MMI Practice questions
A biotech company was hired by the Military to develop a cure for Ebola. They successfully developed a vaccine to treat the symptoms of the virus and lowered the mortality rate for infected patients. Discuss the implications of this on a global scale.
- Cost, availability - Side effects, treating symptoms isn't the same as treating the disease - Not a joint operation if developed by US military. Who pays for it to be globally funded?
There is an outbreak of an incredibly contagious life-threatening disease. The disease is spreading across the country at a rapid rate and the survival rate is less than 50%. You are a senior health care administrator, and when the vaccine is developed, you have priority to receive the drug. Do you take the vaccine yourself or give it to another person? Why or why not?
- Should take priority: more exposed risk, use hospital power outage example - But should not: can't think of it as who gets treatment, but who is not. Have to give to so many other healthcare professionals Distributive justice: easier to explain to public, more ethically grounded
A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who understood the procedure. Can the patient give consent?
- case to case situation - Can't write them off just bc of schiz - Mental illness is not an immediate barrier
You are the emergency doctor on duty when two patients are rushed in within 7 seconds of each other and both desperately need a heart transplant. You only have one donor organ available. And both patients are a match and both are equally medically fit for the operation. One patient is a 35-year old single dad with 3 children, while the other is a 35 year old single male, who's an Olympic Gold medalist. Who would you give the heart to and why?
All excess facts. Pick who will NOT outlive the organ
You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. When should a physician step in to stop a cultural practice? Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine?
Avoid false claims of abuse at all costs, and mother had good intentions, no malice Calling CPS would alienate patient further and show insensitivity towards another culture Compare scar of surgery to bruises Aware parent the consequences, don't say the treatment is wrong but wonder if the delivery of treatment is correct
Robert Collier stated: "Success is the sum of small efforts, repeated day in and day out." Consider the quote you have just read. What does this quote mean to you in terms of how you live your life and how you will pursue your career?
Cross one bridge at a time pre-med example: started out small studying for my mcat, got a score I felt confident in applying with, now i'm here Interviewing from my first med school and it was the result of studying 50 flashcards a day
A 12-year old boy is diagnosed with a terminal illness (e.g., malignancy). He asked the doctor about his prognosis. His parents requested the doctor not to tell him the bad news. What should the doctor do in this situation?
Found out what child understands first, and respect parents request If patient is competent and old enough, disclose it responsibly Reason with parents
As a physician at a local hospital you notice that there is a man with an alcohol dependency who keeps on consuming the hand sanitizer offered at the hand sanitizer stands throughout the hospital. He is not a patient at the hospital at present but has been many times in the past. Consequently, there is often no hand sanitizer for public use. What do you do? Do you remove/change location of hand sanitizer stands? Do you approach him?
Hand sanitizer is useful for others and one person shouldn't ruin a valuable resource for others recognize the context. possibly mental health issues, very desperate, alcohol is an outlet get him help physically get him help mentally family, AA, whatever. Don't move. strategically placed
Nursing workload is a significant problem that needs to be addressed. Often nurses find they do not have adequate time to complete the tasks that are required of them in the time given each shift. How does this impact patient care? What are the implications for the nurses and the work culture and environment? What are the potential policy changes that can help alleviate some of this workload pressure?
Impacts patient care = more touch and go, don't spend as much time as they should Implications = nurses are distressed and will begin to have a divide, feel as though they are worth as much as doctors Policy changes = more staff to accomodate, higher salaries
In June 2011, the Vancouver Canucks lost the Stanley Cup and riots broke out in Downtown Vancouver. Discuss the impact on the community and the range of health care professionals at St. Paul's Hospital.
Large influx of people that the hospital likely was not prepared for Community? not sure it reflects their culture, and I'm sure most of vancouver (who didnt participate) would agree. Know west canada. Mob mentality
If you could have any superpowers, what would it be and why?
Luck or read minds
You are working alone in a convenience store as a cashier late at night. An older man comes in and buys a coffee. He is staggering, seems disoriented, and you smell alcohol on his breath. On the way out, he bumps into a shelf and knocks some cereal boxes off. He tries to put the boxes back, but cannot manage this task. What actions might you take in this situation? Provide reasons for your responses.
Put the cereal boxes back for him, ask if he's okay at least he's on his way out, he's not a problem there anymore problem = is he driving home? tag license plate just incase
You are a health researcher at an academic institution. You have been asked to work on a top-secret vaccine that would treat biomedical weapons or other communicable diseases. Before your break through, you are instructed by the government to stop all research and turn over all materials and copies of your work to be destroyed. You know you are very close to finding a cure. What do you do?
Rules are rules Try my best to explain before turning it over If I had to, I would. Wouldn't try to find a loophole around it or fudge results
A YouTube video of a group of junior high-school boys verbally abusing bus monitor Karen Klein went viral this July. The abuse included taunts, profanity, physical ridicule, and even threats to Karen's person and home, ultimately resulting in her breaking down and crying. The video prompted an investigation on the part of school officials and local police. They were suspended from school and given 50 hours of community service. Klein stated that she would not press charges, partly because of the flood of criticism aimed at the boys. Do you believe the boys' punishments were just, or what could have been done differently?
She received a lot of help Do not believe punishments were just. Acknowledge programs aimed for kids to stop bullying instead of preventing, since preventing bullying has seemingly become futile Should be expelled. These are legitimate hate crimes. even expulsion seems tame
A patient requests needles and syringes at his/her local pharmacy. They do not present with a prescription, and based on the records you can access, they are not receiving treatment for diabetes. Do you sell the syringes or not?
State laws for this stuff Sell regardless because you can't just make assumptions Can't get from me? They will somewhere else. Not necessarily being a hero Can't get it from me? use an old one and get AIDS
What is your opinion about stem cell research using fetal tissue?
Stem Cell Research covers so many areas - cancers, neurodegenerative diseases, diabetes, spinal cord injuries Use blastocysts - if you believe life starts at conception, you cannot kill these Best solution - Find stem cells that are as potent as embryonic stem cells but do not need human tissue to grow
Do you think medicine should be more about changing behaviour to prevent disease or treating existing disease?
The former use babies in river example Acknowledge limitations, these diseases will still arise because not all will change behavior need both
A 17-year old boy lives independently. He is married and has one child. He wants to participate in a medical research study. Does he need his parents' permission?
if the patient is emancipated or not financially dependent on their parents, living independently physically and financially then no
If the Prime Minister/President were to ask your advice on one change that could be applied to the healthcare system that would improve it enormously and have the greatest positive effect, how would you answer?
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Discuss any topical health care issue that is unique to the region for Med School you are applying to?
13% of patient in Arizona do not have healthcare insurnace Prevents them from seeking preventative measures (smoking, early detection)
A patient with Downs Syndrome became pregnant. The patient does not want an abortion. Her mother and husband want the patient to have an abortion. What should a physician do in this situation?
Below age of 18, parents decide Above 18, psychiatric consultant to determine competency
You are the Dean of Admissions at a very competitive medical school. One day as you are leaving your office at the end of the day, you are approached by the mother of a student who was recently rejected from your school. The mother explains that her son has a 4.0 GPA, scored 98th percentile on the MCAT, and has numerous awards and many relevant accomplishments. She wants answers right now and she demands to see every applicants' file. Go inside the room and talk to the parent.
Cannot do that. Tell her the spiel without being confrontational, it's a competitive field and stats do not tell the picture. Extracurriculars are not exclusive to her son. It's a large and competitive pool out there and it really hurts to turn down competitive applicants who would be very successful doctors. limited in who we can take, but we do have the luxury of choosing. Becomes more confrontational? Call security. Interview? Need the intangibles - thigns that can't be tracked or written on paper
You are the director of a financially struggling hospital. You have been unable to generate enough revenues to implement some very important initiatives at the hospital and are at risk of inevitable service cuts, if more funding is not secured immediately. The only secure source of funds that is being offered is by a cigarette company. They are willing to provide your hospital with all the resources required in exchange for advertisement at your facility. What will you and should you do as the hospital director?
Deny My school did the same thing (Bacardi School of Business) Money is important, but so is your integrity. I understand your financially struggling but can't be desperate
A 14-year-old patient requests birth control pills from you and asks that you not tell her parents. What would you do?
Even though below age of consent, healthcare exceptions to STI, mental health, family planning Respect confidentiality (law) but continue asking why Don't just assume sexual activity. Control periods
Regardless of what we do in life, there will be times when we will come into disagreement with an authority figure or a superior. Describe a time when you came into conflict with an authority figure and how you dealt with it.
Have to be respectful Coaches - use chef example. acknowledge depends on what we are doing. playing a game or storming normandy
What experiences have you had (and what insights have you gained from these experiences) that lead you to believe you would be a good physician? Discuss this question with the interviewer
Intangibles spiel communication, experience with diversity, teamwork from sports
As an occupational therapist, you work with clients of all ages. One of your younger clients begins searching you on the Internet and contacts you through social media sites. In this age, it is common for people to have many various personal and professional web profiles through sites like Facebook, LinkedIn, Twitter, Instagram, etc. What measures would you take if this happened? What would you do if the client would not stop?
Make it private, maintain borders of professionalism Explain to client why it is not professional for this Would not stop? End relationship with client
In recent years, there has been an increase in popularity of full contact sports, such as Ultimate Fighting Championship (UFC) and boxing. Should doctors have a role in regulating such sports?
Other than be on standby in case of emergency? No This is their profession, and we have ours. Our responsibility lies in tending to them. Do we regulate war?
Due to a shortage of physicians in rural communities, some policy-makers have suggested that medical programs preferentially admit students who are willing to commit to a 2 or 3 year tenure in rural areas after graduation. Consider the broad implications of this policy for health care and the costs associated. Will this policy be effective?
Pros = unnoticed ailments treated, agricultural professionals do not have to move/take time away Cons = More does not necessarily mean better, more efficient to fix the bad habits of rural citizens, might be logistic nightmare. Country areas can be huge. need physicians covering all
When is it appropriate to participate in assisted suicide of a patient? Why or why not?
Pros: Your body, your choices, sometimes death is the best option Cons: doctors are healers, this shifts how society views the job. Slippery Slope Legality of it. Oregon, I believe? Best to focus on end-of-life care, there will always be a stigma associated with the word "suicide" alone
Imagine your friend's father is 70 years old and has lived in major North American City his whole life. He is taken to the emergency department at the local General Hospital. He has had good health until now and this is the first time he has been to hospital of any kind since he was 20 years old. What changes in the healthcare system and environment in the hospital do you think he would notice?
Technology, more expensive less time spent, use of PAs and NPs, Patient empowerment, more focused on making it easier on patients
Your local Paediatric Association has recommended that circumcisions 'not be routinely performed'. They base this recommendation on their determination that 'the benefits have not been shown to clearly outweigh the risks and costs'. Doctors have no obligation to refer for, or provide, a circumcision, but many do, even when they are clearly not medically necessary. BC Medicare no longer pays for unnecessary circumcisions. Consider the ethical problems that exist in this case. Discuss these issues with the interviewer.
- Deeply rooted in culture, seems as neglecting some cultures - Who should pay? Cosmetic, risk involved, no health benefit, makes sense for patient to pay extra for it - Corporate or Government money shows culture preference
Your mother calls you and asks you to help with a major family decision. Your maternal grandfather is 70 years old and has been diagnosed with a condition that will kill him some time in the next five years. He can have a procedure that will correct the disease and not leave him with any long-term problems, but the procedure has a 10% mortality rate. He wants to have the procedure, but your mother does not want him to. How would you help mediate this issue?
- Is he competent? He can decide for it himself - Best we can do is give our opinion, but we can't force it on him -
A Kootenay town runs a health-collective that provides various alternative and traditional forms of medicine. The physicians there encourage parents of small children not to vaccinate their children. Discuss the positive and negative impacts of this opinion.
- Vaccines are the ultimate in prevantative medical techniques, studied (ingredients are safe in the amounts used), adverse effects are rare, herd immunity, smallpox and polio - people think immunity should be built naturally, use example of makeshift medical techniques and high technology...medicine needs to be futuristic because we need the most advanced techniques available. We still have a long way to go in medicine
A physician picked up a car accident victim from the street and brought him to the ER in his car. He did not want to wait for an ambulance because the patient's condition was critical. Physical examination in the ER reveals quadriplegia. Is the physician liable for this consequence?
- depends, good samaritan law - close to death? bring him - not? irresponsible
A physician went to vacation for 2 weeks. He did not find another physician to cover him. One of his patients with hypertension developed severe headache. The patient has an appointment with the doctor as soon as he comes back from vacation. The patient did not look for another physician and decided to wait. The patient suddenly collapses and was diagnosed to have intracranial haemorrhage. Is the physician responsible for this patient?
- legal obligation to arrange care for patients while gone - seen it from my father on vacation, always on phone and an open line with other physicians - Did doctor make sure to set physician up before leaving?
Discuss one of these health care issues: human genome project, AIDS, abortion, the right to die, the cost of health care, and genetic engineering
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In a class of 78 students 41 are taking French, 22 are taking German. Of the students taking French or German, 9 are taking both courses. How many students are not enrolled in either course?
24
Discuss the pros and cons of legalizing marijuana. How does this impact a physician's present ability to write out prescription for 'medical marijuana'? Would legalization cost the health care system more or less after it was passed?
Acknowledge for as long as it has been around, don't know much about it (no research) Does have adverse effects but has treated more serious conditions in the past I am a father of child with seizures. Do I care about potheads? Never prescribe something that is not legal, but once it is, important to have a repetoire of options
Your company needs both you and a co-worker (Sara, a colleague from another branch of the company, who is gripped by fear of flying since one of her friends narrowly escaped being at the World Trade Centre when it was destroyed) to attend a critical business meeting in San Diego. You have just arrived to drive Sara to the airport. Sara is in the room.
Ask her if she's ready. Don't need to go in-depth because going in-depth brings back in-depth memories. Are you ready? Look her in the eyes "we'll be alright." It's normal to be nervous and I'd tell her even I get nervous too. try not to make a big deal out of it. Compare it to dogs and thunder
Your neighbor has a five-year-old child who has many decayed teeth. The mother asks you for advice because she knows you volunteer for a dental professional and her child is in pain. The mother needs a dentist who will accept monthly payment for treatment. You provide her with different options and coach her on how to seek dental care for a child. One week later you see the mother and ask if she was able to acquire care for the child. She says no. What do you do?
Ask her why (if she's comfortable) Acknowledge it's hard for dentists to alleviate financial costs besides delaying payments try to find programs. Happy Smiles in Canada for example -
You are a 3rd year medical student doing hospital rotations. A fellow medical student who is doing rounds with you often show up to these sessions tired, messy, hung over, or even drunk. One day you found him in the lunchroom unaccompanied, so you decided to talk to him. Please enter the lunchroom.
Ask him what's wrong? Stressed? Family? Anything bothering him? If nothing, that's a problem. Call him out and tell him why I asked. It's not good If something, help him with better alternatives. NEVER OFFER ADVICE I AM NOT QUALIFIED FOR
Your best friend, Jennifer, calls you to tell you that she has been rejected for the 3rd time from all medical schools that she had applied to during the previous application cycle. She invites you over to her house to have a chat about her future plans. Go inside the room and speak with Jennifer.
Assess, be realistic Giving false hope is worse than being brutally honest Even the top candidates have a plan B
You are the executive director of a law firm. You find out that your articling student has accidentally destroyed an important piece of evidence that would have cleared a wrongfully accused person. If you reveal this to the authorities, your student will not only lose her job, but will face jail time for destroying court evidence. What will you do in this situation? What if you had information that the accused person is indeed guilty of other unrelated but more serious crimes for which you do not have any evidence that would hold up in the court?
Be respectful, non accusatory, and make sure it doesn't happen again obligation to report, but also an obligation to let them know it was an accident. even advocate leniency. If it was on purpose, I have to take blame because I am the executive directorand acknowledge it was an accident on my end
You are a family physician. One of your patients, Mark, did not attend one of his classes and missed an important exam. He told you that his teacher would like a doctor's note explaining his absence from class; otherwise, he will receive zero, and all hell will break loose. He wants to you write a note for him, indicating that he was not feeling well enough to write the exam. Not able to find any physical symptoms, explain how you would deal with this. Enter the room and talk to Mark.
Benefit of the doubt, he might actually be sick. Could've waited it out too long and symptoms were alleviated. Implementing moral policies is not part of our job description especially for something this trivial If he was lying and we write the note, we are enabling him to lie again in the future From his position, school is important and students are stressed. The implications of him getting a zero is larger than my integrity of writing him a note for lying
What is the difference between Medicare and Medicaid? (American Question)
Both help cover healthcare costs, but both have different requirements Medicare = long term care for elderly while Medicaid = covers health costs for poor Medicare = 65 and above or with certain disabilities, Medicaid = low income of all demographics Can have both, dual eligible, work together
You are an emergency room physician at a local hospital. A patient comes in requesting painkillers for his back. Upon reviewing his file, you realize that he frequently comes to the hospital requesting painkillers and he has already capped his prescription for the month. Upon examination, you notice no new injuries to indicate an increase in painkillers. You politely tell patient that you will not increase his dosage or re-fill out another prescription for him. He tells you that he will go and inject himself with heroin right now if he does not get the painkillers. What do you say next? What do you do?
Can't give him drugs, can't report him either tell him he doesn't need them and this might be a problem of a larger mental health issue Drug abusers are a dime a dozen. refer him for mental health
You are the father of a 12-year-old boy. Your son's friend, who is also your neighbour, is playing with your son in the backyard. As you approach them to ask them about lunch, you notice some severe bruises on the friend's arm and upper neck. You are worried about these obvious signs and decide to approach your neighbour (the young boy's father).
Can't just assume ask him if he knows about the bruises but don't be confrontational. Might have a logical explanation If it is abuse, understand from the parent's POV as well, but definitely try to nip in bud
Universities are commonly faced with the complicated task of balancing the educational needs of their students and the cost required to provide learning resources to a large number of individuals. As a result of this tension, there has been much debate regarding the optimal size of classes. One side argues that smaller classes provide a more educationally effective setting for students, while others argue that it makes no difference, so larger classes should be used to minimise the number of instructors required. Discuss your opinion on this issue with the examiner.
Can't take shortcuts, and I feel the larger class sizes is such It does matter, but it's also more of a student. Think of how students take into consideration class size when choosing colleges (some prefer to go invisible, others don't) Have to realize colleges are a business, can't survive without making money. Understandable
How does Canadian health care system compare to that of Britain's system vs. the American system?
Canada has universal healthcare, but paid for by taxes. America has private companies Only canadian residents qualify. illegals and expired visas are controversial in america
What is the difference between HMOs and PPOs? (American Question)
Differences in the size of plan, plan costs, and ability to see specialists HMO = Generally more affordable but only if doctor is in network, need a PCP to determine treatment PPO = Have network, but less restrictions to see outside. Don't need PCP to authorize treatment. More expensive, deductibles are common
You are a genetic counselor. One of your clients, Linda, had a boy with a genetic defect that may have a high recurrence risk, meaning her subsequent pregnancies has a high chance of being affected by the same defect. You offered genetic testing of Linda, her husband, and their son to find out more about their disease, to which everyone agreed. The result showed that neither Linda nor her husband carry the mutation, while the boy inherited the mutation on a paternal chromosome that did not come from Linda's husband. In other words, the boy's biological father is someone else, who is unaware that he carries the mutation. You suspect that Linda nor her husband are aware of this non-paternity. How would you disclose the results of this genetic analysis to Linda and her family? What principles and who do you have to take into consideration in this case?
Discuss it privately, can't just assume it was infidelity Maybe husband did know? Benefit of the doubt, re-test for the sake of mind of the couple Tell it like it is and don't imply anything else. Say the facts without emotion
Every week, your classmates gather at the local coffee house to review the lessons from that week. In the last month, everyone has been working on a major paper on Roman history, which accounts for 40% of the course grade. One of your classmates has copies of two of the papers that last years' students wrote for the same course. Your classmate has e-mailed copies of the paper to you and the other people in the group. What would you do in this situation and explain why? Discuss what values and choices are relevant in this situation? What are the implications if you decide to read the paper from last year?
Don't copy, but use as an example especially if they were great papers Mimic the best. Follow the same structure, emphasize the same facts, see the level of detail they use Compare to gen chem 2 professor
A physician became sexually involved with a current patient who initiated or consented to the contact. Is it ethical for a physician to become sexually involved?
Exploitative and taking advantage Clinical judgements can't be clouded by personal concerns
You are on holiday at a Mexican beach resort with some friends who are staying one floor down from you. In the middle of the night, a large earthquake takes place, and the building you are in is severely damaged. You have injured your leg, suspect it might be fractured, and you hear someone yelling for help near by. What would you do?
Have to help myself first before I can help others (think airplane oxygen masks) See if I can walk. if not, have to try to use my phone for help
In June 2011, the infamous Vancouver riots took place after their hockey team lost in the Stanley Cup Finals. Stores were ransacked and cars were burned. Hundreds of people were injured and sent to overcrowded hospitals. As the police chief in Vancouver, what measures or policies would you put in place to make sure this does not happen again?
Hospital space for major events such as these. Tough to predict because of mob mentality Compare it to the eagles superbowl. This was unusual for Vancouver, but sports-related riots have a history in Philadelphia
You are a specialist who has just received lab results with regard to one of your patients. The results indicate that your patient, a single mother of two young boys, has been diagnosed with a terminal cancer and that she will only have 4-6 months to live. There are not many treatment options aside from a few experimental procedures that are still under study. There are some alternative treatments available in Europe; however, they have not been validated by scientific studies in North America. What would you say to your patient once they are in the office? If an alternative treatment, without scientific evidence for its efficacy, existed for a terminal illness would you recommend it to a patient?
I could recommend it but acknowledge that there is no safe backing for it tell her to pursue at her own precaution and give my honest opinion best we can do in these situations is make patient as informed as possible. If it did any harm, I wouldn't recommend it. i would have to know the ins and outs of it first
The apartment next door is for rent. The previous tenants were nothing but trouble and have been evicted. Your landlord tells you about a new tenant he has found with more promising credentials. As he tells you about him, you realize that he is one of the drug addicts who was in treatment at a halfway house you volunteer at. You know that this person has a history of relapsing and may not have been completely honest on the application form. Do you warn your landlord about the person's history or do you keep your knowledge confidential?
I tell him. Irresponsible to not. Imagine the repurcussions if an incident happens and your landlord finds out you knew this would happen delivery matters: don't say "he could relapse" say "has a history of relapsing" don't say opinions. say facts
You enter the cafeteria at work. You sit down to eat with a group of male colleagues who are having a conversation about a female colleague of yours. The comments they make are not very professional and can be deemed rude and offensive. You feel very uncomfortable. What do you do? What do you say to your male colleagues? If this became a regular occurrence, even after you speaking to your colleagues, what other steps would you take to resolve the situation?
If I don't want to create a divide, don't say anything. Don't contribute Next time avoid them. Sometimes people will contribute just to fit in and this isn't one of those instances I'd only speak up if it became too vulgar or if they were said directly to the colleague. A regular occurence? don't associate or speak up Wouldn't tell female colleague because "what they don't know won't hurt them" applies here and could create unnecessary tension
You are a research supervisor and you notice that one of your graduate students has been sleeping in the lounge area within the research facility, because your student is recent international student she cannot afford to rent a place of her own with her student stipend. You are aware that the facilities safety policies prohibit overnight stays. How do you approach the student about this?
If I have the resources, offer a place to stay until she can find. Need her at her best because you are a supervisor Good relationship is important, but don't want to show favoritism for other graduate students. Find a way for her to encourage asking other graduate students because if I ask other graduate students, I would be airing out her private issues
"Liberation Therapy" (LT), a vascular operation developed to potentially cure multiple sclerosis (MS) in certain patients, has recently come under very serious criticism - delaying its widespread use. Among other experimental flaws, critics cite a small sample size in the original evidence used to support LT. As a healthcare policy maker, your job is to weigh the pros and cons in approving novel drugs and therapies. Please discuss the issues you would consider during an approval process for LT.
If this is my job, I'm knowing the ins and outs of all the research, including things that might not be published like limitations Costs vs benefits. Sustainable? long term? How much? Why was LT under so much scrutiny in the first place?
You are a PhD student and your supervisor Prof. Harry, has recently published the results of his publicly funded research project with the intention to commercialize his discovery. What are your views about university professors that use public funding to create for-profit solo ventures?
It was publicly funded, but it was his work People donate not expecting anything in return, they donate in the hopes that their contributions are going towards advancement of science See both sides. Initially wrong, but it's not like the public did the project and he took credit
Statistics have shown that effects of advanced age such as changes in vision and response time may adversely affect elderly drivers' ability to drive safely. As a matter of fact, many doctors discuss the issue of stopping driving with their older patients as a precaution for the safety of theirs as well as the public's. Do you think older drivers have to give up driving when they reach a certain age?
Legitimate concern, not the right method Can't take driving away because they depend on it at times and not all older drivers have the same impairments. Age can't be a hard barrier, but things like eyesight and mental health can
Recently, the Prime Minister suggested the idea of deterrent fees (a small charge, say $10, which everyone who initiates a visit to a health professional would have to pay at the first contact) as a way to control health care costs. The assumption is that this will deter people from visiting their doctor for unnecessary reasons. Consider the broad implications of this policy for health and health care costs
Might go from one extreme to another - see doctor too much, see doctor too less which is the lesser of the two evils? One makes it become more and more of a business This is spot treatment, not source treatment. Need to have better education
Recently, certain hospitals have been charging patients $29/day for their hospital fee on top of the fees charged to MSP. What are the implications of this policy? Discuss both positive and negative impacts with the interviewer.
Might make sense strictly by numbers when you consider they are being fed and housed and taken care of is a hospital setting residential care? or still public care? Charging people at their most vulnerable position. Some can't afford this, especially acute care. Might make people think twice before going to the hospital
The man who lives next door to you often rides his bicycle in the company of his two young children but without a helmet. In fact, on several occasions you have seen him riding with his helmet hanging by its straps from the handlebars. His young children sometimes wear a helmet, sometimes not. If the man fell off his bicycle and hurt his head in a way that would have been prevented if he had worn a helmet, would it be reasonable to ask him to contribute towards the treatment costs for his injury?
No, similar argument to health care right/privelege and smokers His loss is the injury, not the payment. Should learn his lesson, best we can do is tell him to wear a helmet
A proposed bill would require all individuals to vote in federal elections or face a $100 fine. What do you think about this bill?
Not good it's our constitutional right to abstain from voting Those who don't want to vote but are forced will just write-in something silly Shouldn't be forced to vote for the lesser of the two evils and if you don't believe in any of the candidates, you shouldn't vote just out of "whatever is left." Has to be earned
You are a cardiologist at a local hospital, who just finished a shift and has a tight run to your daughter's high school graduation ceremony. As you headed off to the door, Jennifer, a patient who knew you well, saw you from the waiting room and grabbed your attention. "Doctor! I have a bad chest pain. Please stay for a bit. I'll feel much better if you were here." Enter the waiting room and talk to Jennifer.
Obviously be polite, but you are a human being too. It's fine to call whoever is in charge.
You are the team leader of a group assignment and two of your group mates inform you that one of the group members, Tim, has a very strong body odor and they are unwilling to take part in any further group meetings until Tim addresses this issue and takes care of his personal hygiene. Tim is waiting inside the room, go inside and discuss this issue with him.
Own the problem myself and don't say that others are complaining. That would cause further alienation But be aware of a medical problem If it's cultural differences of food? Just recommend some mouthwash. Try to relate
The City of Vancouver has taken great measures to increase accessibility to alternative forms of transportation (Canada Line, Hornby and Dunsmuir Bike Lanes, Proposed Evergreen Line, and Burrard Street Bridge closures). Discuss the impacts (both positive and negative) of these decisions?
People who can't afford cars, safer for environment (carbon footprint), reduce congestion, safer Less lanes for cars, more traffic, are there enough cyclists and pedestrians to make the increased car traffic worth it?
A couple has decided to have a child through artificial insemination. They asked the physician for sex selection of the child. What should a physician advise in this situation?
Remove myself from imposing judgement, honor patient requests If disagree, send to another heal professional
As a physiotherapist, you are referred a 16 year-old for treatment of severe burns that limit function on the patient's arms and hands. Upon examination, you notice other burn marks and unexplained bruises on the patient. After working with the patient for a few weeks, you ask about the other marks on the patient's body. The patient admits to being abused by their parents but begs you not to tell anyone. What do you do?
Respect autonomy but tell her she should report this If she is scared of the repercussions, tell her there is help for that. She is of age for confidential healthcare
Dr. Blair recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr. Blair doesn't believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches, because he believes that it will do no harm, but will give them reassurance. Consider the ethical problems that Dr. Blair's behaviour might pose. Discuss.
Same thing as placebo Doctor has responsibility to give all the facts. His opinion is his opinion and it's up to the patient to decide Put patient in a position to make an informed decision If no harm done, this is a matter of patient trust and integrity
An eighteen year-old female arrives in the emergency room with a profound nosebleed. You are the physician, and you have stopped the bleeding. She is now in a coma from blood loss and will die without a transfusion. A nurse finds a recent signed card from Jehovah's Witnesses Church in the patient's purse refusing blood transfusions under any circumstance. What would you do?
Should I override the patient's wishes in this case Must be respected since she is incapable of making a decision at the time Patients have limited right in choosing their therapy...unlimited right in refusing treatment
You are an occupational therapist that works with a population with complex psychiatric histories. One of your older clients has been recently diagnosed with neurodegenerative disease, and she has schizophrenia. There is a history of the client's children neglecting her needs and taking advantage of the client financially. Nevertheless, the client has a relationship with her family and they want to be named the primary decision maker for the client. How do you work with the client and her family knowing the past history of neglect and present needs of your client?
Stay out of it. Leave personal judgement and inference out. Don't know entire story Tell them about the time commitment needed to be the primary decision maker? Want to take advantage of her vulnerability? Have to take care of her vulnerability too Denying them th status would strain their relationshiop, further alienating her when she needs help
Your 5 year old nephew asks you, "Why is the sky blue?" How would you answer him using a series of simple scientific experiments?
Stick your hand out of the window when driving. Do you feel the air? Standing still, do you still feel the air? Light works the same way as air. We only feel it when it bounces off something, we only see light when it bounces off something Light from the sun hits particles of nitrogen and oxygen that surround the earth. Blue light bounces the best. do you ever see a blue sky when the sun isn't out?
A friend of yours has a cat named Jingles. One day your friend calls you and tells you that Jingles is very ill and in need of a vet. Unfortunately, Jingles does not have insurance and the cost of seeing a vet will be around $1500, which your friend has to pay out of pocket. She cannot afford the cost and asking you for help. What would you do and say in this situation?
This is why you need insurance You spend as much as you need for the health of something as important as your pet. But this can be avoided. Try not to offer monetary help and guarantee somethign I can't
How would you advise patients who are interested in visiting an acupuncturist or a chiropractor?
This will come up Ask if there are any current supplements taken See if they are interfering Interact with her other acupuncturist or chiropractor Find a midway point Supplements are that, supplements to diet and exercise. Cannot replace it
"Education is the kindling of a flame, not the filling of a vessel." - Socrates What does this quote mean to you? Go inside the room and discuss your thoughts with the interviewer.
We aren't trying to just fill our brains with as much knowledge as possible Education should be the catalyst to exploration and lifelong learning
What is your favorite quote? Discuss the quote and what it means to you with the interviewer inside the room.
When you hear hoofbeats, think horses, not zebras Play it safe. I am very by-the-book, and I will think my chances thoroughly. Reflected sports and my studies. Conservative defense, very rarely would I be aggressive. It has cost me before, but I'd rather say "that was a good play by him" instead of "that was a mistake on my part." acknowlegde chances and can't win them all Also reflects my weaknesses
Your friend Jason hasn't come to class for a few days. Being a hardworking pre-med student, he very seldom skips classes. You know that he is applying to medical school in the past several weeks. You called his house and he said you could visit him. You decided to pay him a visit after your classes. Enter the room and talk to Jason.
Wouldn't come in thinking I need to lecture him Just act like I normally came to hang out and then ask what's up if he's stressed. Give a listening ear When you come in saying something along the lines of "we need to talk" it makes things unnecessarily tense
In 2007, the American Family Physician Journal published an article exploring the issue of physicians as role models, using a scenario in which an obese physician is offering nutrition and exercise counselling to his obese patient. According to the author's research, patients have more confidence in health-counseling advice from non-obese versus obese physicians, and physicians with poor personal lifestyle habits are less likely to counsel patients about a healthy lifestyle. Based on these research findings do physicians have a responsibility to act as healthy role models to their patients? Please elaborate.
Yes But doesn't mean physicians aren't humans: humans are flawed too Completely different if a doctor rationalized his flaws but criticized others. If a doctor admits it's not good, it's fair. Acknowledge it's hard for the patient
Is it ethical for doctors to strike? If so, under what conditions?
Yes, it's not like patients get completely abandoned shared responsibility of healthcare How people see doctor. Professionals? yes. Noble health guardians? no
Do you think general practitioners have an obligation to report their patients' health status to a public health agency, if their patients have active infectious diseases?
Yes, physicians job to be aware of issues that aren't just exclusive to the patients they see Department of health needs to know these things to do their job might not be obligated to, but need consent first
A member of your family decides to depend solely on alternative medicine for treatment of his or her significant illness. What would you do?
Your body, your choices Are they competent? Can't control others, but can still provide insight.
A woman enters the emergency room with stomach pain. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm. The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. The woman is an exotic dancer; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. Even after much pressuring from the physicians, she adamantly refuses surgery. Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. They anesthetize her and surgically repair the aneurysm. She survives, and sues the hospital for millions of dollars. Do you believe that the physician's actions can be justified in any way? Is it ever right to take away someone's autonomy?
Your body, your choices Post-surgery quality of life is important to consider as well Was she really not in a state of mind? There are guidelines for deciding incompetent patients, this is not one respect patient's rights
You are a current undergraduate student. During the week of graduation, you attend a number of parties around the Lower Mainland with your best friend, Kelly. The last party is held at a campground in Squamish. The morning after the party, you receive a call from Kelly. She asks that you come over and talk. Kelly reveals that she left early and drove home despite drinking that night. Enter the room and talk to Kelly.
don't just automatically assume it was a bad BAC assess her interpretation of events give her some benefit, but not to the point where it is encouraging most importantly, she already knows the repercussions of what could have happened. doesn't need a reminder. only needs to be reminded it can't happen again
The parking garage at your place of work has assigned parking spots. On leaving your spot, you are observed by the garage attendant as you back into a neighbouring car, a BMW, knocking out its left front headlight and denting the left front fender. The garage attendant gives you the name and office number of the owner of the neighbouring car, telling you that he is calling ahead to the car owner, Tim. The garage attendant tells you that Tim is expecting your visit. Enter Tim's office.
easy
A 18-year old man is diagnosed to have suspected bacterial meningitis. He refuses therapy and returns to the college dormitory. What should a physician do in this situation?
physician should report to the college authority and recommend that the suspected individual should be isolated during the course of his illness. why? putting others at risk. Out of my position to take manners into my hands, still have a responsibility as a physician for public health
In 2007 the Journal of Dental Education surveyed over 1000 dental students and found that 74.7% admitted to some form of cheating during their undergraduate career. The university has asked you to be part of a student focus group to determine how to reduce the incidence of cheating. You are well aware of this behavior as you have observed the reusing of old assignments on many occasions. What suggestions would you make to help reduce the incidence of cheating and improve the academic integrity of students?
tell them why students are so hesitant to report cheating. tarnished reputation, alienation, all have to be considered as heavily as academic integrity stop reusing assignments, make it more difficult to cheat, can still use old assignments for studying but need to change questions (think gen chem 2 professor) some form of anonymous reporting
If you have the choice of giving a transplant to a successful elderly member of the community and a 20-year-old drug addict - how do you choose?
thought process in context, not just a vacuum Are health issues actually caused by drug addiction or old age? can't just write off prospect based off drug addiction or old age Give the kidney to the patient who will outlive the organ
Some medical schools have a preference for selecting medical candidates from certain geographical locations. What are your views about such selection policies? Please discuss your answer with the interviewer inside the room.
totally understandable acknowledge physician shortages, more likely to stay afterwards. biggest issue Two candidates say they love the area but only one of them has actually lived there. Who do you trust more?
