Practice Interview Question Thread

[DrDrLMG!]

Whoartthou would it be ok if I posted scenarios? I have come across some tricky ones and would like to see how others respond to it.

Yes, this is absolutely fine

 

[H2.]

HIV positive patient (Ethical Decision Making)

You are a receptionist in a medical centre. You have found out that a patient, Henry, is HIV positive. He is engaged to Sandra, the daughter of your good friends, who as far as you are aware does not know this. What are you going to do?

• Henry became HIV positive after a syringe attack when he worked at a petrol station. Would that change your view?
• Sandra’s mother found out about this and she was furious that you did not tell her that Henry is HIV positive. What do you do?
• Should people with infectious diseases such as HIV be allowed to practice medicine?
• Don’t people with infectious diseases have rights?

 

[vroomvroom]

I completed this question as if I would in the interview giving me time to think about my answers (2minutes for all questions) and then writing as if I was speaking so I could gage my ability. Basically, I feel like i've missed a couple points and could improve my answers but just wanted a pro to gage my under-interview-conditions ability

HIV positive patient (Ethical Decision Making)

You are a receptionist in a medical centre. You have found out that a patient, Henry, is HIV positive. He is engaged to Sandra, the daughter of your good friends, who as far as you are aware does not know this.

What are you going to do?

As a receptionist, I don't have any medical authority in the situation and therefore can commit no action directly. Furthermore, Henry (and by extension, Sandra) have a right to confidentiality about his condition so it would be entirely disrespectful and wrong of me to break that trust and tell my good friends. However, in some states HIV carriers must disclose their condition to all potential sexual partners and therefore Sandra as a likely sexual partner of Henry may have the right to know Henry's condition. I could potentially follow up through their doctor at my clinic(if HIV disclosure is needed by law) to ensure Sandra's safety.

Note to my answer: Completely unsure if it's okay to follow up through the doctor to ensure Sandra knows - could someone please clarify? I feel this could be misuse of my position as I have no medical experience - would this change if I was another doctor? - An additional question: when something comes up in the interview that I am unsure on (like this), would it be better to acknowledge that this may not be okay and if I were actually in that position I would know my rights to a greater extent?

Henry became HIV positive after a syringe attack when he worked at a petrol station. Would that change your view?

It wouldn't change my view. Despite the unfortunate circumstances under which Henry became HIV positive, the important element here is that he does indeed have HIV and not whether it was due to a lack of safe practice or an incident completely out of his control.

Sandra’s mother found out about this and she was furious that you did not tell her that Henry is HIV positive. What do you do?

Assuming Sandra is of legal age, Sandra's mother has no legal power in this situation and therefore has no right to know Henry's condition through their doctor or any authority, only through Sandra or Henry. I'd emphasise with her the unfortunate circumstances but reinforce the idea it would be wrong of me disclose private details about other patients

Should people with infectious diseases such as HIV be allowed to practice medicine?

From my limited understanding of HIV, it is a disease transmitted through sexual activity or blood contact and i'm unsure on the current laws regarding this issue. From my perspective, as it is already against both moral and legal authority to commit any sexual act with a patient as long as the doctor doesn't work in an area with normal exposure to blood (I believe the risk of infection is far too high) and as long as the doctor has to inform the patient of their HIV status then it is within their rights to practice especially if they are treated for their condition.

Don’t people with infectious diseases have rights?

People with infectious diseases do indeed have rights, however, I believe any person with an infectious disease acting in good faith would acknowledge the risk they present to already vulnerable people and therefore realise that it would be wrong to practise where they present such a risk.
Note: would this break in codes that doctors must agree to in order to practise?

 

[vroomvroom]

Damn noticed some of my sentences didn't make grammatical sense and I haven't unlocked editing power haha

 

[whoartthou]

When answering questions like the child abuse question would it be wrong to acknowledge the limitations of your understanding here whilst still acknowledging it in general as harm or neglect of a child? It's a sensitive topic and there afaik shouldn't be any expectation for us to know the nuances of what constitutes child abuse

Not at all. The question isn't really testing your understanding of what child abuse but rather how you would approach the situation and the ethical principles around it.

 

[Crow]

Note to my answer: Completely unsure if it's okay to follow up through the doctor to ensure Sandra knows - could someone please clarify?

The doctor couldn’t legally disclose that information to you as a receptionist, so you wouldn’t achieve anything by doing this, I wouldn’t imagine.

would this change if I was another doctor?

If you were in a hospital and you were a member of the patient’s treating team, then yes, the doctor could legally disclose information to you. If you weren’t part of the treating team, then no, you couldn’t be given that information legally unless the patient gave you their consent.

Note to all, though: you aren’t expected to know the law regarding disclosure of medical information for the purposes of these interviews. The questions are there to assess ethics/morality/critical thinking, but not knowledge that you’ll be taught in your degree.

 

[H2.]

The doctor couldn’t legally disclose that information to you as a receptionist, so you wouldn’t achieve anything by doing this, I wouldn’t imagine.
If you were in a hospital and you were a member of the patient’s treating team, then yes, the doctor could legally disclose information to you. If you weren’t part of the treating team, then no, you couldn’t be given that information legally unless the patient gave you their consent.

Note to all, though: you aren’t expected to know the law regarding disclosure of medical information for the purposes of these interviews. The questions are there to assess ethics/morality/critical thinking, but not knowledge that you’ll be taught in your degree.

So the doctor can't legally disclose that information, yet a receptionist is still able to find out? how? Are they able to access personal information of patients on their computer?

 

[Crow]

So the doctor can't legally disclose that information, yet a receptionist is still able to find out? how? Are they able to access personal information of patients on their computer?

The scenario is a little far fetched A receptionist may have access to patient information, or they may not - but even if they did, they wouldn’t be legally entitled to access the information.

 

[DrDrLMG!]

The scenario is a little far fetched A receptionist may have access to patient information, or they may not - but even if they did, they wouldn’t be legally entitled to access the information.

Can confirm they definitely have access. I reported a receptionist once because I caught them accessing patient notes that I had just typed up into the electronic medical record. The patient was a family member of theirs and it was so wrong on so many levels.

I reported it to my direct manager, but was called into the Big Boss manager’s office and effectively given a lecture on ‘how things work around here’. Oh, and the receptionist was told they’d been reported, that it was me that had reported them, AND they faced zero consequences. They didn’t speak to me for about 12 months. It was fun times all round.

I remain angry about it to this day (it was about three years ago).

 

[whoartthou]

Can confirm they definitely have access. I reported a receptionist once because I caught them accessing patient notes that I had just typed up into the electronic medical record. The patient was a family member of theirs and it was so wrong on so many levels.

I reported it to my direct manager, but was called into the Big Boss manager’s office and effectively given a lecture on ‘how things work around here’. Oh, and the receptionist was told they’d been reported, that it was me that had reported them, AND they faced zero consequences. They didn’t speak to me for about 12 months. It was fun times all round.

I remain angry about it to this day (it was about three years ago).

Report to AHPRA. That is totally unacceptable.

Regarding the scenario your hands are tied in real life. You are not allowed to disclose it even if there is possibility of harm. There are only some circumstances where confidentiality can be broken which you can search up.

 

[DrDrLMG!]

Report to AHPRA. That is totally unacceptable.

This person is a receptionist though, and not registered with AHPRA. I guess I could have reported the entire practice to, well, I don't even know, to be honest. The health commissioner? But what (relatively) new grad is going to do that?

Anyway, sorry, this is getting a bit off topic. Apologies, I just needed to rant

ETA: though it's useful for people to see how these issues play out 'in real life' I guess, and know that these scenarios aren't posed just for entertainment's sake or to confuse them during interviews.

 

[whoartthou]

This person is a receptionist though, and not registered with AHPRA. I guess I could have reported the entire practice to, well, I don't even know, to be honest. The health commissioner? But what (relatively) new grad is going to do that?

Anyway, sorry, this is getting a bit off topic. Apologies, I just needed to rant

ETA: though it's useful for people to see how these issues play out 'in real life' I guess, and know that these scenarios aren't posed just for entertainment's sake or to confuse them during interviews.

Yeh I meant the practice. Time to go back on topic.

 

[worldno8]

Mrs. Jones has signed a donor card indicating that she is willing to donate her body to science without notifying her husband and son. She gets into an accident and it is determined she is brain dead. The family doctor, who is on call that afternoon, reviews the chart and determines that she would be perfect for medical students to practice the removal of organs for transplantation purposes. The doctor then talks to the family to discuss the procedure and to confirm their consent. They both oppose the procedure and refuse to allow their doctor to move forward. The doctor points out that Mrs. Jones could be helping hundreds of people by educating the medical students and that technically consent has already been provided. The husband understands how beneficial the educational experience is but is too emotional to allow them to continue. The son, a medical student, refuses because he knows the bodies are not treated with dignity. If you were the doctor, how would you proceed? Why?

I'm not too sure about how to deal with the husband's situation. Since organ transplant has to occur soon after death, I assume that there's not much time to negotiate so you can't offer the husband to go to psychological counselling. For the son, I would say to him that we would try our best to treat his mother's body with dignity throughout the procedure and that he may only be exposed or be a witness to a small number of organ transplant procedures in which the patient body was not treated as carefully.

 

[vroomvroom]

Report to AHPRA. That is totally unacceptable.

Regarding the scenario your hands are tied in real life. You are not allowed to disclose it even if there is possibility of harm. There are only some circumstances where confidentiality can be broken which you can search up.

Wow I've created quite a debate on this haha. Feel like I understand better now what they want from the question as opposed to getting caught up in the legal complexities. Would you be able to give me feedback on the response as a whole?

 

[vroomvroom]

The doctor couldn’t legally disclose that information to you as a receptionist, so you wouldn’t achieve anything by doing this, I wouldn’t imagine.
If you were in a hospital and you were a member of the patient’s treating team, then yes, the doctor could legally disclose information to you. If you weren’t part of the treating team, then no, you couldn’t be given that information legally unless the patient gave you their consent.

Note to all, though: you aren’t expected to know the law regarding disclosure of medical information for the purposes of these interviews. The questions are there to assess ethics/morality/critical thinking, but not knowledge that you’ll be taught in your degree.

Thanks for the clarification - I assumed the receptionist would get it through patient files and appointments. How should we deal with situations where we don't really have a good understanding of what the law deems right? Or is that exactly what they're testing? For controversial issues, would it be wrong to side with the side that disagrees with the law?

 

[whoartthou]

I completed this question as if I would in the interview giving me time to think about my answers (2minutes for all questions) and then writing as if I was speaking so I could gage my ability. Basically, I feel like i've missed a couple points and could improve my answers but just wanted a pro to gage my under-interview-conditions ability

HIV positive patient (Ethical Decision Making)

You are a receptionist in a medical centre. You have found out that a patient, Henry, is HIV positive. He is engaged to Sandra, the daughter of your good friends, who as far as you are aware does not know this.

What are you going to do?

As a receptionist, I don't have any medical authority in the situation and therefore can commit no action directly. Furthermore, Henry (and by extension, Sandra) have a right to confidentiality about his condition so it would be entirely disrespectful and wrong of me to break that trust and tell my good friends. However, in some states HIV carriers must disclose their condition to all potential sexual partners and therefore Sandra as a likely sexual partner of Henry may have the right to know Henry's condition. I could potentially follow up through their doctor at my clinic(if HIV disclosure is needed by law) to ensure Sandra's safety.

Note to my answer: Completely unsure if it's okay to follow up through the doctor to ensure Sandra knows - could someone please clarify? I feel this could be misuse of my position as I have no medical experience - would this change if I was another doctor? - An additional question: when something comes up in the interview that I am unsure on (like this), would it be better to acknowledge that this may not be okay and if I were actually in that position I would know my rights to a greater extent?

Henry became HIV positive after a syringe attack when he worked at a petrol station. Would that change your view?

It wouldn't change my view. Despite the unfortunate circumstances under which Henry became HIV positive, the important element here is that he does indeed have HIV and not whether it was due to a lack of safe practice or an incident completely out of his control.

Sandra’s mother found out about this and she was furious that you did not tell her that Henry is HIV positive. What do you do?

Assuming Sandra is of legal age, Sandra's mother has no legal power in this situation and therefore has no right to know Henry's condition through their doctor or any authority, only through Sandra or Henry. I'd emphasise with her the unfortunate circumstances but reinforce the idea it would be wrong of me disclose private details about other patients

Should people with infectious diseases such as HIV be allowed to practice medicine?

From my limited understanding of HIV, it is a disease transmitted through sexual activity or blood contact and i'm unsure on the current laws regarding this issue. From my perspective, as it is already against both moral and legal authority to commit any sexual act with a patient as long as the doctor doesn't work in an area with normal exposure to blood (I believe the risk of infection is far too high) and as long as the doctor has to inform the patient of their HIV status then it is within their rights to practice especially if they are treated for their condition.

Don’t people with infectious diseases have rights?

People with infectious diseases do indeed have rights, however, I believe any person with an infectious disease acting in good faith would acknowledge the risk they present to already vulnerable people and therefore realise that it would be wrong to practise where they present such a risk.
Note: would this break in codes that doctors must agree to in order to practise?

The first two answers are basically you can't do anything and it doesn't make a difference.

I would emphathise with Sandra's mum in this case. You cannot confirm or deny knowledge of the situation as you are only the receptionist. You would listen and try to give her impartial advice.

With regards to practising medicine with HIV, short answer is yes. They should be allowed to practice medicine however, you need to weigh up the what constitutes as discrimination vs duty of care to their patients. If they put the patients at risk due to their status then the patient need to know about it and make that decision. Ideally, they might be restricted in their level of practice such as procedural work may be limited due to exposure risk.

The last question is basically asking is it ok to discriminate against people based on their health status. You could have elaborated a lot more on this topic as what I have said above.

 

[whoartthou]

Mrs. Jones has signed a donor card indicating that she is willing to donate her body to science without notifying her husband and son. She gets into an accident and it is determined she is brain dead. The family doctor, who is on call that afternoon, reviews the chart and determines that she would be perfect for medical students to practice the removal of organs for transplantation purposes. The doctor then talks to the family to discuss the procedure and to confirm their consent. They both oppose the procedure and refuse to allow their doctor to move forward. The doctor points out that Mrs. Jones could be helping hundreds of people by educating the medical students and that technically consent has already been provided. The husband understands how beneficial the educational experience is but is too emotional to allow them to continue. The son, a medical student, refuses because he knows the bodies are not treated with dignity. If you were the doctor, how would you proceed? Why?

I'm not too sure about how to deal with the husband's situation. Since organ transplant has to occur soon after death, I assume that there's not much time to negotiate so you can't offer the husband to go to psychological counselling. For the son, I would say to him that we would try our best to treat his mother's body with dignity throughout the procedure and that he may only be exposed or be a witness to a small number of organ transplant procedures in which the patient body was not treated as carefully.

From a legal perspective the family has the right to the body if they ask for it back despite what Mrs. Jones has written previously if they are the next of kin. I looked this up and as long as the body isn't in the operating theatre they can ask for the operation to be halted.

From an ethical perspective you can easily empathise with the family. Discuss the issues behind the consent process was Mrs. Jones cognitively intact when she signed the form or was she pressured? What did she tell her family? Was there any discussion regarding what will happen to the body after death? What are the families worries? Is there cultural or religious reasons why? You could ask so many questions and explore these in your discussion.

Students seem to always pigeon hole themselves into a black and white answer in scenarios instead of exploring the perspectives of the individual parties that have come to the decision.

 

[Crow]

I looked this up and as long as the body isn't in the operating theatre they can ask for the operation to be halted.

That’s interesting - I am assuming a donor card is different to an AHD? This is contrary to what we’ve learned, as advanced consent provided by the patient when they had capacity trumps the wishes of the family members in these circumstances, doesn’t it?

ETA: This is QLD-specific, but from the Transplantation and Anatomy Act 1979:

Where a deceased person, during his or her lifetime, by signed writing consented to the removal after death of tissue from his or her body for any of the purposes referred to in subsection (1)(c) and the consent had not been revoked by the deceased person, the removal of tissue from the body of the deceased person in accordance with the consent for any of those purposes is hereby authorised.

The purposes under (1)(c) are:

(i) transplanting it to the body of a living person; or (ii) use of the tissue for other therapeutic purposes or for other medical or scientific purposes.

https://www.legislation.qld.gov.au/view/pdf/2016-03-24/act-1979-074

Pages 21-22 if interested.

Though, I guess it doesn't specify that next of kin can't override the decision.

 

[whoartthou]

That’s interesting - I am assuming a donor card is different to an AHD? This is contrary to what we’ve learned, as advanced consent provided by the patient when they had capacity trumps the wishes of the family members in these circumstances, doesn’t it?

Too many nuances in medicine.

Position statement on the legal framework for consent to donation

Organ and Tissue Authority position statement on the legal framework for consent to donation

donatelife.gov.au

In Australia the family will always be asked to confirm the donation decisions of the deceased before donation for transplantation can proceed. Although family objection is always tested to ensure that it is an informed decision, donation does not proceed if a family strongly objects.

 

[Crow]

Too many nuances in medicine.

Position statement on the legal framework for consent to donation

Organ and Tissue Authority position statement on the legal framework for consent to donation

donatelife.gov.au

In Australia the family will always be asked to confirm the donation decisions of the deceased before donation for transplantation can proceed. Although family objection is always tested to ensure that it is an informed decision, donation does not proceed if a family strongly objects.

There are indeed! I just added an edit to my post above, but yeah, there are way too many nuances in medical law!

Back on topic, now, sorry folks!