Multiple Mini Interview
Questions

"Getting involved is something that many people would hesitate to do; however, I believe the more often we confront those who are inappropriate in the workplace, the less often these situations will occur. In this situation, I would approach the group and ask them to clarify what I had just heard. This approach is generally enough to make them realize they are acting out of line. If I had heard correctly and felt the situation was harassment of any sort, I would then take the issue to the proper human resource authorities for review. It's critical to me that everyone in our field act with the utmost integrity and show respect for their colleagues in every possible way."

"Family violence is a grave issue and one that I do not take lightly. We should approach domestic violence as a medical problem because it creates not only physical injury but also emotional and psychological harm to those involved. If my patient disclosed that they were experiencing domestic violence, I would apply the SOS DOC method, which is an approach I recently learned. This acronym stands for Support, Safety, Options, Strengths, Document, Continuity. These are steps that a physician can take when approached by a patient regarding domestic violence. I may not be able to report the incident without admission or permission from the patient; however, I can provide empathy and a safe, non-judgemental environment. With my continued support, I would hope my patient would gain the strength to either report their spouse or leave the situation."

"I appreciate you coming to me and trusting me with your health. I am very dedicated to my patients, and when I sense that there is something wrong, I am the first person to be on your side. With that said, I cannot grant you a doctor's note for the reason of skipping out on a work obligation. I take my word seriously and am not interested in becoming involved in matters of excusal when I cannot find a medical justification. If you do not wish to attend the conference, my recommendation is to be straightforward with your employer."

"I know that I will be an excellent physician because I am naturally curious, empathetic, confident, and a strong problem solver. Having always known that I want to be in the medical field, taking care of others, I chose to pursue my interest by volunteering at our local hospital two days per week. My interest only grew as I saw physicians being able to help others live their best lives while reaching their own highest pursuits. I am someone who cares about humanity and ensuring people are as healthy as possible. While pursuing my undergrad, this desire to help others only grew. Now, recently completing an internship under a general practitioner, I have grown my skills in empathy and gained a fuller understanding of the patient-centered approach. These skills, qualities, and experiences combined give me the confidence that I will succeed as a physician."

"I fully believe in a patient-centered approach, so I would first ask my patient why they want the birth control. Is it for regulating her cycle, or for family planning purposes? I would ask questions to ensure she is in a place of consent if the reasoning were due to sexual activity. Any patient is within her rights to ask for confidentiality; however, I would inquire as to why she does not want her parents to know. This inquiry will help me to understand if she needs referrals to additional resources for family planning and sexual health. In our region, healthcare laws specify that minors can obtain treatment for STIs and family planning, which includes contraceptives and pregnancy-related treatment. These laws allow doctors to maintain confidentiality from their underage patients' parents legally."

"Religious and social norms aside, the Center for Disease Control and Prevention has reported that male circumcision can reduce the risk of contracting HIV from an infected partner by up to 60%. Medical studies also show that male circumcision can reduce the risk of sexually transmitted diseases and penile cancer. There are other benefits such as the reduced risk of urinary tract infections, for starters. With that said, many in the medical profession believe this to be at a higher cost. There is a belief that we perform this procedure without much medical reasoning and more for appearance or societal norms. When doctors perform male circumcision within the first week after birth, there is generally little consequence to the infant; however, this outcome can change when male circumcisions are performed later in life. My stance on male circumcision is that every family should be well informed of the potential benefits, possible risks, and be very clear on why they are deciding on circumcision for the infant in the first place. Should the infants' parent or parents choose to move forward, this should be a private service."

"Nutrition is a fundamental element in health, and I believe this quote addresses that fact. Hippocrates, the 'Father of Medicine,' held strong beliefs that disease was natural, and not due to superstition or punishment from the gods. This belief led him to understand that many cures were naturally available to us on this earth. Today, many of Hippocrates' theories are now far removed from modern medicine. Yet, the saying, 'Let food be thy medicine and medicine be they food,' I believe refers to what we still find today, which is that we can often heal ourselves naturally. In many circumstances, we can use the foods, herbs, and natural resources from the planet to heal our bodies. Hippocrates supported a 'lifestyle medicine' approach, and he was also known for saying, 'Walking is man's best medicine.' This saying is another with merit; however, today, we must be diligent in allowing traditional medicine and alternative approaches to work together to best heal our bodies from illness and disease."

"IVF has always been a controversial practice, with it becoming more mainstream only in the past few years. The medical profession has found better ways to screen and perform genetic testing, making IVF a much more viable option for couples who wish to conceive but may not be able to do so in a traditional manner. I recently read an article in the AMA Journal of Ethics discussing how many European countries have banned the practice of elective sex selection; however, countries such as the US have no such ban. The topic of gender selection generates many different opinions when it comes to medical ethics and even social consequences. One strong argument against gender selection is that the practice potentially reinforces societal gender bias. Others are afraid that once gender selection is mainstream, we will not stop and will begin to select other non-health-related traits in embryos. We also do not know without a doubt that gender selection does not present potential harm to the offspring. In my professional opinion, I believe it's important to utilize the incredible things we can do with science while still respecting the natural order as much as possible. I would not take the risk at this time, nor would I recommend the practice to a patient undergoing IVF, seeking a viable and healthy outcome."

"I understand that some groups, such as the Jehovah's Witness, refuse transfusions of whole blood, red and white corpuscles, platelets and plasma. Many also refuse both natural and recombinant hemoglobin. There is a lot of ethical and legal debate around the refusal of potentially life-saving transfusions with very little agreement between groups. With that said, whether I would agree or not, I would need to do what is ethical and right in that particular situation. I would look to the ethics committee and other more seasoned medical professionals to come up with a response or treatment plan that we collectively felt was ethical and would have the most positive impact on the patient."

"When it comes to reporting the presence of infectious disease to their public health agency, a physician must familiarize themselves with the mandatory reporting obligations in their region. A physician should be aware of what details they disclose, being sure to limit the amount of information they provide, and sticking strictly with information that is mandatory to report. A physician must also ask if the information falls under the 'duty to report' or the 'duty to warn' umbrella. When a physician is concerned about a potential threat to a patient or third party, they must heartily consider all criteria and circumstances, being objective and accurate at all times. If possible, the physician should inform their patient of their duty to report or duty to warn and disclose to their patients which information they intend to share. Then, the physician should document the discussion in the patients' medical records. Of course, this process will pivot if there is an immediate risk of harm or death to the patient or any third party. If the situation were cloudy, leaving me unsure, I would contact the proper medical authority for information and advice."

"Behavior modification is incredibly challenging, and I believe that change is a process, not an event. In many medical studies, we see that change can take six months or more, as humans tend to contemplate change for much longer than is usually necessary. Once someone is aware that there is a problem in their health, it often takes a long time to commit to action and change. For that reason, I would choose to put most of my efforts into treating existing disease and improving the lives of those suffering from illness while, at the same time, working in the background to create change over time. I could do this by educating the patients that I treat and encouraging them to take small steps towards change. In the case of a smoker, for instance, they may be contemplating, 'If I quit smoking, I will reduce the risk of heart disease, but I will also gain weight.' Rather than fighting their thought process, I would encourage them to cut back over time, reducing their commitment to cigarettes just one cigarette at a time."

"I believe that the biggest opportunity for change with the US-based healthcare system is the unequal access to healthcare benefits. People who are not provided coverage through an employer, students, new immigrants - many people cannot afford the hundreds of dollars per month that it can cost to purchase individual health insurance. This issue leaves many people who are in a healthcare crisis feeling lost and desperate. If I could make changes to repair this issue, I would begin by looking at other government structures where access to healthcare is much better. For instance, in the Netherlands, most people have easy access to primary care centers. Health insurance is mandatory; however, it is much more affordable and accessible than the choices we have here in the USA. All in all, if I could make a change, I would entertain an offering similar to that in the Netherlands or even Switzerland, which includes universal coverage through mandatory yet affordable private insurance."

"They say that those who can't do - teach. I disagree with this sentiment. I wholeheartedly believe that as a physician, I need to be my healthiest, perform research, and be the benchmark when it comes to personal health. One example is if a patient comes to a general practitioner because they want tools, resources, and support to quit smoking. How would the patient feel if, during that visit, the GP smelled like cigarette smoke? Another reason that I feel a responsibility to be a healthy role model is that the healthier I am, the longer I will be able to practice medicine and help others. The fewer sick days I have, the better I can do my job. And, the more energy I feel from living a healthy lifestyle, the more people I will be able to influence positively."

"I have come to learn that lobbying impacts many industries and sectors, including medicine, education, law, and politics. When it comes to the medical industry, lobbying can hurt physicians and patients, in a few ways. We see reports that the big pharma lobbying group known as PhRMA has spent as much as $300 million to defend higher prescription drug costs. As we know, unaffordable medication is a significant issue for many ill people in our country. One example of this impact is the outrage over Mylan's EpiPen prices in 2016. When Mylan purchased the rights to EpiPen in 2007, they gradually raised the list price from about $50 per auto-injector to over $600 for a two-pack. The move boosted EpiPen profits to $1.1 billion a year. Much of this was due to greedy pharma lobbying efforts directed at drug pricing and the limiting of generic competitors. After Trumps' speech in 2018 regarding the pending fall of pharmaceutical influence on drug prices, we have seen an uptick of big pharma pouring money into lobbying campaigns when it comes to laws surrounding prescription drug prices. Today, despite this surge in lobbying, we continue to see improvements on drug prices, and I look forward to tracking this topic of money, drugs, and government as my medical career further unfolds."

"Reproductive rights have been an important and critical topic as far back into time as we can imagine. I am aware that in January 2019, the state of New York enacted changes to the Reproductive Health Act, which included further access to abortion and the legalities surrounding the performance of late-term abortions. The law also removed abortion from the state's criminal code, removing criminal liability for doctors and other healthcare professionals. My stance on abortion is not black and white, as every person, case, and circumstance is different. Looking at countries where abortion is illegal, we see around 30,000 deaths of women due to botched procedures. I am happy to see more attention going to the laws surrounding a woman's right to choose, and I hope to see a point in time when all women, no matter where they live, will feel free to do with their bodies as they see fit, under proper medical care and expertise."