Episode: The Clot Thickens – Integrating Stroke into Thrombosis TrainingHost: Dr. Houman Khosravani (Stroke Specialist, Toronto)Guest: Dr. Stephanie Carlin (Assistant Professor, Medicine; Critical Care Pharmacist & Thrombosis Fellowship Graduate)In this special episode of StrokeFM, Dr. Khosravani and Dr. Carlin discuss a manuscript they co-authored regarding the educational gap between stroke neurology and thrombosis medicine. They explore the results of a pilot project that integrated a formal stroke rotation into a thrombosis fellowship, highlighting how cross-pollination between these two disciplines leads to better patient outcomes and more comprehensive specialist training.The Genesis of the Project:During her fellowship, Dr. Carlin noticed a high volume of consults involving stroke patients or patients with concurrent thromboembolic concerns.Surveys of other Canadian and US thrombosis programs revealed that none offered a formal stroke rotation, prompting the creation of this pilot rotation.The Clinical Synergies:There is a massive natural overlap between the two fields, specifically regarding:Anticoagulation management (e.g., for Atrial Fibrillation).Mechanical heart valves.Prothrombotic states (e.g., malignancy, Antiphospholipid Syndrome).Patent Foramen Ovale (PFO) management.Operationalizing the Integration:Duration: A rotation of 4 to 8 weeks is ideal to cover necessary topics.Alternative Models: For centers without dedicated rotations, integration can be achieved through joint case rounds, half-day presentations, or collaborative case conferences.Scope: This model is applicable not just to pharmacy or internal medicine, but also to vascular medicine, hematology, and neurology trainees.Dr. Carlin shares a compelling case study that illustrates the value of this integrated training:The Patient: A young woman in her early 20s on oral contraceptives presented with a large MCA stroke requiring TPA and thrombectomy.The Workup: Lab work revealed a prolonged PTT, raising suspicion for Antiphospholipid Syndrome (APS).The Learning Opportunity:The Stroke Team educated the thrombosis fellow on TPA, EVT, and the timing of antithrombotics relative to hemorrhagic transformation risks.The Thrombosis Fellow educated the stroke team on the nuances of APS testing (e.g., lupus anticoagulant interference) and appropriate contraceptive changes.Thrombosis Canada: A key resource for guidelines on anticoagulation and vascular health.Article: "The Clot Thickens: Integrating Stroke into Thrombosis Training" (The manuscript discussed in this episode).Episode SummaryKey Discussion PointsClinical Spotlight: The Value of CollaborationResources Mentioned

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