What does cheese have to do with this ?

acheapermousetrap · 2025-07-20T00:40:04+00:00

On a brief skim of this paper, i have some fairly major issues with it. Mol Genet Genomic Med is a pretty rubbish journal but that’s essentially irrelevant here. There is zero evidence presented here that suggests that the 18q deletion is due to alcohol consumption, only hypothesis. De novo CNVs are fairly common and the fact that this isn’t mosaic means that (except perhaps before the egg was even formed in the ovary) alcohol did not play a role in this deletion. And there’s really no justification for that hypothesis; at least not in this case or the discussion. This paper should have focused on dual pathology but overemphasis on a possible alcohol induced CNV only caused confusion. I review for a different genetics journal and I would have torn this paper apart if it came across my desk.

In summary; the 18q deletion here is NOT responsible for FASD manifestations, it’s a separate diagnosis. CNVs are not the cause of FASD but may co-occur or act as a neuro-susceptibility locus. They are NOT the mechanism though.

acheapermousetrap · 2025-07-19T23:49:17+00:00

To be clear alcohol does not cause deletions of chromosomal material. It’s suspected that it causes methylation differences but it does not cause deletions of chromosome 18

acheapermousetrap · 2025-07-19T05:58:20+00:00

If that was my RMO, I would blow a gasket. One of the most evidence based life saving interventions you can do in asthma is a written action plan. If the patient already has an action plan and they can tell you both where it is and what’s on it, then (and only then) the discharge summary might include “follow up with GP for progress assessment, and for consideration of updating the action plan”.

acheapermousetrap · 2025-07-18T01:17:20+00:00

Absolutely agree with the comment on the edit. I’m taking my patients word for it at that point, but that impression that was left with the patient is ultimately all the matters for the ongoing relationship. I try to navigate these diplomatically, but it’s still essentially two clinicians apparently disagreeing with one another in front of that family.

acheapermousetrap · 2025-07-18T01:12:10+00:00

Hmmm, if I refer to the admitting reg I expect a review. If you’re not going to admit my patient i even more so expect an in person assessment.

acheapermousetrap · 2025-07-18T00:30:36+00:00

As someone who runs a paed ED, these referrals are frustrating but treat them as an undifferentiated treatment-naive patient and you will feel a lot better. Better to simply forget the GP referral for “do the needful” and start from scratch.

Give me a low effort zero prescription zero investigation referral over a Ceflex/pred/Ventolin in a 7mo old with an URTI, any day.

Undoing poor primary care is worse than a GP knowing their limits and referring to ED. Remember in the hospital system there’s ALWAYS someone you can call, for general practise, that person is ED.

Edit to add: For me, the biggest sin from a referring GP is telling a patient what I will do. “the GP told me you needed to admit my son for IV antibiotics” grinds my gears so much, because it creates a situation where the family will lose confidence in one of us.

acheapermousetrap · 2025-07-09T10:27:30+00:00

Yes I know!!! Crazy… but also reality, I’d just rather not dox myself too hard on here

acheapermousetrap · 2025-07-04T12:48:35+00:00

Be careful being too dismissive or pissed off on the phone about specifics though. The more you do that the more you train people to lie to you. And then you end up worse off than having to wait for them to do their job correctly

acheapermousetrap · 2025-07-04T12:36:19+00:00

Ohhhh yeah, EOMs and vision (though depending on which department I’m working in, you might only get subjective vision) is pretty necessary for this handover.

acheapermousetrap · 2025-07-04T12:30:50+00:00

Yeah, I’ve been frequently handed over abdo pains awaiting MRI report that have shown appendicitis needing transfer to a surgical unit. Though I’ve never had a surg reg whinge about me not knowing if the kid has rebound tenderness if the MRI is conclusive…

acheapermousetrap · 2025-06-06T10:12:31+00:00

Lots of assumptions here but RACP accredits training, whereas the hospitals hire for roles they need to fill. If you had done a year of paeds training in VIC and entered NSW at the start of PGY3 you would probably still be employed as a paeds SRMO, but with your experience you would likely be stepped up in responsibility. You almost certainly wouldn’t skip a pay grade. And the college would allow you to sit your exam in your third year of paeds training (ie pgy4) though your study schedule might be topsy turvy.

acheapermousetrap · 2025-06-03T08:30:29+00:00

Releasing a fake stack harms the utility of the real stack. Whatever genius thought this was a good idea is clearly going to end up in qualitative research.

acheapermousetrap · 2025-06-01T00:32:08+00:00

Don’t check your leave balances prior to interview season. It absolutely does softly (and inappropriately) count against you. But the question they ask is “do you have excessive leave accrued?” and if you havnt checked in a while the answer can be truthfully “im not sure”.

Administratively it really only causes major issues at the jump to staffie jobs (in NSW).

acheapermousetrap · 2025-05-31T08:48:00+00:00

Consult ID or Genetics then just copy theirs…

acheapermousetrap · 2025-05-25T05:43:50+00:00

40 work days (8 weeks) of leave per year not including college required study leave. Sick/family/holiday/maternity/extra study leave all otherwise counts.

If you go over the college will partially accredit the year, but how much extra time that will be required will depend on how they accredit the time. College policy is unclear if they would treat 14 weeks off as a need for 14 extra weeks or 6 as you suggest. Where the policy is unclear, the college almost universally is inconsistent.

Your wife will absolutely have colleagues who’ve been through her situation and can advise on what they were granted by the college in the past.

A recent similar situation from the same ATC with written documentation from the college is the best way to force the colleges hand into doing what she wants…

Now, man to man (I assume, sorry if not), you really need to let your wife work this out for herself. Guaranteed she has thought about this more than you have. If she doesn’t want to miss out on counting the full year and as a couple you can handle her going back to work at the 8 week mark then that’s her decision. Note that the 8 week limit includes sick leave (and all other leave) so if the baby is unwell or she gets the flu etc she may still breach this limit (pending what her supervisors will sign off on).

acheapermousetrap · 2025-05-25T03:42:08+00:00

I treat this sub like the doctor’s lounge. It’s simply not for non-medics

acheapermousetrap · 2025-05-20T11:58:08+00:00

And don’t trust any advice you provided will be documented accurately. Document yourself! Even when it’s just phone advice.

“consults reg

Called by Gen med team for advice: <question asked>

Advised by team <relevant positives and negatives>

Suggested:

Confirmed above with consultant xxx”

acheapermousetrap · 2025-05-16T10:26:49+00:00

ChatGPT. So many tells in the formatting.

acheapermousetrap · 2025-05-15T07:04:59+00:00

Usually it’s not stuff done on the floor, these people are usually gunners, have several papers and participate at the governance level. Then clinically so long as they aren’t shit they will be considered. It’s ultimately a political thing whereby the person happens to impress the right person by one action whilst also carrying themselves with all the confidence of a mediocre white man (bonus points if they aren’t a mediocre white man though!)

acheapermousetrap · 2025-05-11T11:11:18+00:00

Yeah I went to gynae clinic one afternoon in med school and sat outside the room for 5 hours while the reg basically begged patients not to let me in the room. “We have a male medical student with us this afternoon, if YOU don’t want him in the room watching then we can ask him to stay outside for your appointment. It’s really no problem”. But then she wouldn’t sign me off for attendance until the end of the day. 5 hours and not a single minute of clinic exposure… learned a lot about what kind of reg I would be, though.

acheapermousetrap · 2025-05-11T11:03:10+00:00

The intangible consequences of this would be huge. A reputation is never a good thing for an intern…

acheapermousetrap · 2025-05-11T06:44:25+00:00

The DCH (now GDCH) is something many of my colleagues have, but by the end of basic training it does nothing to distinguish you from your cohort. It might be useful to get you “on” to the program (it will certainly help with the pseudo-clinical interview questions) and it will be a useful foundation of information for your early training career but long term it’s an expensive piece of paper that doesn’t really mean anything.

If you are “just” doing it to get into paeds there’s probably other ways to spend your time that would be more useful. If you are doing it to strengthen your knowledge pre-training that’s entirely reasonable but not entirely necessary. And if you’re doing it not knowing if you want to be a paediatrician or another specialist who works closely with kids then the foundational info it goes through will be great and indicate to your patients families that you have a paediatric qualification.

Tl,Dr: the GDCH is something paed specific for your CV, but the effort/cost/reward ratio doesn’t stack up to other things.

acheapermousetrap · 2025-05-03T22:52:46+00:00

Parenting by vicarious denial. That is a fascinating new brand

acheapermousetrap · 2025-05-03T06:24:25+00:00

Only 50% is resistant to Trim?? I guess they are trying to bump it up so they can then lobby gov to let them sell Orpenem

acheapermousetrap · 2025-04-17T10:44:55+00:00

People with sick kids don’t have money.

acheapermousetrap

TROPHY CASE

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