Staying #Up2Date 🚨

1: Maternal Diabetes and Neurodevelopmental Outcomes in Children

This systematic review and meta-analysis of 200+ studies found that children exposed to maternal diabetes were at increased risk for neurodevelopmental disorders (RR 1.28, 95% CI 1.24-1.31) — including ASD (RR 1.25, 95% CI 1.24-1.31), ADHD (RR 1.30 95% CI 1.24-1.37), and intellectual disability (RR 1.32, 95% CI 1.18-1.47). Pre-gestational diabetes was more strongly associated with risk than gestational diabetes (RR 1.39 [95% CI 1.24-1.44] vs RR 1.18 [95% CI 1.14-1.23]). 

2: Reducing Suicide Attempts in Outpatient Mental Health Care

A quality improvement study across 4 US health systems found that implementing the Zero Suicide (ZS) model — a menu of evidence-based suicide prevention strategies — was linked to lower suicide attempt rates in 3 of the 4. The results support wider use of the ZS model in outpatient mental health care.

3: Less ZZZs → Alzheimer’s Disease?

In a 20-year prospective cohort study of 271 adults, researchers examined links between baseline sleep patterns and brain structure on later MRI. Reduced slow wave sleep (SWS) and REM was associated with atrophy of the inferior parietal region — a brain change often seen in early Alzheimer’s. The findings suggest sleep architecture may be a modifiable risk factor for AD development. 

Billable Minds 🧠

Since COVID hit, demand for mental health care has exploded. The accessibility gap for mental health services has widened, adding to the chronic shortage of psychiatrists. 

Is public service for me?

Publicly-funded psychiatry — think hospitals and academic settings — still offers perks. There’s more room to move up, it’s more accessible for patients, and it offers that rare, tangible feeling of actually helping someone. Dr. Ashok Bhattacharya, founder of The Empathy Clinic in Oakville, Ontario, notes that newer grads are increasingly drawn to hospital settings, where psychiatrists are being pushed to focus on mainstream psychiatric problems instead of psychotherapy — which many other disciplines now provide. 

Why go private

But there’s a reason some psychiatrists step off the hospital treadmill. In private practice, “you might spend an hour or two a week with a patient,” says Dr. Bhattacharya. “In hospital settings, you could be seeing someone for 10 to 15 minutes every six weeks.” Not exactly much time to unpack life’s emotional baggage. With pressure to meet quotas, hospital psychiatrists often have little room for deeper therapeutic work. Canada has fewer than 15 psychiatrists per 100,000 people, one of the lower ratios among high-income countries, making time-intensive care a luxury the public system can’t often afford.

Where it gets tricky

Privatization isn’t just about longer sessions and more autonomy — it also raises thorny ethical questions.

“There’s a profit aspect,” says Dr. Mari Kozak, a staff psychiatrist at Oakville Trafalgar Memorial Hospital. Complex cases — think chronic schizophrenia or PTSD — can take years to treat and don’t always fit into a profitable private model. “Some for-profit ADHD or ketamine clinics, for example, make it easy for patients to walk in, get a diagnosis, and leave with the meds they were hoping for.”

That convenience can come at a cost: critics warn it could deepen inequities, drawing psychiatrists away from the public system while offering boutique care to those who can afford it.

Then there’s the tension when psychiatrists work for insurance companies. As you know, psychiatrists often play a role in return-to-work decisions. But what happens when financial incentives creep in? The psychiatrist decides when a patient is ready to return ­— but if they’re not, it can be a financial loss for both the insurer and the psychiatrist, too.

Can care remain patient-centred when profitability starts calling the shots?

Presented by CCFP Ready

Preparing for the OSCEs: Realistic Practice for Exam Success

As you gear up for the OSCE portion of the CCFP exam (family medicine board exam), hands-on, practical experience is key to success. While studying theory is important, nothing compares to practicing in a simulated environment that mirrors the real exam.

That’s where CCFP Ready comes in. Our virtual SOOs (Simulated OSCEs), designed by Canadian family physicians, offer realistic scenarios to help you practice your clinical skills, communication, and decision-making. This year, we’re offering practice SOOs over 3 weekends, each with different cases, providing you with multiple opportunities to practice and refine your skills.

By practicing with content created specifically for the Canadian family medicine residents, you’ll gain confidence and sharpen your ability to think on your feet—ensuring you’re ready for anything the OSCE throws your way.

With hands-on preparation, you’re not just studying—you’re getting ready for success.

Hot Off The Press

1: 🧬 A simple spit test may be the future of prostate cancer screening. In a UK trial of 6,000+ men, a genetic saliva test outperformed PSA screening — diagnosing prostate cancer in 40% of high-risk men, more than half of which were aggressive. Researchers say it could help catch dangerous cancers earlier and cut down on unnecessary biopsies.

2: 🇺🇸 Canadian travel to the US dropped 17% in March — the lowest since COVID — nearly 865,000 fewer border crossings than last year. Travel was up this winter… until Trump took office (again). Now? Tariff threats, annexation talk — and Canadians staying home.

3: 🩻 Canada just released its first updated childhood obesity guidelines since 2007. Published April 14 in CMAJ, the new guidance calls for reduced stigma, broader treatment options, and a shift away from BMI as the sole measure. Behavioural therapy comes first — but in some cases, GLP-1s and bariatric surgery are on the table.

4:🚶‍♀️Exercising just once or twice a week could cut mild dementia risk by 25%, according to a long-term study published in the British Journal of Sports Medicine. The 20-year study tracked ~10,000 adults and found “weekend warriors” fared better than even regular exercisers (who saw an 11% reduction). Researchers estimate 13% of cases could be avoided if all middle-aged adults moved just a little.

Notable Numbers 🔢

1 to 6%: the estimated infection rate after tattooing, according to a 2025 Lancet Microbe series — though most are mild.

93%: the portion of tattoo inks in a 2021 study that violated EU labelling rules. Harmful metals like nickel and chromium were found in nearly all tested samples.

1.62x: the increased risk of skin cancer among tattooed individuals in a 2025 Danish twin study — an association, not causation.

Picks

😂Laugh: at this meme about curve fitting methods!

📺 Watch: Celebrities like Katy Perry and Gayle King take flight to space for 4 minutes!

🐣 Celebrate: Easter (or the long weekend) this week with these fun activities!

🤝  Hire: from the US? The CMA is looking to turn US “brain drain” into Canadian “brain gain” by importing docs from south of the border. Do you agree with this strategy? Hit reply and let us know what you think.

🧠 Read: Some of the smartest people war-gamed out what the near future of the word may look like, as a result of the AI revolution. Check it out.

Relax

First Question: Operation that makes you look sharp?

If you enjoyed the puzzle, challenge your physician friends and see if they can beat your time.

Share Postcall, Get Rewards

Help Us Get Better