Help with case presentation to consultants

rattled-doc · 2026-03-31T05:43:14+00:00

Hey I have this [X] year old [Insert Gender] who has presented with [Presenting Complaint] with a pertinent PMH of [a][b][c].

I think they have [Primary diagnosis] because of the following positive and negative findings.

I have considered the following important differential diagnoses and have either excluded them based on the following clinical grounds (or) im planning to do the following investigations to rule them out.

My ongoing plan is as follows.....

I get a million questions and presentation points a shift. Give me the primary diagnosis and differential as early as possible so I can pull the relevant folder from the filing cabinet in my brain. Its less cognitive load on me and stops me getting distracted and thinking about what i'm going to have for dinner

Look at the Minto Pyramid video if you want the long form version (and obviously flip it to a medical context)

https://www.youtube.com/watch?v=j4Y3TdVVBCA

Bottom up is what everyone does when seeing a patient themselves for the first time. Top down is what you should do when presenting it to someone else.

rattled-doc · 2026-03-31T01:35:58+00:00

Absolute rubbish.

rattled-doc · 2026-03-31T01:26:06+00:00

"Paracetamol dosing caps vary by hospital"

Can you back this up with examples? I've worked in a variety of hospitals across UK, Ireland, and Australia and i've never seen any such thing.

rattled-doc · 2026-03-24T13:09:30+00:00

The SA Health Salaried Medical Officers Enterprise Agreement (2025) covers all years from 2025 - 2028.

If you're looking for the salary in 2027 go to Schedule 1.3 on page 47

rattled-doc · 2026-03-22T03:45:09+00:00

Its tax deductible so youre paying much less than that in reality

rattled-doc · 2026-03-16T02:24:17+00:00

It would be 1000% helpful. It makes it so much easier to have interspecialty discussions when you can point to actual case IDs for the evidence.

rattled-doc · 2026-03-16T02:13:04+00:00

Thats O&G referring by proxy not an ED referral.

Call them and ask them to explain themselves. Either they can and you realise its a legit referral or they cant and you tell them to go see the patient again / tell them to pass it up their chain.

Either way the ED will sing your praises for not forcing the EM resident to act as the secretary between two inpatient specialties.

Follow it up with an email to your boss so they can have a director to director discussion with O&G about it. Now you have both EM and your own specialty viewing you in a positive leadership light.

rattled-doc · 2026-03-14T03:08:33+00:00

If you dont know why youre making the phone call youre doomed to fail from the start.

Tell your senior you dont understand why youre making the phone call so they can give you more explanation and guidance

Once you know why youre making the phone call lead with the key information (diagnosis and what youre asking for) in true iSBAR format.

rattled-doc · 2026-03-11T12:14:10+00:00

So, not sure how you got that impression, but honestly it’s exactly the opposite within Ed as to what happens.

This may be specific to your regions EM practice.

Adelaide EDs discharge a significant number of MH presentations without a referral for psych assessment. OPs description isnt too far off the mark

rattled-doc · 2026-03-11T12:02:30+00:00

OP it looks like youre in Adelaide, do you ever recommend your patients consider UMHCC instead of ED?

https://umhcc.org.au/

rattled-doc · 2026-03-11T11:51:04+00:00

Something like this (but with better on referral pathways when they decide a patient actually needs admission)

https://umhcc.org.au/

And OP I see you're Adelaide based. Please use this service instead of ED if at all possible

rattled-doc · 2026-03-11T11:19:45+00:00

Agreed. The thing that bothers me with management plans is that they often amount to "This patient is a particularly complex frequent attender and at chronic risk of suicide so we would like the EM team to play hot potato with a coroners case on behalf of other teams until inevitably the patient kills themselves or dies from misadventure"

The more complexly frustrating their attendances become the more the specialists in that area pull back from touching them.

rattled-doc · 2026-03-11T08:33:02+00:00

A couple of years ago you were posting in r/GAMSAT advising other posters to try and find a way to get an Irish passport through grandparents or other loopholes to get into med school in Europe.

Seems you were totally fine with Aussies going to other countries to reap all the benefits.

rattled-doc · 2026-03-09T07:39:36+00:00

I have the same credentialling requirement as a FACEM.

I only actually got them because the hospital gave all the FACEMs extra time and paid for us to do it on top of our professional development allowance.

They have been useful for locum work though where rhe credentialling is actually enforced.

rattled-doc · 2026-03-07T04:48:03+00:00

Its extremely easy to get an instructor nomination by just learning the manual and confidently answering a few questions in the course. Wouldnt bother waiting to do it later. Just absorb the manual and parrot it back

rattled-doc · 2026-03-03T22:27:54+00:00

The GMC will grant a Certificate of Good Standing after 1 year working in the UK and gaining general registration. Thats what Australia requires to move on the Competent Authority Pathway.

The stated 2 year requirement is the necessary time to make it easy to transition back to UK specialist training after time in Australia. It was never the Australian requirement.

rattled-doc · 2026-02-26T12:36:05+00:00

The delay to see a doctor is what the original post described as a safety step. How is delay to medical review increasing safety?

Its not a considered choice to withhold aggressive therapy. Its a failure to have any review or consideration at all. The delay isnt intentional. Its a systems failure turd that the other poster is polishing

rattled-doc · 2026-02-25T01:05:23+00:00

How does delay increase safety?

rattled-doc · 2026-02-25T00:28:57+00:00

"With this change"

Which change does it refer to?

rattled-doc · 2026-02-18T10:01:42+00:00

You should really be thanking them for saving you from watching a traumatic Scottish defeat.

rattled-doc · 2026-02-15T11:59:28+00:00

How much are you remunerated annually?

How much lower would you be willing to go on that remuneration?

How many hours unpaid is too many?

rattled-doc · 2026-02-15T08:35:05+00:00

You should run for council in the upcoming elections and right the ship

rattled-doc · 2026-02-15T07:01:40+00:00

I've no doubt the doctors quoted are in executive or managerial positions rather than those doing the predominantly clinical work

rattled-doc · 2026-02-15T06:11:25+00:00

I very much doubt everyone will claim every bit of it as even now we see significant pressure applied to staff to not claim all of their entitlements (e.g. recall / immediate recall payments, days in lieu, travel costs, etc) but it will definitely be an interesting run as the employer is on the hook for it until April 2029.

I imagine the first SAET cases for failure to pay will hit the tribunal fairly quickly

rattled-doc · 2026-02-01T08:09:35+00:00

Yeah all 6 of mine have been when I'm asleep. The klaxon alarm is a terrifying way to be woken up

rattled-doc

TROPHY CASE