
Forged for the Frontlines
Medical and Education Consulting That Transforms People, Programs, and Culture
Real solutions for real-world pressure.
Are you facing burnout in your faculty? Struggling with disjointed workflow and throughput in your ED or ICU?
Need help launching an educational program in your unit or department—or just want your team to teach better, lead stronger, and feel less overwhelmed?
You’re not alone. We’ve been in the trenches too.
At Anvil and Swage, we partner with departments like yours to fix what’s fractured, energize your educators, and align your systems—so you can get back to the work that matters.
Our Services
We understand what it’s like to build a critical care service from the ground up without knowing where to start, or to balance teaching and feedback with the demands of a heavy patient load. We see how talented faculty can slip away due to burnout, misalignment, or lack of support. And we know that when your team has outgrown its current protocols, finding time to rewrite them can feel impossible. We help hospitals, residency programs, fellowship programs, and physician leaders solve these challenges every day, through services designed to meet you where you are.
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Medical Consulting
Expert guidance in ultrasound, airway devices, MCS (such as ECMO, Impella and VADs), and ED optimization & protocols
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Medical Education
Practical training through simulation, board review, on-shift faculty development, and feedback workshops
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Professional Coaching
Values-based coaching for physicians, leaders, and families
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Organizational Culture
Building stronger teams through optimization, alignment, communication, and strategic planning
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Content & Media Creation
Creating engaging podcasts, presentations, grants, and open-access projects
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Presentations & Public Speaking
Delivering impactful keynotes and providing coaching to help professionals craft and refine their own presentations.

“We don’t believe in one-size-fits-all solutions. We believe in asking the right questions, co-creating strategic answers, and building systems that last.”
Meet the Founders
Dr. Mark Ramzy, DO is an Emergency Medicine and Cardiothoracic Intensive Care physician who brings real-world expertise to the bedside and the classroom. As Editor-in-Chief of REBEL EM and a national educator in Emergency Medicine and Critical Care, he is passionate about making complex concepts practical, engaging, and accessible for clinicians at every stage of training.
Diana Misdary Ramzy is a Certified Coach and Adult Learning Strategist who helps leaders and teams grow with clarity and resilience. As Founder of Rested & Regulated, she brings a faith-rooted, trauma-informed approach to leadership education, blending strategy with compassion to create meaningful, lasting impact.

Stop Spinning Your Wheels. Start Building Momentum.
Let’s cut through the noise, clarify your direction, and build something that lasts.
Clients & Collaborations
Get in Touch
Not Sure What You Need?
Feeling like you’re drinking from a firehose as a new program director?
Want your next retreat to be meaningful (and not boring)?
Need support with grant writing or board review prep?
Trying to get your team aligned but not sure where to start?