Starting in 2023, the Medical Board of Australia and the Medical Council of New Zealand brought in what were called “Strengthened CPD” requirements. These put more focus on reviewing performance through self-reflection and peer feedback described in the RACP’s MyCPD Framework as a Category 2 activity.  To help synchronise CPD seamlessly with practice, the value of supervision as a reflective activity has been recognised in the 2024 framework. Time spend supervising trainees can now be counted towards Category 2 CPD “Reviewing Performance” rather than Category 1. In this short and insightf ..read more

This case report has been developed by Trainees, to assist their peers with preparation of long-case presentations. It is not a fully-vetted Education resource but a “passion project” from editors of the Pomegranate Health podcasts.   The case is that of a 32-year-old woman presenting with constant and dull abdominal pain that had been sudden in onset. The pain is accompanied by nausea and vomiting but bowel habits were unchanged. The patient has a history of type 1 diabetes and a simultaneous pancreas-kidney transplant two years prior to the presentation. There is no history of rejection ..read more

Australia is a big continent and sparsely populated continent. 28 percent of Australians live in areas classified regional, rural or remote and their access to health services is much more limited. It’s estimated that between 2009 and 2011 there were 19,000 excess deaths in regional and remote areas as compared to the major cities. No doubt, socioeconomic disadvantage is factor in that mortality gap, but inequitable access to healthcare is also a major driver.  In this podcast we focus specifically on the shortage in health practitioners in the regions. Even in regional centres, the dens ..read more

Type 1 diabetes has a very high treatment burden in terms of direct costs, inconvenience and lost productivity for patients and their carers. Further, all the glucose checking, hormone replacement and consults don’t abolish the vascular complications associated with poor glycaemic control. Only in the last few years has it been possible to pharmacologically alter the course of type 1 diabetes and other auto-immune diseases without generating intolerable side effects. Teplizumab is an antibody to CD3 which was presented to the world in 2019 as delaying the onset of type 1 diabetes in high-risk ..read more

Last November an NHS Hospital Trust in Nottingham sought permission from the UK High Court to withdraw life support from a seven-month old girl called Indi Gregory. The devastated parents did not want to give up on her although they were advised there was no hope of treatment for her profound developmental disability. The family and the medical teams returned to court two more times, right up to the day that Indi was to be extubated.  Conflicts over care have always existed but their frequency has increased as medicinal advances present more options for intervention even in the sickest pa ..read more

The theory that certain fatty acids are essential to the diet and associated with reduced cardiovascular risk has been controversial since it was floated in the 1950s.   In 1971 Danish researchers published the results from a cross-sectional study of Inuit people living on the west coast of Greenland. They ate a fish-based diet rich in polyunsaturated fatty acids known as omega-3s, which were found in their tissues along with much lower levels of pre-β-lipoprotein and plasma-triglycerides when compared to controls.    That association between a fishy diet and lowered cardiovascu ..read more

Semaglutide, has become a blockbuster drug like no other, making its manufacturer Novo Nordisk the most valuable listed company in Europe. Sold under brand names Ozempic or Wegovy, it’s held up as some kind of weight loss miracle cure, but demand is so high, that it’s been hard to supply the patients with type 2 diabetes for whom it was first indicated. Semaglutide is an analog of glucagon-like peptide 1 which has direct, glucose-dependent effects on insulin secretion. In this episode we first talk about how semaglutide compares to other drugs in its class as a treatment for diabetes. The grea ..read more

We’ve known for a decade that about 50 percent of doctors meet the criteria for burnout, and the figure is up to 70 percent among trainees. But organisations have been left to come up with their own solutions to this, the result being that many simply offer band aid solutions rather than systemic ones. Unforgiving work conditions pose a problem for both recruitment and retention of staff to the health workforce. The New Zealand Health Department, Te Whatu Ora, forecasts that within ten years supply of doctors, pharmacists and nurses will fall short of demand by 14 to 18 percent. In response th ..read more

This is the final episode in a five-part series about artificial intelligence in medicine. We start by weighing up the costs and benefits of automation in a health system that’s increasingly pushed beyond capacity. One of the biggest time sinks for health practitioners is filling out and searching through medical records. Some of this could be performed by natural language processors which are becoming more accurate thanks to deep learning.     The power of large language models has been demonstrated by the meteoritic uptake of ChatGPT and doctors are among those who have used i ..read more

This is the fourth part in a series on artificial intelligence in medicine and we try and unpick the causes and consequences of adverse events resulting from this technology. Our guest David Lyell is a research fellow at the Australian Institute of Health Innovation (Macquarie University) who has published a first-of-its kind audit of adverse events reported to the US regulator, the Federal Drugs Administration. He breaks down those that were caused by errors in the machine learning algorithm, other aspects of a device or even user error.    We also discuss where these all fit in to ..read more