Practice Interview Question Thread

[whoartthou]

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!

I feel you completely. That's why I encourage actual practice by vocalizing and not just typing responses. I started first practising by writing out responses entirely and reading them then improved to just writing out points. After a while you do it on the fly. There is no quick fix to issue as becoming good at anything takes time. I have always encouraged students to start early such as in Year 11. However, either due to priorities or lack of maturity it sometimes falls on deaf ears. Remember this skill is required throughout your career when you apply for specialties and jobs in the future.

How long do you think a concert pianist practices before performing on stage from the time they first start playing the piano?

 

[kotoloper]

Thanks so much Crow and whoartthou! I'll just keep on steaming ahead with practice responses and slowly move on to verbalising my answers. Here's just another quick one - I have no idea around the policies surrounding organ donation; is this something I should have a basic knowledge of? It just kinda made sense to me that it was not ethical to consider the brain-dead patient to be a organ donor due to lack of consent, but I'm not sure if this is actually correct. Yup basically extremely uncertain about what I've said, any pointers would be appreciated on what I didn't explore fully or at all!

A man has been in a car crash, and is determined to be clinically brain-dead. It is unclear as to whether he was an organ donor. The man has no immediate family. Doctors speak to the passenger in the car who was the man's friend. The passenger says that he probably would have been fine with donating as they had spoken about it before but couldn't be sure. On the other hand, a patient comes in urgently needing a heart transplant and has about a week to live without a transplant. What should be done? Why?

First, the options available to the patient needing a transplant need to be explored – are there any available donor hearts currently which would be suitable as a donor for the patient? Can the patient be put on the list, and how long would that potentially take? Given that the patient has about a week to live, time is of the essence.

The lack of clarity surrounding the clinically brain-dead patient and consent to be an organ donor suggests that the individual should not be considered at all as a possible donor. The friend’s account that the patient would have probably been fine with donating should not be used as a basis for justification; verbal conversations are an extremely unreliable source of information as memories might not replicate what actually happened, and the friend may be recalling something that never happened. Even so, without clear permission from a patient, it is not ethical to remove their organs for donation; if this were the case, on the basis of this justification, organs could be removed from any deceased patient if someone vouched that they consented on a verbal basis.

The doctor should take the time to explain fully to the patient and their family about the reality of the situation empathetically. The reality is that there are a large amount of patients awaiting a transplant with a disproportionate availability to meet this demand, and it may be unlikely that a heart becomes available on short notice. Furthermore, if the patient's health was already deteriorating and a heart transplant may serve to prolong the patient's life by a fraction, other patients may be prioritised based on the practical benefits. The family should be notified of this and given the facts of the situation in a sympathetic manner, and be allowed to prepare themselves for whatever is to come.

 

[watermelona]

Thanks so much Crow and whoartthou! I'll just keep on steaming ahead with practice responses and slowly move on to verbalising my answers. Here's just another quick one - I have no idea around the policies surrounding organ donation; is this something I should have a basic knowledge of? It just kinda made sense to me that it was not ethical to consider the brain-dead patient to be a organ donor due to lack of consent, but I'm not sure if this is actually correct. Yup basically extremely uncertain about what I've said, any pointers would be appreciated on what I didn't explore fully or at all!

A man has been in a car crash, and is determined to be clinically brain-dead. It is unclear as to whether he was an organ donor. The man has no immediate family. Doctors speak to the passenger in the car who was the man's friend. The passenger says that he probably would have been fine with donating as they had spoken about it before but couldn't be sure. On the other hand, a patient comes in urgently needing a heart transplant and has about a week to live without a transplant. What should be done? Why?

First, the options available to the patient needing a transplant need to be explored – are there any available donor hearts currently which would be suitable as a donor for the patient? Can the patient be put on the list, and how long would that potentially take? Given that the patient has about a week to live, time is of the essence.

The lack of clarity surrounding the clinically brain-dead patient and consent to be an organ donor suggests that the individual should not be considered at all as a possible donor. The friend’s account that the patient would have probably been fine with donating should not be used as a basis for justification; verbal conversations are an extremely unreliable source of information as memories might not replicate what actually happened, and the friend may be recalling something that never happened. Even so, without clear permission from a patient, it is not ethical to remove their organs for donation; if this were the case, on the basis of this justification, organs could be removed from any deceased patient if someone vouched that they consented on a verbal basis.

The doctor should take the time to explain fully to the patient and their family about the reality of the situation empathetically. The reality is that there are a large amount of patients awaiting a transplant with a disproportionate availability to meet this demand, and it may be unlikely that a heart becomes available on short notice. Furthermore, if the patient's health was already deteriorating and a heart transplant may serve to prolong the patient's life by a fraction, other patients may be prioritised based on the practical benefits. The family should be notified of this and given the facts of the situation in a sympathetic manner, and be allowed to prepare themselves for whatever is to come.

disclaimer - im preparing for interviews for the first time as well
i tried to have a go at the question myself without reading your response and here is what i came up with:
(i also don't know anything about organ donation policies so im really not sure about what ive written and whether it makes sense)

A man has been in a car crash, and is determined to be clinically brain-dead. It is unclear as to whether he was an organ donor. The man has no immediate family. Doctors speak to the passenger in the car who was the man's friend. The passenger says that he probably would have been fine with donating as they had spoken about it before but couldn't be sure. On the other hand, a patient comes in urgently needing a heart transplant and has about a week to live without a transplant. What should be done? Why?
The main goal in a medical situation is to save as many lives as possible whilst also making decisions that are as ethical as possible. In this case we know for sure that that the man is clinically determined to be brain-dead and there therefore unfortunately his life cannot be saved. In regards to organ donation, the potential organ donor must give consent themselves, to maintain ethical practice, however in this case there is no way of determining whether he has previously given consent or not as he has no immediate family and his friends response suggests he is unclear about the potential donors consent as well and cannot be used as a legitimate answer.

Now with regards to the patient who has urgently come into hospital and only has about a week to live without a transplant this means that if he is able to receive a transplant he could live longer but without a transplant he will not live longer than a week. However there is still the possibility that while he is receiving the transplant a complication in the operation could occur leading to an unsuccessful transplant resulting in not even that 1 week of life he could have lived, say he had not received a transplant in the first place.

If it is determined that the best option is to consider the man from the crash, this is if no other donors are available in time, the next thing to do is determine whether the organ transplant should go ahead between the man from the car crash and the urgent patient. the first thing that needs to be considered is whether the donor is a correct match for the patient, once that has been confirmed, the decision whether to transplant or not to can be made. This requires looking into the potential donors age, blood type, any underlying health conditions and whether their organ is a match. If they are a match then the next decision to make is whether to donate or not. To do this, any other interfering or possible complications of the urgent patient should be determined and dealt with first. If doctors think that the chances of the operation being unsuccessful are too high, then it is probably best not go ahead with it as then at least they would get the 1 week to live also this is the most ethical response to the situation as there is not risk of going against the potential donor's wishes. However, if no complications are found then I would say that the best thing to do is to go ahead with the transplant because that way there is a chance that the patient will be able to survive and live longer which is the most favourable outcome.

Also as we only know the closest person to the donor was his friend, who was the passenger, it would definitely be best to inform him/update him on the situation and whether the transplant went ahead and the result of it.
-----------------
so i see we both took a different angle on the situation which is interesting - so would it be ethically incorrect, with no exception, to use an organ from someone who has not explicitly given their consent/lack of consent even if it has the potential to save a life?

 

[Sokka]

This was straight off the MSO interview portal, and I actually liked this a lot but couldn't think of much else to say. I recorded myself doing this the first time and I literally rambled about nothing hahaha. My second recording was a bit better, and these are the key points. Any feedback is appreciated
"A patient is more than the sum of his/her symptoms" Discuss what this means.
So I interpret this prompt as telling me, as a doctor, that I should be treating my patients as individuals rather than simply diagnosing and treating their symptoms. Basically, when you treat a patient, you need to take everything about them into account such as their lifestyles, their relationships and their work in order to provide the optimum care and alleviate their symptoms. Having "tunnel vision" (for lack of a better word) and solely treating their symptoms means that I may not be optimising their care. I've actually read a story of a doctor who literally saved a patients life by treating a patient as a whole. From what I remember, the patient came in for a sore hand, but when the doctor performed tests targeted at the patients lifestyle he realised he was having a heart attack.
Furthermore, I also think that this statement explains that the symptoms of patients does not reflect who they are. For example, it would be impossible to know if someone who has an alcohol addiction simply made poor life choices, despite this being a common misconception. There are a variety of factors which may have led to this, such as domestic violence as a young child or being faced with many stressors such as unemployment or mental health issues. What I'm trying to get at is everyone has a past, and it is impossible (and unethical) to deduce anything about patient simply based on their symptoms.

 

[chinaski]

A good start, but perhaps think about broadening your interpretation of the quote beyond the theme of keeping an open mind when diagnosing illness.

A person is a person, first and foremost; they are not a disease or a "patient". As such, defining someone in terms of their illness is a frowned-upon (yet very common) habit: it depersonalises and stereotypes an individual if they are continuously seen through the lens of illness.

 

[Crow]

The organ donation scenario gives an advantage of the patient having one week to live, which gives you more time to explore other potential options rather than make an immediate decision. While you aren't expected to understand the law surrounding healthcare decisions for incompetent adults at this level, it would provide some good discussion points: you could check if the patient has an advance health directive, if they've appointed an enduring power of attorney etc. as these would give you an indication of the patient's previously voiced wishes on the matter in an official capacity. Similarly, you could find out if the car crash victim had any other close relationships in their life, e.g. did they have a long-term partner or other close friends who you could consult that may have a better idea than the friend in this scenario? You can then go into the ethics (pros and cons) of going ahead with the donation or not, which would form the bulk of the answer if I was the one answering this question. I think the answers given above could've gone into the nitty gritty a bit more beyond "it would be unethical to go ahead with the donation against the patient's wishes".

the first thing that needs to be considered is whether the donor is a correct match for the patient, once that has been confirmed, the decision whether to transplant or not to can be made. This requires looking into the potential donors age, blood type, any underlying health conditions and whether their organ is a match. If they are a match then the next decision to make is whether to donate or not. To do this, any other interfering or possible complications of the urgent patient should be determined and dealt with first. If doctors think that the chances of the operation being unsuccessful are too high, then it is probably best not go ahead with it as then at least they would get the 1 week to live also this is the most ethical response to the situation as there is not risk of going against the potential donor's wishes. However, if no complications are found then I would say that the best thing to do is to go ahead with the transplant because that way there is a chance that the patient will be able to survive and live longer which is the most favourable outcome.

In my opinion, this isn't really what the question is asking and isn't a good use of the time you have to answer this question - you don't need to know the process behind organ donation approval and wouldn't be assessed on it in an interview setting. This is an ethics question so you'd be better focusing on the ethics.

Generally speaking, having an understanding of the ethics behind organ donation and the pros and cons of opt-in and opt-out organ donation would probably serve you well in your interview preparation (same goes for a variety of other ethical situations in healthcare: abortion and euthanasia being big ones but also many, many others).

 

[Sokka]

A good start, but perhaps think about broadening your interpretation of the quote beyond the theme of keeping an open mind when diagnosing illness.

A person is a person, first and foremost; they are not a disease or a "patient". As such, defining someone in terms of their illness is a frowned-upon (yet very common) habit: it depersonalises and stereotypes an individual if they are continuously seen through the lens of illness.

What exactly is wrong with “depersonalising” a patient? Please don’t take this the wrong way hahah, I completely agree with you. What I mean is aside from the ethics of not treating others as human (more specifically people who trust u with personal info), what are the real impacts of this?

 

[chinaski]

What exactly is wrong with “depersonalising” a patient? Please don’t take this the wrong way hahah, I completely agree with you. What I mean is aside from the ethics of not treating others as human (more specifically people who trust u with personal info), what are the real impacts of this?

Aside from the effect it has on both the patient and yourself as a practitioner? If you depersonalise someone, you dehumanise them - consider what that means in the context of human relationships and interactions. That's potentially incredibly traumatising for a patient. It can change the very way they perceive themselves. As a practitioner, the moment you start seeing your patient as an object and not a person is the moment you cross a very dangerous line.

 

[watermelona]

The organ donation scenario gives an advantage of the patient having one week to live, which gives you more time to explore other potential options rather than make an immediate decision. While you aren't expected to understand the law surrounding healthcare decisions for incompetent adults at this level, it would provide some good discussion points: you could check if the patient has an advance health directive, if they've appointed an enduring power of attorney etc. as these would give you an indication of the patient's previously voiced wishes on the matter in an official capacity. Similarly, you could find out if the car crash victim had any other close relationships in their life, e.g. did they have a long-term partner or other close friends who you could consult that may have a better idea than the friend in this scenario? You can then go into the ethics (pros and cons) of going ahead with the donation or not, which would form the bulk of the answer if I was the one answering this question. I think the answers given above could've gone into the nitty gritty a bit more beyond "it would be unethical to go ahead with the donation against the patient's wishes".
In my opinion, this isn't really what the question is asking and isn't a good use of the time you have to answer this question - you don't need to know the process behind organ donation approval and wouldn't be assessed on it in an interview setting. This is an ethics question so you'd be better focusing on the ethics.

Generally speaking, having an understanding of the ethics behind organ donation and the pros and cons of opt-in and opt-out organ donation would probably serve you well in your interview preparation (same goes for a variety of other ethical situations in healthcare: abortion and euthanasia being big ones but also many, many others).

right i see, i should have gone into more detail and focussed more on the ethics and pros and cons, thank you so much for the feedback!

 

[Sokka]

Aside from the effect it has on both the patient and yourself as a practitioner? If you depersonalise someone, you dehumanise them - consider what that means in the context of human relationships and interactions. That's potentially incredibly traumatising for a patient. It can change the very way they perceive themselves. As a practitioner, the moment you start seeing your patient as an object and not a person is the moment you cross a very dangerous line.

For discussions sake, wouldnt dehumanising a patient mean the doctor can do their jobs more effectively by working with pure logic without the influence of emotions. In a high stress situation it is very possible for a doctor to work on emotion because they’ve created a connection with a patient, which could ultimately be detrimental as they may not do what’s best.

 

[chinaski]

For discussions sake, wouldnt dehumanising a patient mean the doctor can do their jobs more effectively by working with pure logic without the influence of emotions. In a high stress situation it is very possible for a doctor to work on emotion because they’ve created a connection with a patient, which could ultimately be detrimental as they may not do what’s best.

There's a world of difference between maintaining compassionate objectivity and dehumanising a person. The latter represents an extreme on the spectrum that you should avoid.

 

[kotoloper]

So with ethical situations like the organ donation, should we spend the time just discussing the ethical implications for pros and cons rather than trying to make a decision and justifying it? Thanks for the feedback guys!

 

[Crow]

So with ethical situations like the organ donation, should we spend the time just discussing the ethical implications for pros and cons rather than trying to make a decision and justifying it? Thanks for the feedback guys!

You should definitely make a decision and justify it if that’s what the question asks! But you need to show you have insight into the situation and you can do this by weighing up the pros and cons. You could structure questions along those lines something like:

The pros are x, y and z.
The cons are a, b and c.

Personally I believe the importance of b in particular outweighs the pros, and therefore the donation (or whatever it is!) should not go ahead.

The same would apply if you were asked about your opinion on abortion, euthanasia etc etc - you should be able to show insight into both sides of the fence, as well as be able to pick a side and justify it if you were asked to do so.

However, maybe one of the other experienced members will have something different to say. There are many different angles you can take and still do well in this style of question.

 

[N182]

You should definitely make a decision and justify it if that’s what the question asks! But you need to show you have insight into the situation and you can do this by weighing up the pros and cons. You could structure questions along those lines something like:

The pros are x, y and z.
The cons are a, b and c.

Personally I believe the importance of b in particular outweighs the pros, and therefore the donation (or whatever it is!) should not go ahead.

The same would apply if you were asked about your opinion on abortion, euthanasia etc etc - you should be able to show insight into both sides of the fence, as well as be able to pick a side and justify it if you were asked to do so.

However, maybe one of the other experienced members will have something different to say. There are many different angles you can take and still do well in this style of question.

Will interviewers generally question/discuss with you the pros/cons or is it mostly one-sided?

 

[chinaski]

So with ethical situations like the organ donation, should we spend the time just discussing the ethical implications for pros and cons rather than trying to make a decision and justifying it? Thanks for the feedback guys!

Worth noting that these scenarios - including the one in the stem you've discussed - are given to you with the assumption that you don't know the actual legalities of the situation. Someone with a background in organ donation, for instance, would give a very close-ended reply to this question, as there is legally absolute answer to it. However, for med school interviewees, they want you to explore both sides of the coin, rather than give them a factually-based take on the scenario.

 

[Crow]

Will interviewers generally question/discuss with you the pros/cons or is it mostly one-sided?

This depends on where you’re interviewing and the style of interview for that particular uni. JCU for example will be a “scenario” at the end of the panel-style questions and it’s more of a back and forth discussion with the interviewers. I’ve interviewed elsewhere, however, where I had a 5 minute station with 3 standard questions - so I just had to discuss the pros and cons for the first question, and then one of the follow ups was “would you be in favour of ____” where my answer was “Yes as per part x of my first response, I would because....”. Sorry for being very cryptic but that’s all I can say Just know the style of interview for that uni and you should be able to prepare accordingly.

 

[Benjamin]

Worth noting that these scenarios - including the one in the stem you've discussed - are given to you with the assumption that you don't know the actual legalities of the situation. Someone with a background in organ donation, for instance, would give a very close-ended reply to this question, as there is legally absolute answer to it. However, for med school interviewees, they want you to explore both sides of the coin, rather than give them a factually-based take on the scenario.

I wonder what would happen if an interviewee took the proper legal route here: brain dead patient is technically deceased at time of brain death declaration, all decision making passes to next of kin. In absence of clear objection / refusal of consent for organ donation then 'authorised officer' - i.e. the consultant - can make the decision independently to proceed in SA / ACT / VIC but not QLD/WA/NSW/NT/TAS -- in these states the decision rests with 'friend' as a statutory health attorney.

In practice, proceeding without explicit consent doesn't happen - the potential legal backlash of this is untested and so organ donation usually does not proceed when there is any uncertainty about the donor or next-of-kins wishes.

 

[chinaski]

I wonder what would happen if an interviewee took the proper legal route here: brain dead patient is technically deceased at time of brain death declaration, all decision making passes to next of kin. In absence of clear objection / refusal of consent for organ donation then 'authorised officer' - i.e. the consultant - can make the decision independently to proceed in SA / ACT / VIC but not QLD/WA/NSW/NT/TAS -- in these states the decision rests with 'friend' as a statutory health attorney.

In practice, proceeding without explicit consent doesn't happen - the potential legal backlash of this is untested and so organ donation usually does not proceed when there is any uncertainty about the donor or next-of-kins wishes.

I'd say that paradoxically, a close-ended medicolegally "correct" answer would score less impressively than a response that explored the general themes of the stem made with no prior knowledge of the legal facts. They're not looking for a factual answer, so you're not likely to score unless you tick the correct "discussion" boxes (which are irrelevant points if you just concentrate on the medicolegal response, which is finite and fairly clear-cut). Marking criteria probably centre around the candidates's appreciation of both sides of the issue, rather than an arrival at the "real" answer to the question.

Worth also pointing out that the interviewers in these scenarios may not be across the medicolegal facts themselves - so it's potentially problematic if you have a candidate who actually knows more about the hypothetical topic than the interviewers. As such, I don't think these questions are framed very well, because they potentially put a knowledgable candidate at a disadvantage.

 

[brownpanda69]

This is my first attempt at interview questions. I know it needs a lot of improving, so feedback would be appreciated! Thanks!

You are a haematologist and your patient is a man who cannot speak English and has his daughter to translate. He has leukaemia, but his daughter pulls you aside and asks you not to tell him because in their culture, having cancer is like a death sentence. What do you do?
It is very important to respect the cultural beliefs of the patient. It may cause psychological harm to the patient and his daughter once they learn the diagnosis. I would validate the patient's daughter's concerns and explain that the discussion will be done in a sensitive manner (e.g. for instance, I wouldn't use words like 'cancer' and instead use words like 'growth' or 'tumor'). However, the patient has the right to information about their diagnosis and participation in their healthcare decisions. If the patient wishes to know their diagnosis, I would first ask him if he wishes me to explain the test results or ask if he would prefer me to speak with his daughter and/or other family members. Then, I would explain the diagnosis to my patient in as much detail as he would like, as well as treatment and steps to take. Using family members as translators could possibly take away some of the objectivity of the explanation of the diagnosis, so I would use a translator instead.
You get a translator; the daughter becomes overbearing and talks over the translator. What would you do so the daughter feels that you have taken her concerns into account?
I would explain to her that her father has a right to know and understand his diagnosis, while reassuring her that her father is in good hands, and that the medical team and I will do all we can to ensure that her father will receive the best possible treatment and care.

 

[chinaski]

So some follow up questions to that:

1. What potential problems do you think might arise from your using euphemisms such as "growth" or "tumour" to describe the diagnosis, in lieu of the word "cancer"?

2. How would you go about getting informed consent for treatment of the leukaemia from the patient, if you have not informed him he has leukaemia?