SGEM Xtra: It’s My Life – DPhil in Oxford

0:00Welcome to the Skeptics Guide to Emergency Medicine. Meet him, greet him, treat him and treat him. Today's date is March 5th, 2026, and I'm your Skeptical Host, Ken Mille. The title of today's podcast is… It's my love. I'm glad you're so, yeah. D-Fills in Oxford, and today we're not in the studio, as you can tell by the audio. We're not in Canada A. We're not even in North America. We're in Oxford, and not just Oxford. We're recording this SGM extra in a pub. This will be our second ever pub cast, and we need to travel back in time. And Carl, you know about the time travel thing I have here. That's the sound effect we used for time travel, by the way. Oh no, we spare no expense on this free podcast.

1:02Back to 2012. It was the first pub cast. That happened when I came to Oxford for a mini-me fellowship at the Center for Evidence Based Medicine on how to teach evidence based medicine. I had no idea that the experience would change my professional career and open up so many doors for me around the world. In those early years on the SGM, we did a structured critical appraisal, and maybe the medical students who are here may have heard about this study. This was a famous study done in 2011. And what they did was they compared orthopedic surgeons to anithesis. And they compared dominant grip strength because orthopedic surgeons were known to be as strong as an ox and almost twice as clever. And so what they did was they took the orthopedic surgeons who were getting teased by their anesthesia colleagues, and they tested them on their grip strength. And when they tested their grip strength, what do you think they found? Do you think the orthopedic surgeons were stronger or weaker than the anesthetist?

2:06No significance better. They were stronger, but thank you for playing Ross. That was great. Ross, thank you. Fourth year? Yeah, yeah. You could tell. No, I could tell because the fifth year's would have gotten at the right, correct? See, never tell me anything. Anything. You know what else they did, Ross? They gave a standardized IQ test to both of them as well. Who do you think scored better? Anithesis. Thank you for playing. Julia, it was the orthopedic surgeons and I'll go back to Ross. Was it statistically significant? Yes, it was. Yes, it was. I'm throwing you to easy balls here, okay? Just right across the plate, buddy. All right, yeah. And so we looked at that. The SGM bottom line from that episode was that stereotypical view that you have of orthopedic surgeons. And I'm allowed to make fun of orthopedic surgeons because I started off doing a residency in orthopedic surgery. So I'm allowed to make fun of my in-group. But the stereotypical image of these big, hulking guys, maybe it's not accurate.

3:07Yes, they're strong, but they're not stupid. And so that stereotype was unjustified. Well, over the last 14 years, the SGM has grown to over 85,000 subscribers. It's been translated into about four, maybe five languages now. And it gets about two million impressions per episode on that site, formerly known as Twitter. We've got over 600 episodes, but tonight we're back at Oxford and I thought we'd take the opportunity. Well, we're here at the historic, and can you say this for me? All dates. All dates. All dates. All dates. We're surrounded by centuries of scholarship skepticism and a few pints of beer, right, Nick? Just a few. Just two, two. And so joining me as co-host tonight on this SGM Extra Pubcast is the wonderful Melanie Gollum. She's a D-Fill candidate in the evidence-based healthcare here at Oxford. Melanie is, oh, you for India, what am I supposed to say here? I said, yeah, you got to edit this. So what am I supposed to say here?

4:08Am I supposed to interview you? Technology assessment program manager. That's what HPA stands for, but I didn't know. Yes. HTA, please. Technology assessment program manager in the state. In the US. In the US. The excited states of America. Welcome to the SGM, Melanie. Thank you. Thank you for having me. I feel a little underdressed, though, because we're doing a live show. So I brought something special for Melanie, since she's from the star-spangled banner. I'm winning the song. Yes. Sometimes you just have to sparkle. I know. But. Oh, gosh, there's more. I would be remiss if I didn't bring my Canadian one out. These are the lab coats I like to teach him. Ken has mentioned he's tickled trunk a lot. And anyway, apparently this is from the team. This is true. Yeah, so we have our sparkle lab coats. You have your silver one. I have my red and white Canadian one, eh? So I'm just wondering, Melanie, you know, here we are in this pub and stuff. Do you think that evidence synthesis improves

5:09after a second pint of beer? I know you wrote me this joke here about pre-registering an alcohol protocol, but I was telling you before, I don't get this, but go ahead and explain it. So it was supposed to be that you're supposed to pre-register your alcohol protocol, but the joke fell flat because Melanie doesn't drink. And so it really fell flat. But you know, when I go out with my wife and we go out to a bar, and we're going out drinking, we're being responsible to our medical students. And it's always, okay, what's our protocol? Who's driving and who's drinking tonight? Who gets to have the glass of wine and who gets the car keys? Yes, next one. So that's where it came from. But you should always pre-register your protocol to prevent things like pehacking and harking. Do you guys know what harking is? Oh, I'm getting a nod from Liam back there. Liam, what's harking? Yes, yes. Hypothesizing after the results are known is the hark. And so you're harking. So we don't want to do any harking here, but I think the discussion right flow a little better with a couple of pints of beer.

6:09Not make sense. Now, just to know, in Oxford, we talked about this yesterday. They have a lot of Nobel prize winners here, more than 70. So that's really intimidating for us, because all we want to do is maybe put together a reasonable podcast. And maybe graduate it. Yeah, graduate would be nice. Finish the D fill. So let's find out a little bit more about our wonderful co-host, Melanie Gollum. You have been the shining star. I wrote this about her. And if you've met her, you know, I remember I came to that. What's it called in the summer? The summer school, summer school, a little live or whatever it is. And you walk in the room and there she is smiling, like a summer breeze. And she's just there smiling. And you're like, oh, is this woman, right? And she is so friendly, so nice. Thank you. Thank you. Thank you for making me blush. But you are the heart of the D fill program here at Oxford.

7:09Now for the older people in the audience, and obviously I'm just talking to Carl and myself. And Carl might not even get this, but you're the Julie McCoy of the D fill program. You welcome everybody onto the boat. You make sure that they have a great experience while they're here. They both have a good learning experience, but also a good social experience and just make friends. And so welcome to the show. Later you can tell me who that is. I don't know who that is. Because you're much younger. OK, so a couple of questions here. What drew you to come to Oxford to do a D fill? Ooh. We have. So what drew me to Oxford? I think it's actually during COVID. And me and my former boss, Todd Feynman, who we were going back and forth about the evidence for COVID. It ended up on the Center for Evidence Based Medicine website. And I was like, what? They have a PhD program? Something good can come back out of COVID. So anyway, yeah. And then I applied. Didn't get in. Exactly. Oh, wow. And now she's like the top student here.

8:11So, hey, students, if you don't get it, I didn't get into medical school on my first attempt for obvious reasons. But if that's what you want to do, keep trying. Because it's not your successes that usually define you. It's the failures that you don't let define you that really make you who you are. That was neat. Ooh, wow, are we cool? I told you at two points. So anyway, yes. And then ended up here after, I guess, they reconsidered or maybe I don't know, maybe brides. I'm not sure. I'm not sure. Well, this question is from Ross. Was there something statistically significant about Oxford that made you want to come here? Other than they have this website that's talking about the evidence that Carl put up there about COVID. Yeah, I mean, it's also Oxford. I remember I actually came here when I was a kid. And just I think it wasn't even term time. But I remember thinking, I'd be amazing to go there someday. But knowing that that was completely out of the realm of possibility. And yet, it's around for 1,000 years.

9:14It started in 1096. I did my homework at 96. And we're part of that history now. Part of that journey of learning, teaching, elevating, sort of academia and stuff like that. So hey, what's your research about? Because you're in your four, your five now. Five? You're five. That's my favorite number, by the way. Yeah, I can count to it on one hand. Yes. So my research is on something called living evidence synthesis, which is essentially continually updated either systematic reviews or guidance or ways to evaluate the literature. Why do you think we need to have living systematic reviews? Because the traditional systematic review is like, let's look in the rear view mirror. Let's retrospectively look. Let's out there. Why do you have to have a living review? So also circling back to COVID, they became very important during COVID, because people wanted to stay up on the evidence. They wanted to see what was happening and have their guidance be as up to date as possible.

10:17And sometimes it was even being published on an hourly basis. Yeah, well, they had the amazing platform trial that came out of the UK. It was a platform structure where I think it was recovery and stuff like that. And then it had tested all these different things, but they had the infrastructure set up so that they could start testing things as COVID was unfolding and then publish and change. And they'd say, oh, well, Dexamethasone is effective for patients that are admitted to hospital and they've said, yeah. Exactly. So that was what really propelled living evidence synthesis to the forefront, but living evidence synthesis, especially living systematic reviews and living guidelines, have been around for quite a while, but they're all being done in a slightly different way. So Cochrane's doing them one way. Everyone else is doing them a little bit different. And so my research is more about kind of aligning everyone. And so when you see something that says living, you know what that means and it means the same thing to everyone. So what it means is it's Melanie's way. Yes. That's great. You're putting the stick in the ground,

11:18the flags going up. And if you're doing a living systematic review, the best way. You've published in this area, a living systematic review. So how do you think AI, artificial intelligence, will impact, because can't I go just to chat GPT and say, update the systematic review and hit return? I like how you're tying in your research. I think that's fantastic. I think that there's a lot that can be done. And that was actually, I think originally, what I plan to do was that you can't really have a living evidence synthesis without embracing technology and everything, just because it's not really feasible, like doing it all on Excel spreadsheets and we're going to have to embrace technology. But the hard part is how? Because not everyone has the resources to do so. So how can we do it in a way where kind of everyone, people that have a lot of resources and money and staffing and those that don't? So will, you know, the introduction of AI then sort of level the playing field a bit because right now they're using human intelligence

12:19to do all the hard work and some of it is very tedious work where a large language model AI could go through that quickly and be able to support that researcher who doesn't have the budget to go off and hire some people or carbon-based units to do it where they could do it in silica. Yeah, well, and it's hard because I think you need in order to have that sort of critical mass of input to make, to like extract data from health studies, you need to have enough studies and the thing is it needs to be trained on large, large volumes of literature, which hasn't been done quite yet. So I think we will get to a point where we can, but I don't know if it's quite there yet. There's always going to be a, for now, there's going to be a human in the loop. And I would advocate for having a human in the loop. Yeah. All right, so what would you give as advice to someone who is listening to this show because we have a big audience and maybe they're going, hey, you know what, maybe I'd like to go to Oxford. You know, like, maybe I could do this. I mean, if Melanie couldn't get in, maybe I couldn't get in.

13:20And if Penn didn't get into med school, maybe I could get into med school. So what advice would you give to those people that are interested in doing a deep fill at Oxford? Well, you know, I've probably said this before, but just go for it. And if you are at all concerned, like talk to someone about it, I feel like I've had quite a few people reach out to me and ask questions. And I know I'm always happy to answer. And I think most of us in the program are because we've all gone through our own struggles. We all come from our own paths. And if you're interested enough and you're passionate about what you do, then I think you have a place here. What makes them a good candidate then? Ooh, I don't know if I can answer that. That might be a question for the audience about what makes it good today. Okay, so I, you know, probably the only one that can speak loud enough to be picked up from the audience would be Nick. And so Nick is in the audience. And I have to go gentle here because I have to introduce him. Nick is my super visor.

14:21And I would say he's been super. Oh, Nick, what do you think makes a good candidate? It helps a lot if you can show that your product is like funded and you have a way to think. Oh, they like show me the money. Mix show me the money. But overall, you should definitely make sure, I think that what you're interested in that there are people, whether that be an Oxford or elsewhere, wherever you're looking to do your thing, that there's people who can be appropriate to guide you and make sure that you can be successful in what you want to do that way you end up. Thanks, Nick. All right, so what's been the hardest part and what's been the most rewarding part? Oh wow. So you can flip that around. You can say what's most rewarding and then say what's the most hardest? No, I'm gonna say the hardest part has been, you know, and I think actually when it's first starting, Carl had said this that it's, you know, not a sprint, it's a marathon. And I think it's been echoed by a lot of other people

15:22in the department because that's been the hardest part is, you know, nights, weekends, when we're traveling together as a family, doing school work, bringing my laptop with me, doing title abstract screening, you know, while the beach is just a little bit away. So that's been kind of the hardest part is just kind of put my head down, keeping going even when you don't want to. And the most rewarding part, I can help you out with this besides being on the podcast. Yeah, thank you. Thank you for that. You're welcome. And, you know, I've also said this before, but it's honestly the people, like the people that we meet and that we should be back to the people. It always comes back to the people, yes. I mean, made such good friendships and it's all about the people, yes, I'm looking at you. Oh, no, no, no. People, I mean, it's been the birthday boy. It's been wonderful, the people that I've met and gotten to interact with. Well, why don't we get you off the hot seat, Melanie,

16:23and bring someone else into the hot seat. And we can have a de-fill candidate come up here and find out who they are and what their experience is, because it may be different than yours. Yeah. And I'm gonna let you interview them. And why don't you voluntowl someone to do it? Okay. Who are you picking? It's probably gonna be layout, because she's right here, that just makes sense. Hello. Hey, thank you for joining. Thank you for having me. Okay. So, let's start with who are you, your name? Where you are from and what brought you to Oxford? Sure. So my name is Layal Bukarfouche. I'm from Detroit, Michigan. Shout out 313. We're off. No, okay. And what brought me to Oxford? Well, that is a really funny story. Oh, okay. We've got some time. Go ahead. I was looking for programs. You know, I was planning on applying everywhere. And so I connected with my supervisor, one of my supervisors, Dr. Georgia Richards, on LinkedIn.

17:23And you know, reshot to her randomly. I was just like, oh, can we chat? You know, I saw this PhD program. I just wanna talk about it, see if it would be a good fit. And we talked and she's like, I'd love to sponsor your application. Oh wow. And yeah, she worked with me for two years before applying because I wasn't in policy yet. And I knew I wanted to do a project in policy. And I told her, you know what, like coming up, I think I'm gonna get this job. Like let's wait, hold off for the next application cycle. So she kept working with me, we stayed in touch. And I applied and I never looked back. That's great. Yeah. Were you intimidated at all? Were you like, now I got this? Oh, no, I was really in touch. Yeah, yeah. I mean, I felt like that. Yeah. That's fair. You know, like I, this was like my, you know how they tell you to like apply to like schools that you're like, oh, this is my safety school. This is like my mid-range school. And this is my like out of my league school. Yeah, this was my like shot in the dark. Like I didn't know. Like you know what would happen. Fantastic. And it happened. Yes. I didn't know. And that's been a common, common refrain.

18:24Yeah, yeah. So tell me about your area of research. Oh, yeah. Sure. So drugs, specifically medications for opioid use disorders. So I come from a, you really got kind with that. So I started my career as a clinical researcher in addiction medicine at Johns Hopkins. And so I coordinated clinical trials in the injectable form of buprenorphine. So some people call it Spockstone. It was a braver in product. And so I spent a lot of time seeing patients, seeing the impacts of medications for opioid use and how that helped people stabilize their lives. And how it was limited by policy intervention. Like, you know, the bread that you can use it for. And you know, just so many different aspects of the medication are limited by policy. Yeah. Especially in the US. And so I wanted to delve more into that on a policy level because I don't like people telling me what to do. And the government was telling me what to do.

19:25And that's not it. And so I wanted to change that. And so I jumped into policy. And it's great, you know, with this area of research for, you know, my medication for opioid use. I want to look at the implementation shortfalls of this, you know, medication rollout that impacts acts. I think it's about like 35%. I remember that 35% number that you were throwing out. Yeah. Yeah. So only about 35% of people who need the medication get it. And I think to a lot of different, you know, policy-aric aspects and, you know, conditions that, you know. And so I want to apply a realist lens. Because I think that's the kind of thing that's missing at least in the US literature. And I'm excited to delve more into that. Good. That's fantastic. Yeah. So what have you found is the best thing about being at Oxford? Wow. Well, I mean, there's so much. I mean, I think I'm overwhelmed by the history and how much just has happened here and really humbled to kind of study in that same space. Yeah. And, you know, now meeting you all for the first time in the program, too, has been crazy amazing.

20:26Like, yeah. It's just great to have that kind of, the place where being an intellectual is cool. Yeah. Yeah. Because everywhere else, you're weird. Yeah. That's true. That's very true. You can really dive deep. Yeah. You can dive deep. You can drink a few pints and talk about nerdy stuff. And it's like normal, just like we're doing right here. Yeah. That's fantastic. Well, I don't know if I have any other question. Uh-oh. Oh, what's the hardest thing? Is that what you wanted to talk about? Oh, I've been the hardest thing about your time in Oxford. So the thing that's been, that's been racking my brain, is how to get my hair dryer from America to work. Because, because it won't, it's because it won't. And I have a lot of hair. And I did my hair dryer. Like, I got a converter. I got a converter. I'm making a experiment to make it work. And it still didn't. So I had to buy one from here.

21:28And that didn't work. How did it work? Let's get down to it. How did it work? It sucked. That was probably the most emotionally just stressful thing. Yes. Still heartbreaking. Yeah. So maybe a hat. Maybe a hat goes with that, right? A hat. Then you don't have to worry about the hair, right? Right. I guess. Yeah, I guess. I'm not a hat girl. We got to rewaster. I expect that. We'll workshop that in post. OK. Good, good, good. Well, thank you for taking the time to be on here. And next we'll move on to Taylor. Hi, how are you? It's so good to see you. It's been ages. It's been a few minutes, yeah. So I'm the story of transition. OK, well, before we get into that, Taylor, yes. We should say who you are. And I also want to personally, even though I said it like 50 times, happy birthday. It is your birthday. Thank you. But yeah, go ahead and say your name, where you from, and what brought you to Oxford? Oh, my name is Taylor Hershberg.

22:31And I, well, people are a place more than a place is home. I don't know. Oh, a deep, real fast. Yeah, yeah, I've lived in four continents, in eight US states. Where would you say you're from? I have from Kentucky, I think. OK. And you're roots. A Jewish guy from Kentucky. And I like it. OK, great. So yeah, so Oive, I know. And what brought me here, well, you know what I think is great about Oxford is you actually can create knowledge and science. And people here are brave enough to do it with you. And so I came here because I study migrant health, and specifically queer migrant health. And the Middle East. And so not a lot of people want to take that on. Yeah, you're brave. Subject. Because of all the political risk associated with it.

23:31So it was absolutely my choice to come here was because my supervisors were brave enough to do it with me. Wow. That's amazing. Yeah. That's amazing. So was it a difficult process to like apply and get in under that topic? Actually, I think it was radical enough to get people's attention. And I was able to speak to supervisors that did a rapid qualitative data collection, which is really useful for humanitarian and complex situations or public health emergencies. So I actually connected with Marta Winnott, who is a fantastic supervisor. And that is how I came to Oxford. Fantastic. And this next question might be difficult, because I know you've been kind of transitioning with your research. But what is your area of research? Or what's your planned area of research? Or kind of what are you interested in at this point?

24:31Yes. So unfortunately, because of the wars and other personal matters, I had to move on from that topic in region. So I'm still sticking with mental health and the LGBTQI community. So I'm figuring that out right now. And that's one of the great things about this program is just for 10 minutes, Carl walked into a room and sprinkled me with knowledge and was like, how about you do this as an idea of how you focus in on your topic? So my recommendation is make your topic feasible. Make really just come in and know exactly what you want to do and reach out to members of the department to ask advice. They care about you and your topic just as much as you care about it. So I have to say the evidence-based health care supervisors, leadership are, yeah, you guys are pretty cool. So. That's great.

25:32So what are you hoping to, I mean, I know, again, you're focusing on your topic. But are you hoping it's like a big topic that's going to change the world? Are you just like, let me just get this done so I can get my defil from Oxford? Maybe, okay. Well, you know, I call it activism science for me because it's not only trying to change the way that people do to care for others, but it's also a part of protecting patients. So my background is in nursing, and particularly with doctors without borders, was where I think I spent my early career. And I think what it is in the reason why I come in and came into Oxford was the name provided enough power. I felt like to bring attention to a group that has often forgotten. And so I think it's my still the same mode. Like I'm here to look at ways we can take evidence

26:33to shape medicine and shape access to protect vulnerable communities. Wow. So to answer your question, yeah, change the world. Yeah, I love it. That's fantastic. I mean, that's what you got to do, shoot for the stars, right? Well, I mean, all of us here have that responsibility. You know, as you're practicing medicine, like one patient can change the world. You can change the world. Like in every interaction we have, we have that opportunity. And so particularly when you're creating knowledge. Are we changing the world right now? Is that what's happening? I don't know. I think we all are all the time, right? Okay. I think someone had three beers before the thing. So what is your favorite thing about Oxford? And I guess should we start with the worst thing? Because I mean, have you had issues with blow drying your hair as well? Is that a common thing? You know, actually, yes. You've got a great hair. You've got a great hair, so. I mean, I think the hardest thing about Oxford

27:34is it's rather, it's a big bureaucracy that's rather decentralized. So come in with patients, particularly with the admin, because they're there to be on your side. And they're figuring it out just as much as you are at times. That is the hardest part. The best part is, I don't know when I wake up early in the morning and get a cup of coffee. And that is some of my favorite time to be at Oxford is when you're walking around and people are taking time to just kind of just take a moment with where we're at this ancient place of learning. And so it's absolutely beautiful. Like, I don't know if you're up, I was up this morning with the sunrise and just seeing the mist and the sun coming up and going on a run and it was, it's gorgeous like these historic buildings. And you just, you feel like it's a magical place. Well, it is, yeah. It is. It's been around for a while. It's a hot minute. It's survived a few times. Well, Taylor, I think that's all for you for today.

28:39But thank you so much for taking the time. On your birthday. Yes, on your birthday. Thank you. My only words I have to share is, imagine peace, everyone. Ah, beautiful, beautiful. All right. All you are said is give peace a chance. Ah. That was nice. That was nice. No, any other volunteers? No, no. You've been yelling at me. I'm surprised. Thanks, Melanie, for stepping up and doing that. You know, I don't know as much about all the other D Phil students. So it's nice to get a little, a bit of more history and background and what you're doing and stuff like that. So that's great. Before we wrap up, because we're near the end of the show, is there anything else you would like you would like them to know about Oxford, the D Phil program, the Senate's Rabbite? This is just basically at the end. Yeah. Let's give you an open-ended question. Oh dear. Okay. Discuss. Okay. Well, yeah. I was gonna say you made me think too about all the people that couldn't be here because of, you know,

29:40things that are going on in the world and just life they got in the way of them coming here. But I think, again, getting back to the people, like I love the different backgrounds that everyone comes from and just learning about everyone's, you know, what they're interested in and their country, what they like to do, what their norms are in their areas. Future of EBM though. I don't, I don't know if I have anything profound to say. So why don't we circle back to your song choice then? Oh, okay. Why did you pick Bon Jovi? Oh. And I am diehard Bon Jovi all the way. This is my life. It's my life. Yes, yes. So it talks for your life now. Or is it consuming a lot of your life? It's my life. Maybe all of the above. That might be why. But I think too, just having these conversations and kind of. So it wasn't the 80s and the big hair. Oh, I really love that. I was, yeah, I was Bon Jovi for Halloween one year.

30:40Were you? So yes, it was great. Did the poofy hair and everything. But that's the only concert I've been to multiple times is Bon Jovi. But yes, so Bon Jovi all the way. Yeah, we could finish with that. That concludes the second SGM Pubcast. We'll be back next episode trying to cut the knowledge translation window down from over 10 years ago. Using the power of social media. Melanie, I have one more request for you. Uh-oh, OK. I'm ready. Should I break my skull? Could you read the SGM tagline? Oh, OK. But not in English in American. Oh, American. OK. Put your best American. What is American? Is it Southern? OK. Remember to be skeptical of anything you've done. Even if you've heard it on the skeptic side, you're very lucky enough. It's about to be romantic. It's my life. Life.