🔺 Pathophysiology of Hyperthyroidism

 What happens when there’s too much thyroid hormone in the body?

When thyroid hormone levels are elevated, the body doesn’t just “speed up”, it becomes overstimulated across multiple systems. This isn’t a random collection of symptoms; it’s a predictable physiological response to excess T3 and T4.

The Thyroid Axis

 The thyroid axis is one of the most common clinically encountered endocrine systems. It regulates metabolism, temperature, energy, and mood. Understanding how it works helps you reason through symptoms like fatigue, weight change, palpitations, constipation, and menstrual irregularities.

The Hypothalamic–Pituitary Axis: Physiology, Reasoning, and Clinical Relevance

 Welcome to endocrine! This post is designed to help you reason through the hypothalamic–pituitary axis (HPA), not just memorise it. You don’t need to know everything yet. What matters is understanding how the system works, how it regulates itself, and how that explains common clinical presentations.

Preparing for exams - how to make the next two months work best for you

 Exams are just under eight weeks away - close enough to feel real, but still enough time to prepare steadily without panic. The key now is consistency. Small, regular efforts will carry you much further than bursts of late-night cramming. 

This post pulls together some evidence-based strategies, links back to resources you already have, and sets out how you can use the coming weeks to your advantage.

Surgeons Outside of Cities: New Research from UOW GSM

 We’re proud to celebrate Dr Tracey Edwards, UOW Medicine Class of 2023, whose latest article has just been published in the Australian Journal of Rural Health.

📖 Read the full open-access article here: Surgeons Outside of Cities – AJRH 2025

The study, co-authored with colleagues Dr David Garne, Prof Rowena Ivers, Prof Judy Mullan, Prof Kylie Mansfield, Prof Andrew Bonney, Dr Colin Cortie, and myself, examined ten years of workforce data on surgeons across Australia (2013–2022).

Key findings from the research include:

• The total number of surgeons in Australia rose from 4,568 to 5,724 across the decade.

• Only 15.5% of surgeons now practise in rural areas (down from 16.9% in 2013), despite 29% of Australians living outside metropolitan centres.

• Female surgeons remain under-represented, particularly in rural settings (12.4%), with the paper noting barriers such as long hours, lack of mentoring, and family/partner considerations.

• Surgical sub-specialties other than general surgery are rare in regional and rural Australia.

This work highlights both progress and persistent challenges in ensuring equitable surgical care for all Australians. It underscores the importance of initiatives to attract and retain surgeons in regional and rural practice, including targeted training, mentoring, and support for women in surgery.

Why “High Yield” Thinking is Harmful in Medicine

 You may hear medical students talk about “high yield” and “low yield” topics, the idea that some things are worth learning because they’ll score marks, while others can safely be ignored. I, like many others, find this discussion at best irritating and at worst exasperating or even offensive. Why?

This mindset is short-sighted and demeaning to patients and their experiences. Labelling parts of the curriculum as “low yield” suggests they are less valuable, when in reality, every condition, system, and clinical story matters to the people living it. The “rare” syndrome, the “niche” complication, or the “uncommon” presentation may be the defining moment in one patient’s life - and the patient in front of you deserves your full attention, not a calculation of yield.

There is also a degree of arrogance in the “high yield” mindset. As students, you do not yet have the experience to judge what will or won’t be important in your future practice. What feels irrelevant today may be critical tomorrow. Senior medical educators have designed the curriculum with decades of accumulated wisdom. To dismiss parts of it as “low yield” is to assume you know better than those who have seen the consequences when knowledge gaps harm patients.

Focusing only on what might appear in exams encourages skipping over knowledge simply because it’s uncommon, uninteresting to you, or because you don't yet have the experience to understand its value. That erodes your future readiness as a doctor and risks patient safety. Medicine is built on breadth as well as depth - on curiosity, humility, and a willingness to take every presentation seriously. You don’t get to choose which patient walks through your door. When it’s their story, it will always be high yield.

Instead of chasing the most marks for the least effort, or trying to be “strategic,” aim higher: focus on becoming the best doctor you can be. That means:

• Building strong foundational concepts that you can apply across conditions.
• Seeking integration: understanding how systems connect, not just isolated facts.
• Practising clinical reasoning: applying knowledge in scenarios, not memorising lists.
• Reflecting on the kind of doctor you want to be - one who values marks, or one who values patients.

Exams will come and go, but your patients will live with the consequences of how seriously you approached your learning. Choose to respect the curriculum, respect your educators, and above all respect your patients - because in real medicine, everything is high yield.

Understanding common fracture types 🦴

 Fractures are important—not just because they’re common, but because they reveal how bones respond to force, age, and physiology. One way to think about them is as patterns left behind by trauma: each shape tells you something about the mechanism, the anatomy involved, and what might go wrong next.

In this post, we’ll walk through common fracture types and explore how to reason through them. Not just what they look like, but why they happen, how they present, and what they mean for your patient.  

Osteoporosis: The Silent Thief of Bone 🦴

Hey students! 👋 Let’s take a deep dive into osteoporosis—a condition that’s far more than just “brittle bones.” In Australia, 1 in 3 women and 1 in 5 men over 50 will experience an osteoporotic fracture. 

But what’s really happening at the cellular level, and how do we tackle it? Let’s break it down (pun intended 😉).

Understanding, investigating and managing pericarditis

You’ll hear it described as “sharp chest pain,” “worse when lying flat,” or “relieved by sitting forward.” But what’s actually happening when someone has pericarditis—and how do we reason through it clinically?

Let’s explore the pathophysiology first, then walk through how to spot it, investigate it, and manage it.

🧠 Psychosis or delirium : a complex interplay

Acute physical illness doesn’t just affect the body - it can destabilize the mind. For patients with schizophrenia, dementia or other psychotic or neurodegenerative disorders, infections like pneumonia or urinary tract infections can trigger agitation, paranoia, or hallucinations. 

Understanding this interplay is essential for safe, compassionate care in hospital settings.