Interview Question Time!

Discussion in 'Interviews' started by Matt, Nov 23, 2007.

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  1. Emmmmma

    Emmmmma New Member

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    [MENTION=8866]Dr Worm[/MENTION] - What a speedy reply! :D (My Newcastle MMI is tomorrow... yay!)
    Please know that I seriously considered everything you recommended in this thread, and I feel you've better shaped the way I tackle interviews (also helped for my UWS MMI a few weeks ago). You are a total legend, thanks again for your help - gold star smiley for you too =)

    [MENTION=998]Season[/MENTION] - I like your idea, I find it helpful to verbalise my thought process. I have a habit of internalising my reasoning sometimes (not so good...), so I'll keep your comment in mind for tomorrow =)

    For anyone skimming this thread, the general lesson I have learnt is: hurry up and get to the point... and don't be linguistically fluffy about it!
    (But I guess we'll see how well that has worked on Jan 18, hey?!)
     
  2. Havox

    Havox Sword and Martini Guy! Emeritus

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    Just answer the question don't write an essay, be honest and be yourself.
     
  3. miss_universe

    miss_universe muse. Emeritus

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    I agree with Hav, and in reality the interview will be very different to this thread and you will find you will just get to the point (hopefully...)
     
  4. pgawk

    pgawk Ekki múkk

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    Wow, scenario 1 presents such a moral dilemma … As many have said, I don’t think that anyone could argue that one approach is ‘right’, while the other is ‘wrong’, rather it is the process by which one rationalizes their decision that is the crux of this question.
    I would really appreciate feedback that current medical students can provide, since you’re far more cognisant of the nitty-gritties of medical ethics than a med hopeful like me.
    I have to answer this honestly and do exactly what I think I would do, if put in this situation. Bear in mind, if I was actually given this in a med interview, I would probably get the eff out of the room, commando roll out of the nearest window, drown my sorrows in a sea of Lindt chocolate bunnies and cry myself to sleep.
    I know this sounds terribly unethical but my immediate, honest decision would be to continue on the track with the 5 people. I’m not saying this sets perfectly well with the moral understandings that have been instilled in me, however I think, deep in my gut, that this is the choice I can best rationalize.
    I well and truly believe that the role of a doctor is to preserve life. However, at the same time, I don’t think it’s ethical to put another’s life at risk in order to achieve this. The question states that ‘if you do nothing, the train will continue on its track’. Now, be it a terrible stroke of luck, or the act of a divine intervener, these unfortunate people have been placed on the track that the train is currently on. In the same regard, the 1 person was fortunate enough to be on the other track. I don’t think it is my responsibility, as a doctor, to decide whether the lives of 5 people hold more value than the life of 1and if, then in order to preserve those 5 lives, an active involvement in the death of that 1 person is justified. To change the course of the train, I believe, is to essentially take the role of that ‘divine intervener’ and, to my knowledge, the golden rule of being a doctor is that you are an advisor, rather than a decider (and you are certainly not entitled to ‘play God’). I know this sounds so, so, so, so, so wrong but I see it as homicide to press the button. Now at the same time, one can argue that indecision is essentially the same as making a decision and that, as a doctor, if someone comes in with a cancerous brain tumour, I can’t just throw my hands up and say ‘sorry, fate has decided that you are going to die of cancer, there’s nothing I can do about it’. However, I think that there is a big distinction between this, and that is that I am actively jeopardizing a life, in order to preserve others. If I continue on the track, I am not actively jeopardizing the lives of 5 people, in order to preserve 1. I did not choose to travel on their track with the knowledge that my brakes would fail. Of course, one could argue that allowing the person who needs surgery in scenario 2 to die is essentially a similar form of inaction and therefore fits into my ‘definition’ of morality, however there is a conflict. I don’t believe it is ethical to preserve the life of someone if it puts the life of another at risk, unless the person whose life is at risk CHOOSES to go through with it.
    It is my duty to save as many lives as possible without actively endangering others and in the case of failing to operate on the one patient; I believe that inaction becomes synonymous with action because allowing one to die of an ailment that is curable is not inaction (from what I understand).
    If the brakes had broken down and the train approaching a fork where it would go on track A with 5 people or track B with 1 person and I HAD to choose between track A or track B (ie. There are two levers) otherwise not choosing would DEFINITILEY result in the death of ALL 6, then I would apply the principle to preserve as many lives as possible, and choose to go on track B instead (since choosing A would be the active death of 5 people, B would be the active death of 1 and indecision is an action that would result in the death of everyone (which, I believe) is the worst possible outcome) However, this question is worded differently, and thus, my answer is as such.

    tl;dr: I'm fond of Lindt chocolate bunnies and I refuse to set foot in a train ever again.
     
    Last edited: Apr 22, 2012
  5. pgawk

    pgawk Ekki múkk

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    I’m going to have a crack at this because I’m typically not so good at critical thinking in terms of government expenses and what not. I tend to be a fence sitter so I'm going to try to take a stronger stance with this one... Okay, here it goes.

    I think it’s extremely important to increase the number of physicians and other health care workers in areas like rural Northern Territory because of the sub-standard access many communities have to health care-services which no doubt can result in a lower quality of life. However, at the same time, I don’t believe this solution is an effective approach in combatting that.
    Students only have to commit to a 2-3 year tenure and in reality, many will simply return to urban areas at the end of this, which really makes the approach seem like a short term fix more than anything. While improving access to doctors will save the health care system money in terms of immunizing against and eradicating disease in these areas before they reach critical states that are expensive to treat, the expenses and resources required to turn these students into doctors is phenomenal and I don’t think the benefits of having this group working in under-serviced areas for such a short amount of time will balance this. I do believe that this approach will improve the standard of health in these areas simply because of the increased access to medical treatment and advise, however; I think that it is more important to address the root of this problem by pursuing other, more viable options that can offer a long-term solution. It would be more wise of the health care system to perhaps increase access to resources and offer other incentives that would make physicians more inclined to working in these areas, for much longer periods of time.
    Also, I’m not sure what the implications of ‘preferential admission’ are but if it means lowering the criteria necessary for admission, then there’s always a worry that the standards necessitated for med-students that are imposed by having higher entry criteria might be compromised, which I think again questions the effectiveness and viability of this policy.

    Would it be fair to mention that students won’t even be fully qualified physicians in the 2-3 years after graduation (they’d still be interns, wouldn’t they?) and these areas would be in need of doctors with more experience with treating/ performing minor surgeries and what not? The reason I say this is because my parents used to live in cities with very limited access to health-care and people would only visit the doctor when they were (almost literally) on the verge of death. I think that experience would be critical in treating cases like those.

    Feed back would be great :) I really hate these sort of questions
     
    Last edited: May 9, 2012
  6. Dr Worm

    Dr Worm Regular Member

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    hi [MENTION=12045]pgawk[/MENTION]

    From memory, academic discussions about this question usually concern the the active / passive or omission / commission distinction., (Both of these are highly google-able terms) or the (several varieties) of utilitarianism (which is/are concerned with achieving the best possible outcome (with or without the caveat "for the greatest number of people" and/or maximum possible happiness, for arguable definitions of happiness).

    The active/ passive distinction, (acts and omissions OR omissions and commissions doctrine) is significant in both ethical/philosophical discussion and the medico-legal field, in which case it is particularly relevant to euthanasia, abortion, end-of-life decisions/ care (in which case see "the doctrine of double effect" and "thall shalt not kill but need not strive officiously to keep alive"), and medical litigation.

    Most humans, and many philosophers argue that there is a significant distinction between active and passive killing (and, indeed, active and passive anything). This seems to be very reflective of our intuitive sense that doing something is different to allowing something to happen. The converse argument is usually outcomes based, and generally utilitarian (outcomes based).

    If you're interested, or expecting to get a question like this, you might google these terms. You might get a more classic and arguably more generally useful approach to these topics by googling them as "+philosophy" rather than "+healthcare". With the exception of advanced pure logic, many philosophy research articles are perfectly intelligible to the lay reader, so you might try googlescholar. Somewhere around here is a copy of Jonothan Glovers (1977) "causing death and saving lives", which is interesting, and gives a good overview of thought, but is very much biased toward the authors opinion. A more general introduction would be found in any (ie many) general "essays in philosophy" "intro to philosophy: essays" etc type of books. This is one for the library/ ebooks. There are many such books, and not all of them will discuss these issues. If I find the particularly good one I have, I shall advise.

    I'm not sure how many unis use the train track question, or variations on it: I know of one course in nsw that has used variations on this as an interview q, but it's not common (I think) but might be more common in postgrad interviews.

    Variations on this theme (if you DO get this question, either in an interview, or first year philosophy) it will often be used to encourage you to consider an inconsistency in your viewpoint. You have predicted such possibilities well in your answer. Predictable follow ups include...
    - if you had to choose track A or B, what would you choose?
    - you can choose A (1 dies) B (5 die). If you make no decision, 50% chance of either? are you comfortable making no decision?
    - If you make no decision, your train derails, killing all on board. Still happy to make no decision? (a) you're the only one on board b) there are 2 people on board, c) there are 600 people on board)
    - variations on this theme are almost endless
    -the 1 person on the track is your only child. the 5 are all aged over 65. (Same deal: your child is aged 3, a much loved child. However they have a genetic disorder which guarantees mild retardation and/or dementia and/or death before age 30/ etc. The 5 are all aged 65 and are all brilliant scientists: they have world hunger/ cured cancer (all of it, who knew. ;-p) and are on their way to announce it. If they die, the secret dies with them
    -the 1 person is some random. 4 of the 5 are random, one of the 5 is a young artist named Adolf Hitler. It's 1938
    -if you WOULD switch tracks to save the greater number of people, then you are standing on a bridge, watching a train wreck about to happen. if it does, it will kill everyone on the train (who may or may not =1 or 1,000 peopple, who may or mayn't include your children, nobel laureates on the brink of announcing the solution to all our environmental woes, and/or hitler). You have no way to warn anyone in time. Unless....if the train hits something else, the emergency brake will be activated. All will be saved. There's a 70 year old man, morbidly obese, emphasytic, mid stage dementia. Right near you on the bridge. Do you push him?

    I maintain that it is unlikely that you will get questions like these (I could be wrong) If you do:

    In this and some related questions - assuming you are neither the Pope nor Peter Singer - it is very, very likely that you will be tripped up, and struggle to make a logically cohesive argument unless you are very familiar with both the history and philosophy of your own argument and the opposing point of view, and manage not to sound like an extremist if your argument is pushed to it's limits. Especially if there is a follow up question. Questions like this are (in my view) "watch you think" questions where it is most likely better to discuss uncertainty, unfamiliarity, and contradictions in your own thinking (Isn't that interesting. Choice A seemed like the most logical answer, at first, and I felt it was the best option because y, but when the situation is changed even a bit, I'm not so comfortable with that argument." etc.

    I will insist that few unis use these type of questions and if they do, they are looking to see you think, rather that to see you take a position and hold it out of stubbornness. In my humble opinion, this is a "talk through the issues" question; there is no right answer.b

    You did that well. I got the impression that you appreciate the distinction between: what you feel to be right, and the limits of your argument.
    You are quite right to feel irrational and uncertain at times; in my opinion, best to admit it (at least for this kind of question, maybe for others...)


    FOR the second one, you did well to identify a number of issues with explanation. It would be fair to mention all those issues, and your own experience/family experience of rural life (provided it was relevant, and you didn't take this to be a universal truth). I would have been inclined to talk about the impact on students/docs, but - realistically - there is only so much time, you may not be able to cover all aspects of an issue, nor would you be expected to. You did well to avoid any rigid point of view (sticking to discussing possibilities and thoughts etc). I think you're taking a good approach

    (sorry It took me so long to reply, I've been meaning to : if this is rambly, it's because it got written and autosaved over a few attempts, my apologies)
     
  7. pgawk

    pgawk Ekki múkk

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    [MENTION=8866]Dr Worm[/MENTION]: Thank you for investing so much time and effort into your response :), I never really considered the underlying purpose i.e. are they looking for an answer/opinion or your ability to consider the scope and limitations of what you're arguing? I'll keep it in mind when responding in the future. I'm going to start making a habit out of reading up on the ethical and philosophical arguments that you mentioned. I couldn't agree more with your point about being familiar with the philosophy/ history of what you're arguing. I think it'll give me a lot more confidence and allow me to answer such questions in front of an interviewer without vaporising out of fear. That point you raised about impact on students/ docs was brilliant! I'm going to try to not become so engrossed in the positives/ negatives for one group/ body and attempt to broaden my horizons when discussing these, from now on.
    As always, your advice is invaluable and I'm so, so grateful for it. :) I really look forward to responding to more of these interview-style questions in the coming months and hopefully in an actual med-interview setting (eventually) LOL.
     
  8. Dr Worm

    Dr Worm Regular Member

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    [MENTION=12045]pgawk[/MENTION]: I think a broad knowledge of philosophy was helpful for me, but exactly as you say: knowing what different approaches are possible is most helpful for understanding a range of views.
     
  9. Yammers

    Yammers New Member

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    Do universities usually ask questions to do with everyday situations such as the following... ?
    X is dismissing a student and tells him to find another teacher as he has not kept up to date with his work. You feel that X is being unreasonable. What would you do?

    Are these kind of questions too specific for interviews? If you were asked this question, how would you answer?
     
  10. miss_universe

    miss_universe muse. Emeritus

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    Yes thats the kind of question but obviously fake names etc, not real life situations. Also, the question really should be, how would YOU answer.
     
  11. Dr Worm

    Dr Worm Regular Member

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    [MENTION=14324]Yammers[/MENTION]: Second what Muse said above. There is some variation between unis in interview style, obviously. There's a lot of information on MSO about interviews, including 3 whole theads devoted to interview questions. A guide (with links) to this information is here:

    http://www.medstudentsonline.com.au/f40/guide-interview-sub-forum-24080/

    Almost all of the practice questions in the 3 IQT threads have been written with med school interviews in mind, usually by people who've been to them, so I'd suggest that they're a good place to start. If you post a reply/practice answer to any of those questions, you'll usually get feedback pretty promptly. If you want feedback on a different question you've practice-answered, you're welcome to post it, so long as posting the question doesn't breach someone's copyright.
     
  12. ozhwang

    ozhwang New Member

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    Did anyone get an interview for USyd DMD?
     
  13. blueocean

    blueocean New Member

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    This is my first time answering these types of questions and I don't know a lot about the health care system, all the ins and outs, but I'll give it a try.

    I feel that there are a few factors to consider with this approach- preferential admission. The fact that students are to commit to a 2 or 3 year tenure isn't ideal in the sense that it may get students/doctors to rural/under-serviced areas when they graduate, but there isn't necessarily any guarantee that after the 2 years is up, that they will continue to work in these areas. They could come back to urban areas and practice there for the rest of their careers and essentially this is problematic because it doesn't satisfy what the purpose of 'preferential admissions' was all about - that is providing under-serviced regions with more doctors.

    Another issue I have with this approach is that after medical students graduate, they are essentially still interns and still learning the major things regarding being doctors. If they are to work in under-serviced areas, I assume that there won't be many doctors to supervise them, which is what happens in hospitals in urban areas, so essentially, I don't believe that they will be ready to work in such stressful and demanding areas because of their lack of experience, firstly, as well as the fact that they still have so much more to learn.

    Possible solutions to the problems I have mentioned with idea of preferential admission is to provide students with other incentives to work in under-serviced areas. This could include scholarships which state that once a doctor has built up an experience of 5-10 years in an urban setting, then they need to work in a rural hospital for 5 years. Another solution may be to, instead of working 2-3 years after students graduate in an under-serviced location all at the same time, it could be broken up, such that students can work 1 year in a rural settting for every 5 years that they work in the city. This way, they build up their experience and can be more valuable to rural hospitals, for example.

    So far, this is what I've come up with, I would really appreciate any help and feedback. Sorry if I start to ramble towards the end.
     
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