10.1016/j.jsurg.2025.103583. Epub 2025 Jun 27. PMID: 40580606.
    https://pubmed.ncbi.nlm.nih.gov/40580606/

    ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
    If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen
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    Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
    Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation
    Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review
    Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review
    Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review
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    34 mins
  • Behind the Mask of Shame Part 1 - The Background

    Behind the Mask of Shame Part 1 - The Background
    Apr 13 2026
    A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons’ emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.In this first episode, we talk with Dr. Will Bynum and Professor Luna Dolezal about how they understand shame in medicine, why it's so hard to see even when it's everywhere, and how developing what they call "shame competence" might be one of the most important steps we can take toward humanizing surgical training.Host: Steven ThorntonGuests:Will Bynum (Associate Professor of Family Medicine, Duke University)Luna Dolezal (Professor of Philosphy and Medical Humanities, Exeter University)Publications Discussed:Dolezal L, Bynum W. Shame competence: addressing the effects of shame in health care. Lancet. 2024 Oct 19;404(10462):1514-1515. doi: 10.1016/S0140-6736(24)02269-4. PMID: 39426826. https://pubmed.ncbi.nlm.nih.gov/39426826/ The Nocturnists. Shame in Medicine: The Lost Forest [podcast series]. The Nocturnists; 2022. https://thenocturnists.org/shameinmedicine Nguyen LN, Bynum WE 4th. When I Say…self-conscious emotions. Med Educ. 2021 Mar;55(3):291-292. doi: 10.1111/medu.14425. Epub 2020 Dec 23. PMID: 33289140. https://pubmed.ncbi.nlm.nih.gov/33289140/ Tracy, J. L., Robins, R. W., & Tangney, J. P. (Eds.). (2007). The self-conscious emotions: Theory and research. The Guilford Press. ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewOral Board Simulator: https://app.behindtheknife.org/oral-board-simulatorTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
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    51 mins
  • Artificial Intelligence for the Clinician Episode 5: Are Radiologists Out of a Job?

    Artificial Intelligence for the Clinician Episode 5: Are Radiologists Out of a Job?
    Apr 9 2026

    Welcome back to the AI journal club! In this episode, we bring you a deep dive into a game-changing paper from The Lancet -- the MASAI study. This is the first randomized controlled trial to evaluate the use of artificial intelligence in breast cancer screening and we're so excited to discuss it.

    We'll break down the study's impressive findings on interval cancer rates, sensitivity, and massive workload reductions for radiologists. Beyond the data, we'll tackle the big-picture questions and some sensational recent headlines. Are we deploying AI too fast? Or is it time to go faster?

    Hosts:
    - Ayman Ali, MD
    Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery.

    - Ruchi Thanawala, MD: @Ruchi_TJ
    Ruchi Thanawala is an Associate Professor of Informatics and Thoracic Surgery at Oregon Health and Science University (OHSU) and founder of Firefly, an AI-driven platform that is built for competency-based medical education. In addition, she is the Director of the Surgical Data and Decision Sciences Lab for the Department of Surgery at OHSU and Associate Program Director for the Clinical Informatics Sub-specialty Fellowship.

    - Phillip Jenkins, MD: @PhilJenkinsMD
    Phil Jenkins is a general surgery PGY-4 at Oregon Health and Science University and a National Library of Medicine Post-Doctoral fellow pursuing a master’s in clinical informatics.

    ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

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    26 mins
  • Journal Review in Thoracic Surgery: VV ECMO in Pre-Lung Transplant Patients - A Bridge to Somewhere

    Journal Review in Thoracic Surgery: VV ECMO in Pre-Lung Transplant Patients - A Bridge to Somewhere
    Apr 6 2026
    Join the Johns Hopkins Thoracic Surgery Subspecialty team on this rapid research review revealing how investigative efforts have changed the way we view and use Veno-venous (VV) ECMO therapy in the pre-lung transplant patient population working to avoid ventilator dependence and the associated morbidity while facilitating continued ambulation and preoperative optimization. Hosts:- Dr. Alfred J. Casillan, MD, PhDAttending Thoracic Surgeon Johns Hopkins Hospital - Kyla Rakoczy, MD Johns Hopkins General Surgery ResidentReferences:Awake ECMO as Bridge to Lung Transplantation Fuehner T, Kuehn C, Hadem J, Wiesner O, Gottlieb J, Tudorache I, et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. American Journal of Respiratory and Critical Care Medicine. 2012;185(7):763–768. PMID: 22268135 Link: https://pubmed.ncbi.nlm.nih.gov/22268135/Predictors of Successful ECMO Bridging Tipograf Y, Salna M, Minko E, Grogan EL, Sonett JR, Bacchetta MD. Outcomes of extracorporeal membrane oxygenation as a bridge to lung transplantation. Annals of Thoracic Surgery. 2019;107(5):1456–1463. PMID: 30790550 Link: https://pubmed.ncbi.nlm.nih.gov/30790550/Intubation Status and ECMO Bridging Outcomes Zhou AL, Jennings MR, Akbar AF, et al. Utilization and outcomes of nonintubated extracorporeal membrane oxygenation as a bridge to lung transplant. Journal of Heart and Lung Transplantation. 2025;44(4):661–669. PMID: 39486773 Link: https://pubmed.ncbi.nlm.nih.gov/39486773/ECMO Duration and Waitlist Mortality Shou BL, Kalra A, Zhou AL, et al. Impact of extracorporeal membrane oxygenation bridging duration on lung transplant outcomes. Annals of Thoracic Surgery. 2024;118(2):496–503. PMID: 38740080 Link: https://pubmed.ncbi.nlm.nih.gov/38740080/Mechanical Ventilation as a Risk Marker Mason DP, Thuita L, Alster JM, Murthy SC, Budev MM, Mehta AC, et al. Lung transplantation in recipients requiring mechanical ventilation: outcomes and risk factors. Journal of Thoracic and Cardiovascular Surgery. 2010;139(1):114–119. PMID: 19931096 Link: https://pubmed.ncbi.nlm.nih.gov/19931096/***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewOral Board Simulator: https://app.behindtheknife.org/oral-board-simulatorTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
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    17 mins
  • Mastering M&M: A Practical Guide to Presenting Complications

    Mastering M&M: A Practical Guide to Presenting Complications
    Apr 2 2026

    Welcome back to Behind the Knife with Cody, Patrick, Jason, and Ayman. Today, we are tackling a defining professional ritual for every surgical trainee: the Morbidity and Mortality (M&M) Conference. We are providing a practical roadmap to help you build clear, high-quality presentations that facilitate real learning for the entire room. Whether you are a junior resident preparing for your first case or an attending looking to moderate effectively, this episode covers exactly what to include, what to leave out, and how to properly frame a complication.

    Hosts:

    • Cody Mullens, MD
    • Patrick Georgoff, MD
    • Jason Bingham, MD
    • Ayman Ali, MD


    ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

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    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
    If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen
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    41 mins
  • Clinical Challenges in Transplant Surgery: How Xenotransplantation Will Change Our Lives

    Clinical Challenges in Transplant Surgery: How Xenotransplantation Will Change Our Lives
    Mar 30 2026
    Xenotransplantation—the use of organs from other species to treat human disease—has long existed at the intersection of science fiction and surgical innovation. While early efforts were marked by limited success and ethical controversy, recent advances in genetic engineering, immunosuppression, and organ preservation have brought the field closer than ever to clinical reality.In this episode of Behind the Knife, we are joined by Dr. Joshua Mezrich to explore the history, science, and future of xenotransplantation. Through a narrative lens, we trace the evolution of transplantation from its earliest experimental days to the modern era of gene-edited porcine organs, highlighting key breakthroughs, ethical challenges, and the pioneers who shaped the field. We also examine the current state of clinical trials and what xenotransplantation may mean for the future of organ availability and transplant practice.Hosts - Madeline Cloonan, MD PhD, General Surgery Resident, University of Nebraska Medical Center, @maddie_cloonan - Joshua Mezrich, MD, Professor, University of Wisconsin School of Medicine and Public HealthLearning Objectives By the end of this episode, listeners will be able to:- Describe the historical evolution of xenotransplantation, including the primate and early porcine eras - Explain the key immunologic and biologic barriers to xenotransplantation, including hyperacute rejection and the role of natural antibodies - Summarize major scientific advances that enabled modern xenotransplantation, including cloning and CRISPR-based gene editing - Discuss recent clinical experiences and ongoing trials of xenotransplantation in humans - Evaluate the ethical considerations and societal implications of xenotransplantation - Consider the potential role of xenotransplantation in addressing organ shortage and reshaping transplant eligibility and allocationCheck out Dr. Mezrich’s new book! https://www.amazon.com/Every-Living-Creature-Xenotransplantation-Change-ebook/dp/B0FH14LF6K***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6***Surgical Instrument FlashCards: https://app.behindtheknife.org/premium/surgical-instrument-flashcards Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
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    46 mins