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Practice Interview Question Thread

chinaski

Regular Member
Some general points:

The responses above tend to under-estimate the reality of what it's like when an older family member actually requires assistance in living. It's often a case of that person being highly dependent on others for even simple things like going to the toilet, showering, dressing, cooking etc. There is also not uncommonly cognitive and behavioural issues that add another layer of complexity, vulnerability and distress. The dynamic between the parent and child then shifts, so the child has to assume a "parenting" role (and conversely, the parent has to reconcile becoming more dependent). This shift in the relationship is seismic in nature and often associated with a great deal of conflict and grief. There's also often not a lot of room to compromise. When someone needs care, they need care. It's a bit like arguing that you could compromise with a three year old child about the level of supervision and help you impose in day-to-day life: no amount of sensitive conversations changes the reality that they are not capable of being independent and safe by themselves.

It's important to understand this, because your responses should be framed in a way that tries to appreciate the perspective of each person in the situation. If you under-estimate the gravity of the situation, then you under-estimate and over-simplify your insight into what it's like for each person. Also, consider the cost and feasibility of some of the solutions you are proposing! The cost of private nurses is prohibitively expensive, for instance, and out of reach of most people.

Finally, with respect to Question 4: you guys really need to provide a less egocentric response here. I'm reading a lot about "me, me, me" and a suggestion that the onus and responsibility lies on the grandmother to adapt and accept you, but critically, no reciprocal consideration. Ultimately, if you provide a response that suggests little-to-no empathy or understanding for what it's like to be the conservative grandmother, and an assumption that your position is automatically justified (ie she must change in order to accept your ways), then this suggests a general lack of flexibility and ability to compromise on your part. Also, you need to also make room for the possibility that she might actually teach you something beneficial - her perspective isn't necessarily wrong.
 
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Sokka

Guest
Some general points:

The responses above tend to under-estimate the reality of what it's like when an older family member actually requires assistance in living. It's often a case of that person being highly dependent on others for even simple things like going to the toilet, showering, dressing, cooking etc. There is also not uncommonly cognitive and behavioural issues that add another layer of complexity, vulnerability and distress. The dynamic between the parent and child then shifts, so the child has to assume a "parenting" role (and conversely, the parent has to reconcile becoming more dependent). This shift in the relationship is seismic in nature and often associated with a great deal of conflict and grief. There's also often not a lot of room to compromise. When someone needs care, they need care. It's a bit like arguing that you could compromise with a three year old child about the level of supervision and help you impose in day-to-day life: no amount of sensitive conversations changes the reality that they are not capable of being independent and safe by themselves.

It's important to understand this, because your responses should be framed in a way that tries to appreciate the perspective of each person in the situation. If you under-estimate the gravity of the situation, then you under-estimate and over-simplify your insight into what it's like for each person. Also, consider the cost and feasibility of some of the solutions you are proposing! The cost of private nurses is prohibitively expensive, for instance, and out of reach of most people.

Finally, with respect to Question 4: you guys really need to provide a less egocentric response here. I'm reading a lot about "me, me, me" and a suggestion that the onus and responsibility lies on the grandmother to adapt and accept you, but critically, no reciprocal consideration. Ultimately, if you provide a response that suggests little-to-no empathy or understanding for what it's like to be the conservative grandmother, and an assumption that your position is automatically justified (ie she must change in order to accept your ways), then this suggests a general lack of flexibility and ability to compromise on your part. Also, you need to also make room for the possibility that she might actually teach you something beneficial - her perspective isn't necessarily wrong.
Thanks for your response, really appreciate it! Would you consider writing out a sample response so we have a good example of exactly what to do?
 
S

Sokka

Guest
I don't have time to do your prep for you. ;) Besides, these questions exist to test your insight, empathy, flexibility and motivations, not mine! Parrot learning "model" answers isn't what you should be doing.
Hahaha I didn’t mean it like that!
I just thought that by seeing a high quality response I’ll be able to compare my answers and identify exactly where my weaknesses are, and know how high of a level to aim for. Atm I’m kind of going in blind with no knowledge of what an amazing response is (and as a result my responses aren’t that great).
If you don’t have time though, no stress :)
 

Scorpion

Member
Hahaha I didn’t mean it like that!
I just thought that by seeing a high quality response I’ll be able to compare my answers and identify exactly where my weaknesses are, and know how high of a level to aim for. Atm I’m kind of going in blind with no knowledge of what an amazing response is (and as a result my responses aren’t that great).
If you don’t have time though, no stress :)
While I'm only a yr 12, I have read through several of your answers and think you're doing fine so far. I believe you could improve upon exploring different possibilities with questions instead of assuming a situation will progress in a certain way. This lateral thinking will come with practice but maybe try drawing out a mind map to help you start doing this? I also think you would benefit from explicitly considering each situation from the perspectives of each stakeholder. If somebody has cheated off you in a test for example, you need to not only consider its impacts upon you but also those of the one who cheated and the rest of the class.

In addition to this a typed model answer, while potentially beneficial, does not replicate an interview situation, and there is a difference between being able to type a model answer and being able to speak it. I would encourage you to time & record yourself answering a question like this, listening back to it and critiquing yourself. You will likely pick up on areas to improve upon yourself, and you can always type out the key points you made here to see if we can offer any further feedback.

And finally, don't lose faith! Be grateful you started interview prep early and you still have plenty of time before interviews to become proficient at answering questions. You can do it! :)
 

dani01

Member
Hi this is my first go at a prompt since so far I've just been looking into other topics. Would love some some constructive criticism.

Imagine you are working as a GP in metropolitan Sydney. Matthew, a 45 year old gardener has come in to your clinic complaining of back pain after he carried a 15 kg bag of mulch into a garden where he was working at. You tell him to avoid any heavy lifting until his pain goes away, however he does not accept your advice. He instead replies that his job requires him to carry heavy materials and that he cannot stop working because he has to make ends meet and pay off extra loans in which he is in debt for.
1. As Matthew’s GP, what would you do next?
2. During the middle of the consult, Matthew desperately begs that you prescribe him some opioids (painkillers) and he becomes agitated and flustered. What would you do next ?
3. After trying to persuade him many times not to work, Matthew still insists that he works (basically doesn’t care what you say). What adjustments can you propose to Matthew he undertakes, so that he can work as safely as possible.



Firstly, I would acknowledge the fact that Matthew is in a very difficult situation as he has emphasized that he cannot stop working due to financial reasons. I would tell Matthew that I’m very sorry for the position he is in, and I would talk with him, explaining to him the full extent of his injury, whilst making sure that Matthew fully also understands the seriousness of this injury and that he may injure himself more if he were to continue working. I would ask him questions along the way to see if he is retaining what I’m telling him. I would again reinforce the fact that if he were to avoid heavy lifting, he could recover in a much faster time and hopefully get back to work quicker. I would suggest if he could make any adjustment to his work- for the next few weeks he could maybe work with a partner and the partner could do the heavy lifting, or if he works for someone, he could talk to his boss and maybe enquire about the possibility of paid leave. I would even mention the possibility of worker’s compensation. After I’ve assessed Matthew I would obviously do my best to relieve him of as much pain and discomfort as possible. I would discuss possible treatments and the options available for him. And then I would come up with a management plan for him- one that we can both agree on, even if that means allowing Matthew to work- however agreeing on a manner that is safe as possible.

Well this is very complicated situation because I have to really consider whether I think I need to prescribe painkillers or if there is another reason as to why he is asking for them. So I would start off by trying to calm him down by showing compassion towards Matthew saying things such as “I understand you are in a great deal of discomfort” etc and recognize what he is going through. I will change my tone as need be and start to ask him more questions, “I can see this is making you uncomfortable, is there a particular reason why?” “what is making you distressed." Once he has calmed down to a state where I can talk with him, I would evaluate and explain to him the results of the physical examination of his back and see whether I think he needs them. If he doesn’t need them I will politely explain why and tell him other options I want to try first to alleviate his pain. If he gets agitated again I will ask him “is there something else I can help you with? I can see this is making you very worried." I wouldn't want to make any assumptions, maybe he is distressed about work, maybe his financial problems or maybe he wants these opiods for another reason he doesn't want to reveal. I would explain to him that whilst painkillers will relieve pain, it is not going to treat his injury.

3. (I mentioned this in part 1 at the end) What other suggestions could I add?

Thank you to whoever answers!! Also would a station be dedicated to a single prompt like this, and then you discuss with the examiner? Or would you get maybe 2 of these prompts in a certain ethical scenario station? Thanks!
 

Scorpion

Member
Hi this is my first go at a prompt since so far I've just been looking into other topics. Would love some some constructive criticism.

Imagine you are working as a GP in metropolitan Sydney. Matthew, a 45 year old gardener has come in to your clinic complaining of back pain after he carried a 15 kg bag of mulch into a garden where he was working at. You tell him to avoid any heavy lifting until his pain goes away, however he does not accept your advice. He instead replies that his job requires him to carry heavy materials and that he cannot stop working because he has to make ends meet and pay off extra loans in which he is in debt for.
1. As Matthew’s GP, what would you do next?
2. During the middle of the consult, Matthew desperately begs that you prescribe him some opioids (painkillers) and he becomes agitated and flustered. What would you do next ?
3. After trying to persuade him many times not to work, Matthew still insists that he works (basically doesn’t care what you say). What adjustments can you propose to Matthew he undertakes, so that he can work as safely as possible.



Firstly, I would acknowledge the fact that Matthew is in a very difficult situation as he has emphasized that he cannot stop working due to financial reasons. I would tell Matthew that I’m very sorry for the position he is in, and I would talk with him, explaining to him the full extent of his injury, whilst making sure that Matthew fully also understands the seriousness of this injury and that he may injure himself more if he were to continue working. I would ask him questions along the way to see if he is retaining what I’m telling him. I would again reinforce the fact that if he were to avoid heavy lifting, he could recover in a much faster time and hopefully get back to work quicker. I would suggest if he could make any adjustment to his work- for the next few weeks he could maybe work with a partner and the partner could do the heavy lifting, or if he works for someone, he could talk to his boss and maybe enquire about the possibility of paid leave. I would even mention the possibility of worker’s compensation. After I’ve assessed Matthew I would obviously do my best to relieve him of as much pain and discomfort as possible. I would discuss possible treatments and the options available for him. And then I would come up with a management plan for him- one that we can both agree on, even if that means allowing Matthew to work- however agreeing on a manner that is safe as possible.

Well this is very complicated situation because I have to really consider whether I think I need to prescribe painkillers or if there is another reason as to why he is asking for them. So I would start off by trying to calm him down by showing compassion towards Matthew saying things such as “I understand you are in a great deal of discomfort” etc and recognize what he is going through. I will change my tone as need be and start to ask him more questions, “I can see this is making you uncomfortable, is there a particular reason why?” “what is making you distressed." Once he has calmed down to a state where I can talk with him, I would evaluate and explain to him the results of the physical examination of his back and see whether I think he needs them. If he doesn’t need them I will politely explain why and tell him other options I want to try first to alleviate his pain. If he gets agitated again I will ask him “is there something else I can help you with? I can see this is making you very worried." I wouldn't want to make any assumptions, maybe he is distressed about work, maybe his financial problems or maybe he wants these opiods for another reason he doesn't want to reveal. I would explain to him that whilst painkillers will relieve pain, it is not going to treat his injury.

3. (I mentioned this in part 1 at the end) What other suggestions could I add?

Thank you to whoever answers!! Also would a station be dedicated to a single prompt like this, and then you discuss with the examiner? Or would you get maybe 2 of these prompts in a certain ethical scenario station? Thanks!
(Disclaimer: yr 12)
I liked your answer to 1., and I can't think of any extra considerations right now (maybe somebody else has ideas?). For question 2, you danced around the topic of opioids a little and I think it's important to explicitly mention they are a potentially addictive medication and therefore should only be prescribed when absolutely necessary. You could then go into the risks surrounding addiction to/dependence on medication (inability to withdraw, leading to a painful experience down the track when he's unable to renew a prescription). The fact that the patient is becoming quite insistent upon obtaining such medication could be seen as a red flag of sorts, as they may have already developed a dependence on the drug. You may need to look into this patient's medical history to see whether they have been prescribed opioid medication in the past. While you are right to not make assumptions, you are justified in considering the possibilities and one of the reasons opioids are a prescription-only drug is to reduce the risk of addiction by giving controlled doses to patients (I think- please correct me if I'm wrong). At the end of the day, if you don't believe opioids are the best medication to prescribe your patient, it is your obligation as a doctor not to do so despite any protest from the patient. If the patient doesn't back down, becomes abusive or violent, you may need to call security.

It is my understanding that most MMI stations are dedicated to a single prompt like this, but you are less discussing with the examiner than telling to the examiner. That is, the examiner will only read the questions and then it's up to you to do all the talking. Bear in mind I haven't actually done an MMI before, and the only interview I'm planning on doing this year is primarily panel-style, so my understanding is very limited.
 
Hi this is my first go at a prompt since so far I've just been looking into other topics. Would love some some constructive criticism.

Imagine you are working as a GP in metropolitan Sydney. Matthew, a 45 year old gardener has come in to your clinic complaining of back pain after he carried a 15 kg bag of mulch into a garden where he was working at. You tell him to avoid any heavy lifting until his pain goes away, however he does not accept your advice. He instead replies that his job requires him to carry heavy materials and that he cannot stop working because he has to make ends meet and pay off extra loans in which he is in debt for.
1. As Matthew’s GP, what would you do next?
2. During the middle of the consult, Matthew desperately begs that you prescribe him some opioids (painkillers) and he becomes agitated and flustered. What would you do next ?
3. After trying to persuade him many times not to work, Matthew still insists that he works (basically doesn’t care what you say). What adjustments can you propose to Matthew he undertakes, so that he can work as safely as possible.



Firstly, I would acknowledge the fact that Matthew is in a very difficult situation as he has emphasized that he cannot stop working due to financial reasons. I would tell Matthew that I’m very sorry for the position he is in, and I would talk with him, explaining to him the full extent of his injury, whilst making sure that Matthew fully also understands the seriousness of this injury and that he may injure himself more if he were to continue working. I would ask him questions along the way to see if he is retaining what I’m telling him. I would again reinforce the fact that if he were to avoid heavy lifting, he could recover in a much faster time and hopefully get back to work quicker. I would suggest if he could make any adjustment to his work- for the next few weeks he could maybe work with a partner and the partner could do the heavy lifting, or if he works for someone, he could talk to his boss and maybe enquire about the possibility of paid leave. I would even mention the possibility of worker’s compensation. After I’ve assessed Matthew I would obviously do my best to relieve him of as much pain and discomfort as possible. I would discuss possible treatments and the options available for him. And then I would come up with a management plan for him- one that we can both agree on, even if that means allowing Matthew to work- however agreeing on a manner that is safe as possible.

Well this is very complicated situation because I have to really consider whether I think I need to prescribe painkillers or if there is another reason as to why he is asking for them. So I would start off by trying to calm him down by showing compassion towards Matthew saying things such as “I understand you are in a great deal of discomfort” etc and recognize what he is going through. I will change my tone as need be and start to ask him more questions, “I can see this is making you uncomfortable, is there a particular reason why?” “what is making you distressed." Once he has calmed down to a state where I can talk with him, I would evaluate and explain to him the results of the physical examination of his back and see whether I think he needs them. If he doesn’t need them I will politely explain why and tell him other options I want to try first to alleviate his pain. If he gets agitated again I will ask him “is there something else I can help you with? I can see this is making you very worried." I wouldn't want to make any assumptions, maybe he is distressed about work, maybe his financial problems or maybe he wants these opiods for another reason he doesn't want to reveal. I would explain to him that whilst painkillers will relieve pain, it is not going to treat his injury.

3. (I mentioned this in part 1 at the end) What other suggestions could I add?

Thank you to whoever answers!! Also would a station be dedicated to a single prompt like this, and then you discuss with the examiner? Or would you get maybe 2 of these prompts in a certain ethical scenario station? Thanks!
(Disclaimer: yr 12)
I liked your answer to 1., and I can't think of any extra considerations right now (maybe somebody else has ideas?). For question 2, you danced around the topic of opioids a little and I think it's important to explicitly mention they are a potentially addictive medication and therefore should only be prescribed when absolutely necessary. You could then go into the risks surrounding addiction to/dependence on medication (inability to withdraw, leading to a painful experience down the track when he's unable to renew a prescription). The fact that the patient is becoming quite insistent upon obtaining such medication could be seen as a red flag of sorts, as they may have already developed a dependence on the drug. You may need to look into this patient's medical history to see whether they have been prescribed opioid medication in the past. While you are right to not make assumptions, you are justified in considering the possibilities and one of the reasons opioids are a prescription-only drug is to reduce the risk of addiction by giving controlled doses to patients (I think- please correct me if I'm wrong). At the end of the day, if you don't believe opioids are the best medication to prescribe your patient, it is your obligation as a doctor not to do so despite any protest from the patient. If the patient doesn't back down, becomes abusive or violent, you may need to call security.

It is my understanding that most MMI stations are dedicated to a single prompt like this, but you are less discussing with the examiner than telling to the examiner. That is, the examiner will only read the questions and then it's up to you to do all the talking. Bear in mind I haven't actually done an MMI before, and the only interview I'm planning on doing this year is primarily panel-style, so my understanding is very limited.
you both mention alot of really good points!! so not much else i can think of to add except maybe;
for q1: it would be good to organise a follow up appointment in a couple of weeks to make sure he is following his treatment plan properly and that it is actually working effectively and his pain is improving.
also for q2: im not sure if this is worth mentioning that to help with the pain, instead of opiods which are potentially addictive as Scorpion said, he could try safer alternatives such as over the counter medication for pain relief if he needs it. even if it is less powerful that opiods it will still help with the pain to some extent.
 

dani01

Member
(Disclaimer: yr 12)
I liked your answer to 1., and I can't think of any extra considerations right now (maybe somebody else has ideas?). For question 2, you danced around the topic of opioids a little and I think it's important to explicitly mention they are a potentially addictive medication and therefore should only be prescribed when absolutely necessary. You could then go into the risks surrounding addiction to/dependence on medication (inability to withdraw, leading to a painful experience down the track when he's unable to renew a prescription). The fact that the patient is becoming quite insistent upon obtaining such medication could be seen as a red flag of sorts, as they may have already developed a dependence on the drug. You may need to look into this patient's medical history to see whether they have been prescribed opioid medication in the past. While you are right to not make assumptions, you are justified in considering the possibilities and one of the reasons opioids are a prescription-only drug is to reduce the risk of addiction by giving controlled doses to patients (I think- please correct me if I'm wrong). At the end of the day, if you don't believe opioids are the best medication to prescribe your patient, it is your obligation as a doctor not to do so despite any protest from the patient. If the patient doesn't back down, becomes abusive or violent, you may need to call security.

It is my understanding that most MMI stations are dedicated to a single prompt like this, but you are less discussing with the examiner than telling to the examiner. That is, the examiner will only read the questions and then it's up to you to do all the talking. Bear in mind I haven't actually done an MMI before, and the only interview I'm planning on doing this year is primarily panel-style, so my understanding is very limited.
you both mention alot of really good points!! so not much else i can think of to add except maybe;
for q1: it would be good to organise a follow up appointment in a couple of weeks to make sure he is following his treatment plan properly and that it is actually working effectively and his pain is improving.
also for q2: im not sure if this is worth mentioning that to help with the pain, instead of opiods which are potentially addictive as Scorpion said, he could try safer alternatives such as over the counter medication for pain relief if he needs it. even if it is less powerful that opiods it will still help with the pain to some extent.


Thankyou both so much! Scorpion. You are very right about the fact I didn't mention possible addiction. I was definitely thinking it but I wasn't sure how up front to be? I didn't want to show that my first thought for this question was addiction instead of the patient actually being in pain. Thanks for your help. watermelona I didn't even consider a follow-up appointment something that is so obvious. Good point!
 

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Scorpion

Member
Thankyou both so much! Scorpion. You are very right about the fact I didn't mention possible addiction. I was definitely thinking it but I wasn't sure how up front to be? I didn't want to show that my first thought for this question was addiction instead of the patient actually being in pain. Thanks for your help. watermelona I didn't even consider a follow-up appointment something that is so obvious. Good point!
I think the fact that the question discussed opioids and the patient becoming flustered mean you need to consider the possibility for the patient's safety. It is very possible that the patient is not lying about their pain but have become dependent on opioids to manage it over time. You don't necessarily need to express this conclusion to your patient up front, particularly if they are becoming frustrated with you, but that doesn't stop you from mentioning it to the interviewer as a possible consideration.
Edit: It also doesn't need to be your 'first thought' for this question. You can first discuss the possibility the patient is in pain but has not developed a dependence and then mention this possibility.
 

Sir

Member
Greetings fellow MSOers, I shall have a crack at the below question. Any feedback or thoughts no matter how brief are greatly appreciated.

Dr Mathers is a naturopath who specialises in special natural vaccines to his patients. The vaccine is made up of water, sugar and other herbal extracts all mixed together. Dr Mathers doesn't believe they work, but more so elicit a placebo effect that comforts the patient using the vaccine. He recommends and advertises homeopathic medicine to people with mild and non-specific symptoms such as muscle aches and joint issues. Dr Mathers doesn’t believe that the vaccine causes harm because no patients, so far have come back to him with complaints.

1. Do you believe that homeopathic medicine should be used as an alternative to widely accepted evidence-based treatment? Should they be used at all?
I believe all treatments deserve consideration in terms of their efficacy and safety. In this situation however, we are assessing the opportunity cost of potentially substituting evidence based treatment which has likely undergone the standardized phase-directed procedure of approval for a treatment which Dr Mathers is stated to not believe in. Although the question does not present evidence against the vaccine and it could be possible that there are not actually any harms associated with his vaccines in particular, I believe doing whats best for the patient definitely encompasses using the most widely accepted treatment there is as of now. Dr Mathers view of only using them on patients with mild and non-specific symptoms is not a decision I would support, given that all patients no matter their problems deserve the most beneficial treatment as these situations can easily deteriorate and become volatile. Despite that, if it does turn out in the future there is accredited evidence to support homeopathic treatments in specific circumstances where they are more effective than alternatives, then they could potentially be used.

2. A patient comes into a GP’s office wanting to use a certain herbal extract for their osteoarthritic pain in their knee. How should you go about as the GP in this scenario.
As their GP, I have a duty of care towards upholding what is best for the patient, whilst also allowing them to have autonomous choice. I would begin by acknowledging the osteoarthritic pain they have in their knees and the difficulty and inconvenience that it would be causing them in their life. Prior to deciding a treatment and management plan, I would ask them why they want to use this specific herbal extract and potentially where they got this information or perception from. Before the follow up appointment I would conduct research into the area I was informed by the patient and cross reference this information with other sources derived from areas of my expertise. In the circumstance where this herbal extract is potentially better than alternative treatments I would be happy to prescribe it, otherwise I would outline the potential benefits and concerns of each treatment option ensuring they are fully informed of the situation. It could also be possible that they desire this medication for financial or religious reasons. In these cases I would work with them to assess whether there are cheaper or more religiously appropriate options that are the best alternative available for them, which may or may not be the herbal extract.

3. Do you believe that the placebo effect should be manipulated by physicians to provide treatment for patients? Discuss?
Although there are potentially utilitarian benefits towards manipulating the placebo effect in these circumstances, I believe it is immoral to use patients as a means to an end. Specifically exploiting the placebo effect often involves lying to the patient about what particular treatment they are receiving which is the underlying basis of this effect can hugely damage the trust between patients and their physicians, undermines their ability to consent to any course of treatment and go against their best interests. Although not exploiting the placebo effect could bring some short term harms towards the efficacy of certain medications, the long term relationship between patients and their physicians is something I believe should not be compromised especially with potentially greater conflicts in the long term if this were to be uncovered.

4. With the use of homeopathic medicine, how may this affect the views of medicine and how it is practiced from the viewpoint of a member of the general public? Discuss?
The use of homeopathic medicines would I believe overall provide an unfavorable outlook by the public upon views of medicine. Often, the public's faith and trust within the medical profession underlies the reason they visit physicians in the first place, to draw expertise from their knowledge which is thought to be constantly developing and founded upon evidence based science. When the use of homeopathic medicine which regardless of whether is good or bad is not currently proven to be effective is endorsed, this could significantly foster anti-scientific views and bring speculation about whether other creditable treatments provided are really the best for the public in their eyes.

5. Do you believe that the actions undertaken by Dr. Mathers are ethically responsible? Discuss?
Dr Mathers actions are not ethically responsible, given his duty of care to act in the best interests of patients no matter who they are in all circumstances. Despite this being his area of specialty, his different styles of prescription to patients depending on severity indicates his belief that this could be a determining factor in the type of treatment they receive. This could actively diminish their trust in the medical system. Additionally, the justification he uses of homeopathic treatments as not having caused any safety concerns before is invalid as it could simply be the case due to their milder symptoms no major safety concerns were identified. Also this does not address how effective they are compared to alternative evidence based treatments which could have been used instead. Finally exploiting the placebo effect in and of itself is unethical for reasons I outlined above.
 

dani01

Member
Greetings fellow MSOers, I shall have a crack at the below question. Any feedback or thoughts no matter how brief are greatly appreciated.

Dr Mathers is a naturopath who specialises in special natural vaccines to his patients. The vaccine is made up of water, sugar and other herbal extracts all mixed together. Dr Mathers doesn't believe they work, but more so elicit a placebo effect that comforts the patient using the vaccine. He recommends and advertises homeopathic medicine to people with mild and non-specific symptoms such as muscle aches and joint issues. Dr Mathers doesn’t believe that the vaccine causes harm because no patients, so far have come back to him with complaints.

1. Do you believe that homeopathic medicine should be used as an alternative to widely accepted evidence-based treatment? Should they be used at all?
I believe all treatments deserve consideration in terms of their efficacy and safety. In this situation however, we are assessing the opportunity cost of potentially substituting evidence based treatment which has likely undergone the standardized phase-directed procedure of approval for a treatment which Dr Mathers is stated to not believe in. Although the question does not present evidence against the vaccine and it could be possible that there are not actually any harms associated with his vaccines in particular, I believe doing whats best for the patient definitely encompasses using the most widely accepted treatment there is as of now. Dr Mathers view of only using them on patients with mild and non-specific symptoms is not a decision I would support, given that all patients no matter their problems deserve the most beneficial treatment as these situations can easily deteriorate and become volatile. Despite that, if it does turn out in the future there is accredited evidence to support homeopathic treatments in specific circumstances where they are more effective than alternatives, then they could potentially be used.

2. A patient comes into a GP’s office wanting to use a certain herbal extract for their osteoarthritic pain in their knee. How should you go about as the GP in this scenario.
As their GP, I have a duty of care towards upholding what is best for the patient, whilst also allowing them to have autonomous choice. I would begin by acknowledging the osteoarthritic pain they have in their knees and the difficulty and inconvenience that it would be causing them in their life. Prior to deciding a treatment and management plan, I would ask them why they want to use this specific herbal extract and potentially where they got this information or perception from. Before the follow up appointment I would conduct research into the area I was informed by the patient and cross reference this information with other sources derived from areas of my expertise. In the circumstance where this herbal extract is potentially better than alternative treatments I would be happy to prescribe it, otherwise I would outline the potential benefits and concerns of each treatment option ensuring they are fully informed of the situation. It could also be possible that they desire this medication for financial or religious reasons. In these cases I would work with them to assess whether there are cheaper or more religiously appropriate options that are the best alternative available for them, which may or may not be the herbal extract.

3. Do you believe that the placebo effect should be manipulated by physicians to provide treatment for patients? Discuss?
Although there are potentially utilitarian benefits towards manipulating the placebo effect in these circumstances, I believe it is immoral to use patients as a means to an end. Specifically exploiting the placebo effect often involves lying to the patient about what particular treatment they are receiving which is the underlying basis of this effect can hugely damage the trust between patients and their physicians, undermines their ability to consent to any course of treatment and go against their best interests. Although not exploiting the placebo effect could bring some short term harms towards the efficacy of certain medications, the long term relationship between patients and their physicians is something I believe should not be compromised especially with potentially greater conflicts in the long term if this were to be uncovered.

4. With the use of homeopathic medicine, how may this affect the views of medicine and how it is practiced from the viewpoint of a member of the general public? Discuss?
The use of homeopathic medicines would I believe overall provide an unfavorable outlook by the public upon views of medicine. Often, the public's faith and trust within the medical profession underlies the reason they visit physicians in the first place, to draw expertise from their knowledge which is thought to be constantly developing and founded upon evidence based science. When the use of homeopathic medicine which regardless of whether is good or bad is not currently proven to be effective is endorsed, this could significantly foster anti-scientific views and bring speculation about whether other creditable treatments provided are really the best for the public in their eyes.

5. Do you believe that the actions undertaken by Dr. Mathers are ethically responsible? Discuss?
Dr Mathers actions are not ethically responsible, given his duty of care to act in the best interests of patients no matter who they are in all circumstances. Despite this being his area of specialty, his different styles of prescription to patients depending on severity indicates his belief that this could be a determining factor in the type of treatment they receive. This could actively diminish their trust in the medical system. Additionally, the justification he uses of homeopathic treatments as not having caused any safety concerns before is invalid as it could simply be the case due to their milder symptoms no major safety concerns were identified. Also this does not address how effective they are compared to alternative evidence based treatments which could have been used instead. Finally exploiting the placebo effect in and of itself is unethical for reasons I outlined above.

Hey! I've never done an interview before but just wanted to note one thing.
You mention really good terms such as opportunity costs etc, which shows you've done your research however I think maybe even referencing the 4 pillars of ethics would help you improve even more. So in terms of beneficence, the doctor is meant to act in the patient's best interest. Given that he is giving a vaccine that he believes doesn't work is obviously not acting in their best interest, as he does not think its going to help them relieve symptoms (at least from a medical standpoint). And then non-maleficence. The fact that he doesn't believe it causes harm, reinforces that he is not aware of any harm this vaccine could do, nor has there been much evidence surrounding it of if there is he hasn't looked into it. Just because so far no one has come back to him with complaints does not mean there are no side effects or the vaccine has no complications and risks. Therefore he very well could be causing harm to his patients without even knowing it. If you consider just these 2 ethical implication, it would be very wrong if he were to prescribe this over evidence-base treatment, where there is more knowledge surrounding harm which may be caused and benefits of treatments.

Ok that's all I've got. But definitely look into it yourself since I'm in the same boat as you! Apart from that everything seemed really well written and thought out to me :)
 
Greetings fellow MSOers, I shall have a crack at the below question. Any feedback or thoughts no matter how brief are greatly appreciated.

Dr Mathers is a naturopath who specialises in special natural vaccines to his patients. The vaccine is made up of water, sugar and other herbal extracts all mixed together. Dr Mathers doesn't believe they work, but more so elicit a placebo effect that comforts the patient using the vaccine. He recommends and advertises homeopathic medicine to people with mild and non-specific symptoms such as muscle aches and joint issues. Dr Mathers doesn’t believe that the vaccine causes harm because no patients, so far have come back to him with complaints.

1. Do you believe that homeopathic medicine should be used as an alternative to widely accepted evidence-based treatment? Should they be used at all?
I believe all treatments deserve consideration in terms of their efficacy and safety. In this situation however, we are assessing the opportunity cost of potentially substituting evidence based treatment which has likely undergone the standardized phase-directed procedure of approval for a treatment which Dr Mathers is stated to not believe in. Although the question does not present evidence against the vaccine and it could be possible that there are not actually any harms associated with his vaccines in particular, I believe doing whats best for the patient definitely encompasses using the most widely accepted treatment there is as of now. Dr Mathers view of only using them on patients with mild and non-specific symptoms is not a decision I would support, given that all patients no matter their problems deserve the most beneficial treatment as these situations can easily deteriorate and become volatile. Despite that, if it does turn out in the future there is accredited evidence to support homeopathic treatments in specific circumstances where they are more effective than alternatives, then they could potentially be used.

2. A patient comes into a GP’s office wanting to use a certain herbal extract for their osteoarthritic pain in their knee. How should you go about as the GP in this scenario.
As their GP, I have a duty of care towards upholding what is best for the patient, whilst also allowing them to have autonomous choice. I would begin by acknowledging the osteoarthritic pain they have in their knees and the difficulty and inconvenience that it would be causing them in their life. Prior to deciding a treatment and management plan, I would ask them why they want to use this specific herbal extract and potentially where they got this information or perception from. Before the follow up appointment I would conduct research into the area I was informed by the patient and cross reference this information with other sources derived from areas of my expertise. In the circumstance where this herbal extract is potentially better than alternative treatments I would be happy to prescribe it, otherwise I would outline the potential benefits and concerns of each treatment option ensuring they are fully informed of the situation. It could also be possible that they desire this medication for financial or religious reasons. In these cases I would work with them to assess whether there are cheaper or more religiously appropriate options that are the best alternative available for them, which may or may not be the herbal extract.

3. Do you believe that the placebo effect should be manipulated by physicians to provide treatment for patients? Discuss?
Although there are potentially utilitarian benefits towards manipulating the placebo effect in these circumstances, I believe it is immoral to use patients as a means to an end. Specifically exploiting the placebo effect often involves lying to the patient about what particular treatment they are receiving which is the underlying basis of this effect can hugely damage the trust between patients and their physicians, undermines their ability to consent to any course of treatment and go against their best interests. Although not exploiting the placebo effect could bring some short term harms towards the efficacy of certain medications, the long term relationship between patients and their physicians is something I believe should not be compromised especially with potentially greater conflicts in the long term if this were to be uncovered.

4. With the use of homeopathic medicine, how may this affect the views of medicine and how it is practiced from the viewpoint of a member of the general public? Discuss?
The use of homeopathic medicines would I believe overall provide an unfavorable outlook by the public upon views of medicine. Often, the public's faith and trust within the medical profession underlies the reason they visit physicians in the first place, to draw expertise from their knowledge which is thought to be constantly developing and founded upon evidence based science. When the use of homeopathic medicine which regardless of whether is good or bad is not currently proven to be effective is endorsed, this could significantly foster anti-scientific views and bring speculation about whether other creditable treatments provided are really the best for the public in their eyes.

5. Do you believe that the actions undertaken by Dr. Mathers are ethically responsible? Discuss?
Dr Mathers actions are not ethically responsible, given his duty of care to act in the best interests of patients no matter who they are in all circumstances. Despite this being his area of specialty, his different styles of prescription to patients depending on severity indicates his belief that this could be a determining factor in the type of treatment they receive. This could actively diminish their trust in the medical system. Additionally, the justification he uses of homeopathic treatments as not having caused any safety concerns before is invalid as it could simply be the case due to their milder symptoms no major safety concerns were identified. Also this does not address how effective they are compared to alternative evidence based treatments which could have been used instead. Finally exploiting the placebo effect in and of itself is unethical for reasons I outlined above.
(im just preparing for interviews for the first time so these are just some thoughts!)
your response is really thorough and covers alot of areas very well which is really good!! just a few things i thought about asw:

q1 - you could also mention that homeopathic medicine may be an option in case that, for some reason for a particular patient; the evidence based methods have not helped their condition/symptoms improve or if the evidence based methods have the potential to cause undesirable side effects (tbh im not sure, is this incorrect? can someone correct me if so). also maybe could relate it to patient autonomy and if they strongly prefer to use homeopathic medicine instead for some personal reason it may be good to have it as a potential option alongside evidence based treatment options as well.
q2 - im not sure if im reading into the scenario too much but there is no confirmation by a doctor that the pain is 'osteoarthritic' (as in i dont know if the patient just told me (the GP here) that his pain was osteoarthritic - by assuming based on maybe the internet or other people - or whether this is some follow up appointment where he has previously been diagnosed and he is requesting new treatment?) so to check i would maybe have him take a scan or x-ray to see the state of his knee before choosing a treatment plan to treat his exact condition.
q3&4 - i had pretty much the same ideas :)
q5 - i definitely agree its very unethical, but maybe note that whilst his intention is to comfort the patient, as said in the prompt, (or is this being 'too nice' to the doctor?) - using placebo effect is still very unethical because...(continue answer)

overall i thought your response was really good and had some ideas which i hadn't thought about for my own response too, so thank you :) !
 

whoartthou

Regular Member
Greetings fellow MSOers, I shall have a crack at the below question. Any feedback or thoughts no matter how brief are greatly appreciated.

Dr Mathers is a naturopath who specialises in special natural vaccines to his patients. The vaccine is made up of water, sugar and other herbal extracts all mixed together. Dr Mathers doesn't believe they work, but more so elicit a placebo effect that comforts the patient using the vaccine. He recommends and advertises homeopathic medicine to people with mild and non-specific symptoms such as muscle aches and joint issues. Dr Mathers doesn’t believe that the vaccine causes harm because no patients, so far have come back to him with complaints.

1. Do you believe that homeopathic medicine should be used as an alternative to widely accepted evidence-based treatment? Should they be used at all?
I believe all treatments deserve consideration in terms of their efficacy and safety. In this situation however, we are assessing the opportunity cost of potentially substituting evidence based treatment which has likely undergone the standardized phase-directed procedure of approval for a treatment which Dr Mathers is stated to not believe in. Although the question does not present evidence against the vaccine and it could be possible that there are not actually any harms associated with his vaccines in particular, I believe doing whats best for the patient definitely encompasses using the most widely accepted treatment there is as of now. Dr Mathers view of only using them on patients with mild and non-specific symptoms is not a decision I would support, given that all patients no matter their problems deserve the most beneficial treatment as these situations can easily deteriorate and become volatile. Despite that, if it does turn out in the future there is accredited evidence to support homeopathic treatments in specific circumstances where they are more effective than alternatives, then they could potentially be used.

2. A patient comes into a GP’s office wanting to use a certain herbal extract for their osteoarthritic pain in their knee. How should you go about as the GP in this scenario.
As their GP, I have a duty of care towards upholding what is best for the patient, whilst also allowing them to have autonomous choice. I would begin by acknowledging the osteoarthritic pain they have in their knees and the difficulty and inconvenience that it would be causing them in their life. Prior to deciding a treatment and management plan, I would ask them why they want to use this specific herbal extract and potentially where they got this information or perception from. Before the follow up appointment I would conduct research into the area I was informed by the patient and cross reference this information with other sources derived from areas of my expertise. In the circumstance where this herbal extract is potentially better than alternative treatments I would be happy to prescribe it, otherwise I would outline the potential benefits and concerns of each treatment option ensuring they are fully informed of the situation. It could also be possible that they desire this medication for financial or religious reasons. In these cases I would work with them to assess whether there are cheaper or more religiously appropriate options that are the best alternative available for them, which may or may not be the herbal extract.

3. Do you believe that the placebo effect should be manipulated by physicians to provide treatment for patients? Discuss?
Although there are potentially utilitarian benefits towards manipulating the placebo effect in these circumstances, I believe it is immoral to use patients as a means to an end. Specifically exploiting the placebo effect often involves lying to the patient about what particular treatment they are receiving which is the underlying basis of this effect can hugely damage the trust between patients and their physicians, undermines their ability to consent to any course of treatment and go against their best interests. Although not exploiting the placebo effect could bring some short term harms towards the efficacy of certain medications, the long term relationship between patients and their physicians is something I believe should not be compromised especially with potentially greater conflicts in the long term if this were to be uncovered.

4. With the use of homeopathic medicine, how may this affect the views of medicine and how it is practiced from the viewpoint of a member of the general public? Discuss?
The use of homeopathic medicines would I believe overall provide an unfavorable outlook by the public upon views of medicine. Often, the public's faith and trust within the medical profession underlies the reason they visit physicians in the first place, to draw expertise from their knowledge which is thought to be constantly developing and founded upon evidence based science. When the use of homeopathic medicine which regardless of whether is good or bad is not currently proven to be effective is endorsed, this could significantly foster anti-scientific views and bring speculation about whether other creditable treatments provided are really the best for the public in their eyes.

5. Do you believe that the actions undertaken by Dr. Mathers are ethically responsible? Discuss?
Dr Mathers actions are not ethically responsible, given his duty of care to act in the best interests of patients no matter who they are in all circumstances. Despite this being his area of specialty, his different styles of prescription to patients depending on severity indicates his belief that this could be a determining factor in the type of treatment they receive. This could actively diminish their trust in the medical system. Additionally, the justification he uses of homeopathic treatments as not having caused any safety concerns before is invalid as it could simply be the case due to their milder symptoms no major safety concerns were identified. Also this does not address how effective they are compared to alternative evidence based treatments which could have been used instead. Finally exploiting the placebo effect in and of itself is unethical for reasons I outlined above.

This response would be considered a high scoring answer if you were wondering sokka. Although it could still be improved it definitely encompassed the major issues.

I would also like to point out that I am impressed by scorpion's analysis of responses. Reflecting back when I was in year 12 I was pretty much a moron.
 

dani01

Member
how long do you take writing one of these? I found myself practising with writing at the start then thought I should replicate the interview as best as possible. So on google doc I actually say my answer into my earphone mic and then what I'm saying comes up in writing. Then later I just edit it a little you- know taking out those ums and what not. But I would definitely recommend this! Because obviously on the day you won't have the opportunity to organise and formulate your thoughts so well. so practising like this could be more beneficial :))

also hoping someone can answer this. but whats the general rule of thumb when someone in a senior position is being SO rude to you. Do you want to talk to them first, seek an apology? If they don't change their behaviour then seek help. When do we get to the point that we report them? Thankyou
 

whoartthou

Regular Member
how long do you take writing one of these? I found myself practising with writing at the start then thought I should replicate the interview as best as possible. So on google doc I actually say my answer into my earphone mic and then what I'm saying comes up in writing. Then later I just edit it a little you- know taking out those ums and what not. But I would definitely recommend this! Because obviously on the day you won't have the opportunity to organise and formulate your thoughts so well. so practising like this could be more beneficial :))

also hoping someone can answer this. but whats the general rule of thumb when someone in a senior position is being SO rude to you. Do you want to talk to them first, seek an apology? If they don't change their behaviour then seek help. When do we get to the point that we report them? Thankyou

Excellent suggestion. In an actual interview depending on the university you may only get 10-20 seconds to analyse the question before having to give a response otherwise there may be awkward stares. In universities that allow reading time you will get at least ~1 min to consider the question.

Usually student responses are not as articulate as the one above written by Sir which is totally normal. An articulate response may give an overall impression of maturity but without adequate content it will not carry you to a high score. I would not have been able to give such an articulate response in an interview setting.
 

Crow

Staff | Junior Doctor
Moderator
also hoping someone can answer this. but whats the general rule of thumb when someone in a senior position is being SO rude to you. Do you want to talk to them first, seek an apology? If they don't change their behaviour then seek help. When do we get to the point that we report them? Thankyou
I think this completely depends on the context, but just keep in mind the interview is assessing your insight and how you’d actually respond in a real life circumstance - so don’t think there is a one size fits all approach where if the person exhibits x behaviour you will simply talk to them first and then if they exhibit y behaviour then you escalate - it would definitely be situationally dependent. Generally speaking, I would feel uncomfortable confronting a senior consultant (especially in the position as a med student) and so personally I’d be more likely to consult a university staff member (usually there is a wellbeing counsellor / harassment officer, or at least my uni has one) and ask for advice on the matter - initially you could keep the details of the consultant confidential but if you feel action needed to be taken, then you could discuss their details with the staff member. They would potentially be able to do it in a manner where the consultant doesn’t find out it was you that reported them.

In an interview setting if asked this question, it would be important to show insight into what challenges being a junior who has a disagreement with a consultant presents - this could have repercussions for your career, affect your reputation among other students and hospital staff etc. A standard answer of “I would confront the staff member first and then report them if it wasn’t resolved” with no other back up or justification probably wouldn’t score well. Honesty and rational justification will serve you better.
 

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kotoloper

Member
Hi everyone, I just tried to do a timed practice question and it went absolutely atrociously! I had a brief idea of what I wanted to say before started, but when I started after saying a sentence I just forgot how to say words! I also kept having mind blanks and disjointed sentences. Any tips on how to work on this apart from just continuing doing practice questions out loud? Starting to feel a little stressed!
 

Crow

Staff | Junior Doctor
Moderator
Hi everyone, I just tried to do a timed practice question and it went absolutely atrociously! I had a brief idea of what I wanted to say before started, but when I started after saying a sentence I just forgot how to say words! I also kept having mind blanks and disjointed sentences. Any tips on how to work on this apart from just continuing doing practice questions out loud? Starting to feel a little stressed!
It honestly does come down to practice making perfect! Just keep at it and continue practicing out loud. I also strongly encourage 1. Recording yourself and playing back the recordings to pick up on common mistakes you may be making without being consciously aware of it (e.g. umm-ing and ah-ing, doing awkward things with your hands) and 2. Forming a group that you can practice with. The latter is extremely helpful as you get to practice under the pressure of being in front of other people (i.e. what you have to do in an interview) and you also have different perspectives on the actual content of the questions you're answering. I would recommend practicing both online and in-person with others so you're prepared for all types of interviews you could sit this year.

In the interview you shouldn't be afraid to say "Do you mind if I just take a moment to collect my thoughts?" and pausing for a moment to think about what you want to say. This will serve you better than blabbering about with useless statements to fill in gaps in time.
 

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