1: Holter Your Horses

An RCT across 45 UK hospitals and 2,234 patients explored whether 14-day cardiac monitoring affected diagnosis, treatment, or outcomes for adults presenting to the ED with syncope that remained unexplained after evaluation. Those randomized to 14-day monitoring did not report a significant difference in syncopal episodes after 1 year compared with standard care. The findings highlight the difficulty of diagnosing an underlying cardiac arrhythmia and the need for further research into diagnostic pathways.

2: Where There’s Smoke, There’s… Further Aneurysm Risk?

A cohort study assessed the lifetime risk of de novo intracranial aneurysm formation and modifiable risk factors among young survivors of saccular aneurysm-associated subarachnoid hemorrhage. Over 57 years of radiological follow-up and 13,738 person-years, 106 patients (19.5%) developed 158 de novo aneurysms, 23 of which ruptured. Independent risk factors included female sex (HR, 1.76; 95% CI, 1.16-2.69), family history (HR, 2.17; 95% CI, 1.22-3.87), and smoking (HR, 1.75; 95% CI, 1.13-2.71). Smoking cessation was associated with a dose-dependent lower risk, suggesting that survivors of aneurysmal subarachnoid hemorrhage face a lifelong risk of further aneurysm formation, with smoking cessation as a key modifiable prevention strategy.

3: Don’t Leave Your Statin on Read

A health system-embedded randomized trial of 20K adults found that digital outreach via secure portal messaging, SMS texting, and email increased 14-day statin refill rates to 14.4%, compared with 12.0% with usual communication. A second outreach attempt also improved refill rates among those who did not pick up their prescriptions the first time around. These results support digital outreach as a scalable strategy to improve short-term statin adherence among patients with or at risk for atherosclerotic cardiovascular disease and documented nonadherence.

Sponsored by Wealthsimple

There’s a strange financial moment that happens in medicine.

For years, you’re training on a resident’s salary. Then, seemingly overnight, you’re an attending earning several times more. There’s finally money left after the bills are paid, and suddenly the financial advice that once seemed straightforward gets a lot more complicated.

Max your TFSA. Contribute to your RRSP. Save for a house. Pay down debt. Invest.

Okay. But in what order? For physicians, that answer can change significantly as income rises.

Take the classic TFSA versus RRSP question. Both let investments grow without being taxed while they remain in the account, but the tax treatment is very different. TFSA contributions are made with after-tax dollars and withdrawals are tax-free. RRSP contributions can reduce taxable income today, while withdrawals are generally taxed later.

That distinction matters more as your tax bracket changes. A resident earning $65,000 and an attending earning $250,000 could look at the same accounts and have very different reasons for where to put the next dollar.

Then life adds another variable.

Maybe buying a home is next. For an eligible first-time buyer, an FHSA allows up to $8,000 in annual contributions, to a $40,000 lifetime maximum. Contributions are generally tax-deductible and qualifying withdrawals toward a first home are tax-free.

And eventually, you may run out of registered room altogether.

That’s when a non-registered investment account can enter the picture. There’s no contribution ceiling, but unlike a TFSA or RRSP, investment income and realized gains may be taxable.

For incorporated physicians, there may be yet another decision: whether surplus money stays within the corporation and is invested through a corporate account, or comes out to fund personal goals.

There isn't one neat order that works for every physician. Your income, tax bracket, unused contribution room, debt, home ownership plans, corporation and retirement goals can all affect what makes sense next.

The important part may not be knowing what every acronym stands for. It’s knowing what your next dollar should do. Wealthsimple advisors can help build a financial plan around your income, goals and where you are in your career.

1: 💊 The next frontier for semaglutide? Children as young as 6. Novo Nordisk has reported that in its late-stage trial called STEP Young, about 40% of children aged 6 to under 12 treated with semaglutide were no longer considered obese after 68 weeks. Everyone in the trial also followed a reduced-calorie diet and increased physical activity. Novo says kids tolerated the drug much like adults and teens did in earlier trials. With prescriptions among US children under 12 already up 300-fold — despite GLP-1s not being approved for that age group — this could be the next big frontier for the drugs.

2: 😴 Would you prioritize sleep for $4.75? Research says: university students just might. Those who got bedtime reminders, morning feedback and a small cash reward for hitting 7 hours of sleep had 26% more nights meeting that goal. Their average sleep rose by about 19 minutes on weeknights, and their grades improved too. The biggest academic gains showed up among 1st-year students, especially in STEM courses and classes held in the middle of the day. An organization paying healthcare workers for sleep has yet to be established.

3: 🏒 The opposing team wasn’t the biggest threat at this hockey tournament. A new CMAJ report details how 4 Alberta youth hockey teams were exposed to carbon monoxide during a weekend tournament after a blocked heater exhaust released the colourless, odourless gas inside the arena. Players developed symptoms including headache, dizziness and nausea, but the cause wasn’t immediately obvious. The case is a reminder that CO poisoning can show up in unexpected places, and that clusters of similar symptoms should raise suspicion of an environmental exposure.

4: 🇨🇦 If you’ve lost the plot on the Canada-US trade war, here’s where things stand. After talks collapsed last month, Trump’s latest tariffs hit billions of dollars in Canadian goods, and Canada’s dollar-for-dollar response kicked in Tuesday, with new duties ranging from 15% to 50% on hundreds of US products. The fight is spilling beyond tariffs, too: Trump has threatened further action against Canadian autos and, most recently, to block Bombardier aircraft sales in the US unless production moves south of the border. So, what could cost you more? Here are some of the everyday items Canadians could soon pay more for.

405 million: the estimated number of UTI cases worldwide each year, as rising antibiotic resistance has researchers revisiting a century-old treatment: viruses that kill bacteria. Several trials are now testing bacteriophage therapy for recurrent and drug-resistant UTIs, including one recruiting 216 women across Canada, Europe, and the US.

75%: the share of producers of one famous French cheese who stopped production during this summer’s extreme heat, after dried-out pastures made its centuries-old recipe impossible to follow. And some of France’s other iconic cheeses could be in trouble, too.

5 days: how long aged mice given compounds found in edible sea squirts were trained on a learning and memory test before performing more like younger mice. The supplements were also linked to more and healthier brain synapses, less inflammation and, bizarrely, thicker, darker hair. Seafood and anti-aging? Sign us up.

💰 Save: 20% on regular-priced merchandise at participating Rexall locations if you work in healthcare. The discount runs through Healthcare Hero Thursdays. Just sign up for their free Be Well program before you go.

🫁 Learn: how to recognize when a persistent cough could signal something more serious, including the early signs of ILD and lung cancer, what to investigate and when to refer. Take the course.

🍳 Make: one of these editor-picked September dinners for when summer is over and figuring out what to cook every night is back.

📚 Read: Exit Party, the new novel from Canadian author Emily St. John Mandel, who wrote Station Eleven. It's set in 2031 Los Angeles after the collapse of the United States, which is a pretty irresistible premise. 

🎧 Listen: to this podcast that investigates the massive data centres powering the AI boom, why communities are pushing back against them and what our growing appetite for AI actually looks like on the ground.

🍕 Watch: this video tour of Europe’s tastiest cheap eats, from pizza in Naples and tapas in Madrid to Venetian cicchetti and Portuguese barnacles. Probably best not watched hungry.

First clue:

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your physician friends to beat your time.

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