MMI Example Station: Personal and Professional Ethics

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If you are preparing for the multiple mini interview, you must be prepared for a scenario that tests your response to a moral or ethical problem.

Here’s an example from a recent potential MMI station:

“You are a third year medical student and a friend confides in you that he has been feeling depressed lately and thought about committing suicide once a few weeks ago. He asks you not to tell anyone as he thinks he is coping better now. What possible action should you take and why?”

 

There are many similar scenarios to this and they are all easy to answer once you have an idea about what exactly is being tested.

Here the panel want to ensure that you understand your professional duty as a doctor, firstly to patients but also to your colleagues.

The first question to ask yourself in any such scenario is,

“Could patients could be at risk?”


It seems clear that there is at least a small chance that this doctors depressed and suicidal behaviour could put patients at risk.
This could be during his current clinical attachment or perhaps in the future when he has a more responsible role.
There is therefore a duty to ensure that you consider the risk to patients, first and foremost as well as formulating a sensitive response to this friends distressing problem.

1. The first thing to say would be that you are concerned for BOTH your friends well being and safety of any patients that he may be in contact with who may therefore be put at risk.

2. Initially it would be reasonable to approach him directly and highlight your concerns to him if you have a good rapport with him.

3. Make sure that he seeks professional help rather than just assume he is better and the problem has been resolved.

4. Persuade him to approach his personal tutor for support. This step will ensure he gets the right sort of help and can be allowed to step away from the clinical setting in the meantime.

5. Do not under any circumstances collude with him in covering this problem up. As a doctor you have a greater responsibility in this scenario and the success of your answer depends upon this carefully considered approach.

6. If it is not clear that he is taking this seriously and has not sought help you may need to highlight the problem to other people in a responsible position. The first step would be your own personal tutor.

7. You may be pushed by the examiner to show more loyalty to a friend and let him deal with this issue privately. Insist that you understand this point of view but take your responsibility to patients very seriously.

8. You may also be pushed to try to deal with the issue yourself. Whilst you can lean a sympathetic ear to your friend, he is at risk of future self harm at the very least and urgent professional help is needed. As a friend you are probably best placed to persuade him to seek this help himself, especially since he has confided in you already.

9. Remember that this may represent a ’cry for help’ and you have a responsibility to your friend, even though he seems to be playing it down by suggesting he is better now. This may simply be his way of talking about a difficult and embarrassing subject.

10. As you discuss this scenario, remain calm and firm in your argument. Try to sound reasonable throughout. Consider other options presented to you by stating that you appreciate that point of view.

11. Finally, be aware that sometimes you may be given a hint to correct your argument if you are going down the wrong track. Be alert to this although usually in this type of scenario the panel will be challenging you to see how well you can argue your position.

This a common type of scenario. The best preparation is to read the GMC guidelines for doctors and be aware of the duties of a good doctor. You can refer to these in your answer for extra marks.

If you’d like to access MMI mark schemes and more example scenarios and strategies try our Multiple Mini Interview Guide.

 

Best of luck!

Leo

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