Multiple Mini Interview Questions

Multiple Mini Interview Questions

1. 1.

   One of your patients asks for a doctors' note to excuse them from a work conference. You do not see any symptoms of illness. Talk to the patient about your decision to provide or not provide them with a doctors' note.

   This question is a role-play opportunity or 'acting' question. For acting questions, a panel of interviewers, or perhaps even an actor, will be waiting in the interview room, and you must approach the situation as you would in real life. In this scenario, you must show professionalism, empathy, and compassion.
   
   

   

   Rachelle's Answer

   "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."

   Anonymous Answer
   "In this situation, a conflict exists between satisfying my patient's request and being honest and refusing to do so. Satisfying my patient's request would ensure my patient is able to be excused from work and avoid reprimand, and would not damage my relationship with the pt. Refusing to meet the patient's request, on the other hand, would likely damage my relationship."
   
   Margarita's Answer
   This question asks you to describe what your conversation would be with the patient directly. Your answer is more of your inner thoughts.
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2. 2.

   Is it ethical for healthcare workers to go on strike? Why or why not?

   When you build your response to this question, be prepared to support the pros and cons of each side. You know that the right to strike is a fundamental human right. You are also aware that when essential service providers such as healthcare workers go on strike, it must not be to the detriment of the health and safety or welfare of the public whom they serve.
   
   

   

   Rachelle's Answer

   "Striking for better working conditions is a human right, especially when addressing labor negotiations and other critical topics such as patient care. With that said, healthcare worker strikes can negatively impact many services and communities. Doctors who are on strike face a moral dilemma between abiding by the Hippocratic Oath and addressing or standing up for issues critical to the healthcare industry. I believe what is most important is the motivation behind the healthcare worker strikes. Steps should be taken to minimize the impact the strike will have on public health in general. Healthcare workers should acknowledge the moral obligation they have to best serve those in their community. Collective bargaining agreements should be handled promptly, and delays avoided at all costs. If they choose to strike, it's a healthcare workers' responsibility to avoid asking for unrealistic demands or needs that will put a strain on their government or their community."

   Anonymous Answer
   "Striking for better working conditions is a human right, but it is more complicated in healthcare because it can affect patient care. Healthcare workers have a moral obligation to treat their patients but also have a right to fair working conditions, such as not overseeing too many patients at once or having shifts that are too long, both of which can lead to mistakes. Also, safety is an issue for healthcare workers. During the COVID-19 pandemic, there was an ongoing issue about healthcare workers not having adequate access to PPE, which puts them at risk of contracting COVID-19. However, whatever the conditions justified for healthcare workers going on strike, their profession represents an altruistic duty to serve the community. Healthcare workers striking can affect timely care that can lead to preventable deaths. Negotiations should be made promptly in order to minimize disruptions in care as well as active understanding of the conditions that, if left unheard, can resort to workers striking. Healthcare workers choosing to strike should also understand that their actions can put a strain on the healthcare systems in place."
   
   Rachelle's Answer
   Excellent work! Your answer shows a lot of thought, and it's great that you included the COVID-19 pandemic as a recent example to support your stance.
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3. 3.

   You witness a group of male colleagues speaking inappropriately about a female colleague. What do you do?

   In the 'Me Too' era and amidst other equality movements, the panel wants to see how you would approach a workplace situation that you know is inappropriate. Harassment is troubling, in any circumstance. Still, people often have trouble reporting this type of behavior. Talk about your approach and what you would say to stop this type of situation.
   
   

   

   Rachelle's Answer

   "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."

4. 4.

   After noticing bruises and burns on a patient, they disclose their spouse is physically abusing them. The patient begs you not to tell anyone. What do you do next?

   Guidelines for physicians may vary, depending on your region; however, for much of the world, there are approaches in place for physicians who suspect their patients are victims of domestic violence. Physicians can play a significant role in identifying partner abuse. Talk to the panel about what you would do if you were in a situation where you became aware of domestic violence asked to keep it a secret. Be sure to show a professional understanding of your duties as a physician while still respecting patient confidentiality.
   
   

   

   Rachelle's Answer

   "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."
5. Talk about physician-assisted death. When is this an appropriate solution? The controversy surrounding physician-assisted death is not a new topic. Depending on your region, and the laws surrounding physician-assisted death, your answer will vary. Bring to light not only your professional thoughts around the issue but also touch on the primary points discussed in the medical community. Be sure to present a balanced response that holds empathy for those desiring a physician-assisted passing. Example #1: "The ethics surrounding the legalization of physician-assisted death continues to be a controversial topic within the medical community in my region. Many people are concerned about the way they will die, wishing to escape a sufferable death from chronic illness and disease. This desire to die on one's terms is entirely understandable, and often justifiable. On the one hand, many in the medical community believe that by offering physician-assisted death, we dramatically alter the role of a physician within society. Many believe that the healthcare industry's focus should remain on delivering better access to hospice and palliative care for those requiring end of life care. Alternately, many healthcare professionals believe that the way we die is just as important as the way we live. Many healthcare providers believe that people should have the right to choose when their suffering ends. Patients facing instances such as incurable disease or a terminal illness with a prognosis of death in 6 months or less should be allowed to die with dignity and on their terms. I am an advocate for patient-centered care, which I believe includes end-of-life wishes, so long as the physician's clinical judgment is sound and the patient is of sound mind to make the decision surrounding their passing."6. Which would you choose: To travel 1,000 years into the past or 1,000 years into the future? Choose your preference and discuss. There is no wrong answer to this question. The panel will be looking for your ability to communicate your thoughts clearly and present your stance firmly and with conviction. Decide which situation you would prefer and give critical reasoning to support your preference. Depending on the amount of response time given, be prepared with a few specifics regarding the ways you would make a difference, medically speaking, during your hypothetical time travel. Example #1: "I would rather travel 1,000 years into the past, under the assumption that I could keep the knowledge and expertise that I currently have. Being who I am today, I could travel 1,000 years into the past to help fight disease and make significant advancements in the history of medicine. I could help eliminate a lot of risk, death, and disease, better ensuring that the world is around for another 1,000 years into the future." Here is an anonymous answer example: "i would travel 1,000 years in the future if i was able to bring back knowledge about advancements. in 1,000 years, there are likely to be significant advancements in the practice of medicine as well as treatments for diseases that currently have no treatment, such as terminal cancer or alzheimer's. being able to help a family member live longer so that he could see his grandchildren, a graduation, or his children's wedding would be meaningful." In response to the anonymous answer example, here is what Rachelle Enns said: Moving 1,000 years into the future to gather information on medical advancements is a smart approach! It seems you are bringing in a personal story of someone in your family with Alzheimer's. If this is correct, you may want to give more detail regarding this relationship to draw an even stronger connection. Here is an anonymous answer example: "this is a tricky question. both traveling 1000 years in the past or 1000 years in the future would quench my curiosity of those times. 1000 years ago in the past would situate me in a time in the past that was poorly recorded and introduce me to natural beauties that may have now been paved. however, there is also the risk of becoming a victim of the times, as i would be poorly adapted to a world with unsophisticated technology and extremely different world views, in addition to the communication barriers that would take place. 1000 years in the future would be more of a gamble in the sense of would i know what i'm getting. would i be in a world that has overcome or been defeated by the issues we have today regarding climate change, resource scarcity, international conflict, and the threat of annihilation? or perhaps would it those threats still exist, with progress made? would this world be like the canticle of leibowitz, where a society has been reborn from the ashes of nuclear war, only to fall victim to the human issues that led the world to its initial annihilation? ultimately, i believe i would go to the future, as there is a higher likelihood that communication and transportation would be easier. plus, i'm interested to see how the world's technology and knowledge has expanded. just make sure that i have the necessary equipment to survive and return to the present if necessary!" In response to the anonymous answer example, here is what Margarita Clarke said: This is a great answer! Nice intro, straight to the point, and because the interviewer asked you to discuss your answer, going beyond 3 sentences is necessary. A couple of your phrases can use some condensing and word changes, ie. your last sentence begins with "Plus", I would suggest changing that to "Furthermore". In response to the anonymous answer example, here is a revised answer from Margarita Clarke: "This is a tricky question. Both traveling 1000 years in the past or 1000 years in the future would quench my curiosity of those times. 1000 years ago, in the past would situate me in a time that was poorly recorded and introduce me to natural beauties that may have now been paved. However, there is also the risk of becoming a victim of the times, as I would be poorly adapted to a world with unsophisticated technology and extremely different world views, in addition to the communication barriers that would take place. 1000 years in the future would be more of a gamble in the sense of would I know what I'm getting. Would I be in a world that has overcome or been defeated by the issues we have today regarding climate change, resource scarcity, international conflict, and the threat of annihilation? Or perhaps would those threats still exist with the progress made? Would this world be like the Canticle of Leibowitz, where society has been reborn from the ashes of nuclear war, only to fall victim to the human issues that led the world to its initial annihilation? Ultimately, I believe I would go to the future, as there is a higher likelihood that communication and transportation would be easier. Furthermore, I'm interested to see how the world's technology and knowledge have expanded. Just make sure that I have the necessary equipment to survive and return to the present if necessary!"7. Under what circumstances would you recommend a homeopathic approach to treatment? Many people seek out homeopathic treatments when it comes to issues such as asthma, ear infections, allergies, or skin conditions. But where do you draw the line as a medical professional? The panel would like to know that you understand all perspectives when it comes to non-traditional approaches to medical treatment. Be sure to demonstrate an understanding of each side while being able to explain why you think your position is the more sound option. Example #1: "People often use homeopathic practices along with care from their medical doctor to deal with health problems, or to alleviate symptoms. Although I understand that there are many homeopathic remedies available, such as baking powder for itch and calendula for open wounds, there are no current circumstances where I would recommend a homeopathic treatment. I have not performed enough research on homeopathic remedies to be comfortable recommending them as an alternative to traditional medical treatment. I wholeheartedly believe in a modern approach to medicine and an individualized treatment plan. Still, I believe that homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious."8. Do you believe a family doctor is obligated to report their patients' infectious disease to their public health agency? Why or why not? As a physician, you may face ethical dilemmas when it comes to disclosure of patient information and the protection of the public. You have a legal duty and moral obligation of confidentiality; however, some exceptions apply. These exceptions occur when doctors are REQUIRED by law to disclose information, or when the doctors are PERMITTED by law to disclose the information. This exception may include reporting a patients' infectious disease to the public health agency, depending on the region where you plan to practice medicine. Provide a balanced response to this question, fully supporting your stance. Example #1: "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." Here is an anonymous answer example: "a family doctor is required to report communicable diseases to a public health agency because state and federal public health agencies have mandatory reporting requirements for various infectious diseases. however, physicians should only report what is required to ensure that the patient's privacy is protected. for mandatory reporting requirements, the patient should be notified if the disease has to be reported, if possible. mandatory reporting requirements are necessary for public health agencies in order for those agencies to allocate resources for public health crises, such as epidemics. reporting should only be done when the threat of public health outweighs the patient's right to privacy, such as in contact tracing used for covid-19. if the reporting situation was unclear, i would consult my state public health agency for guidance." In response to the anonymous answer example, here is what Rachelle Enns said: It's clear that you have a firm knowledge of physician responsibilities and obligations to various parties. Your answer is clear, confident, and informative. Well done!9. Which is more important to you; changing behavior to prevent disease or working harder to treat existing disease? Whether its behavior change or disease prevention, the panel wants to see where you would choose to focus the majority of your efforts. Express your preference clearly, and support your reasoning while also giving the nod to the opposing side. Example #1: "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." Here is an anonymous answer example: "although i believe behavior modifications, such as diet and exercise, are important to maintaining health, i understand that change is hard. habits can become ingrained over time, and it takes a while to break those bad habits. also, factors in a patient's life can impact his or her ability to become healthy. for instance, my brother who works the night shift at the hospital is often busy and tired leading him to make bad food choices. based on the patient's circumstance, i would first treat their existing disease with medications and suggest gradual behavioral changes. i would recommend small changes like adding a few minutes of exercise each day or adding fruits and vegetables to meals. this may make it more likely for patients to adopt lifestyle changes. one office visit will not result in a revolutionary change, but neither will eating one fast food meal suddenly lead to bad health." In response to the anonymous answer example, here is what Rachelle Enns said: You bring a thoughtful perspective to this scenario, and it's a great touch to add in the example of your brother to support your stance.10. Share your thoughts on gender selection and the topic of family balancing in the in vetro fertilization process. Rather than only giving your opinion on gender selection for family balancing, be sure to provide a reference to any medical journals and reputable texts on the topic. Your response will vary based on critical factors such as the region where you are attending medical school, and where you will practice medicine. Example #1: "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."11. An emergency room patient will die without a blood transfusion. The patients' medical records state refusal of blood transfusions due to religious reasons. What do you decide to do? Expressed consent is a fundamental issue in the medical community. The panel wants to see that you are capable of critical thinking, making sound medical decisions, while also displaying empathy and respect for the beliefs of your patients. Show that you can think in a multi-faceted, fair manner that respects all groups. Example #1: "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."12. What experiences and qualities lead you to believe that you will be an excellent physician? Personal questions like this one do require some reflection and the ability to speak about yourself in a way that showcases your strengths but still comes across as humble. Think about why you want to be a physician or what led you to this particular career path. When you answer, be honest while making a connection between your top qualities, life experiences, and this profession. Talk about your values and how these align with the vision of the school for which you are applying. Example #1: "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." Here is an anonymous answer example: "i will make an excellent physician because i am empathetic, a committed person, and persistent. volunteering in hospice care exposed me to the emotional suffering of others. i saw one patient who was cheerful and always had a smile when we were playing bingo but saw how quickly that would change when her disease progressed. she became no longer interested in activities and became unable to take care of herself. even so, her positivity influenced me and i wanted to be there for her by continuing to visit and try my best to make her feel less alone. i was committed to my students while i was a graduate teaching assistant. i made sure that my students could contact me freely if they had issues with the lab course. i was surprised when one of my students at the end of the semester thanked me for my responsiveness as maybe other teaching assistants were not. i am also committed to improving myself. i know my verbal communication skills need improvement. i have worked on this by putting myself into uncomfortable situations, such as being a teaching assistant. initially, i was nervous and was unable to get out what i wanted to say. through preparation, i became more effective in conveying information to my students. i continue to work on my communication by volunteering at the food bank and interacting with people from different backgrounds. during my graduate research, i ran into some struggles with my experiments. i would try to find out what went wrong by modifying or repeating the experiments. when i could not figure it out, i would ask someone more experienced, such as a ph.d. student in my lab or my professor. similarly, as a physician, i would work tirelessly for my patients, whatever the challenge is, as well as care for them and be a trusted partner in managing their health." In response to the anonymous answer example, here is what Rachelle Enns said: Excellent job with this response! The details you provide and the storytelling are a wonderful touch. This answer does more than tell the interviewer why you will be an excellent physician; it also shows the interviewer your skills in action. Good work!13. Discuss the pros and cons of legalizing marijuana. Would you ever prescribe or encourage the use of legal cannabis? Why or why not? Another 'policy' based question, this query is looking for your opinion on a popular topic that is often controversial - the use of cannabis. Whether cannabis use is legal in your region or not, your response may vary. Overall, the panel is looking for a mature perspective and a balanced response. Show that you have reflected on the subject by providing a well researched and fair opinion. Example #1: "There are numerous studies available that show the pros and cons of legalizing marijuana. I believe there are many pros to the use of CBD, a chemical compound found in cannabis plants, including anxiety, arthritis pain, depression, inflammatory issues, and even muscle-spasticity found in Multiple Sclerosis. When it comes to the risk associated with the use of marijuana to gain a high, there is a lot of research still to be done. From what we know, chronic pot use can impact the brain, and regular inhalation can cause lung issues. I have not performed enough research to prescribe or encourage the use of legal cannabis comfortably; however, I feel knowledgable enough to feel comfortable with a patient using a topical CBD ointment for arthritic symptoms, for instance."14. A fellow medical student often shows up on rotation hung-over and smelling like alcohol. You decide to talk to them in private. Enter the room and have this conversation. This question is a role-play opportunity or 'acting' question. For acting questions, a panel of interviewers, or perhaps even an actor, will be waiting in the interview room, and you must approach the situation as you would in real life. This role play, or acting style question requires you to enter the room in character and speak to the panel as though they are the fellow medical student that you are approaching in regards to their drinking habits. The interview panel will be looking for strength in character, proper concern, empathy, and an attitude of helpfulness towards your peer. Example #1: "I've noticed some concerning behavior, and because I like you and care about you, I thought I should approach you in person before reporting any observations to our supervisor. For the past few weeks, I have noticed you smell like alcohol and often appear disheveled from what seems to be a lack of rest. Is there anything going on in your life that you need to discuss? If you are not comfortable opening up to me, there are many resources available to help with the stress and pressure of medical school. I want what is best for you, and for you to succeed, I think it's time you put some thought into improving how you show up to your rotations." Here is an anonymous answer example: "how have the rotations been for you? they have been exhausting for me, both physically and emotionally. have you been able to cope with the stressful rotations? i know we're all feeling stressed about the long hours and constant work we have to do. have you been doing anything to take your mind off the rotations? yeah, i know, we're all busy. any activity you've been doing to relax? have you been sleeping well? i am concerned because i have noticed you are smelling of alcohol during the shifts. is there anything you'd like to talk about? if any of us are not at our best, the patients suffer. would you like someone to talk to? i am available to talk as well as our colleagues if you'd like. are you sure you're okay to see patients? i can cover for you if you'd like. i am worried about your well-being as well as the well-being of our patients. if this behavior persists, i will have to tell our attending. patient safety is my utmost priority." In response to the anonymous answer example, here is what Rachelle Enns said: You ask some really great questions here, and it sounds like the hope is that your colleague will open up to you and have a transparent conversation that leads to change. It's great that you emphasize putting patient safety first.15. You have two patients who need a kidney transplant. One patient is an elderly physician with kidney failure; the other is a 20-year-old high school dropout brought in again for binge drinking. You have only one kidney. Who do you give the kidney to? The panel would like evidence that you can communicate your approach when it comes to this challenging hypothetical scenario. Be sure to present your thoughts supporting both sides while showcasing your professionalism and strong problem-solving skills. Example #1: "As a physician, I can empathize with the fact that both of these patients are in a position of suffering, and it's up to me to make a sound decision based on my medical expertise. First and foremost, I would put each patient on dialysis while I made my decision. Next, I would research which patient had a better chance of recovering from a kidney transplant surgery by looking into their medical history and performing a series of tests. If I chose to provide the kidney to the elderly physician versus the 20-year-old high school dropout, I would make this decision on their ability to accept the organ and recover from the transplant with minimal complications. My choice would have nothing to do with their career or social status. If the elderly physician presented the best outcomes, I would give him the kidney with the expectations that the organ would provide him with another 15-20 years of good health. If the younger patient received the kidney, I would also ensure that he had health coaching related to binge drinking and taking care of his new organ. It would then be essential that the non-recipient remained on dialysis and the organ transplant list until another match became available." Here is an anonymous answer example: "as a physician, i expect i will have to make some tough decisions. i would first ensure that each patient receives dialysis for their kidney conditions before making a decision. after reviewing each patient’s medical history and performing tests, i would begin to make a decision. in this case, the patient i would choose for the kidney transplant would be the person who would tolerate the kidney better with less of a chance of transplant rejection. the person i chose to receive the kidney would be less likely to have complications and would have a greater chance of survival. if i choose the elderly physician for the transplant, it would be because the patient would be able to live a healthy life 10 to 15 years following the transplant. if i choose the high school dropout, it would have to be on the condition that the patient receives counseling for his or her binge drinking to ensure that this damaging health behavior would cease. my choice would be made on medical factors and not social or economic factors. i would do my best to remain objective and only consider each patient’s medical case history. the patient i didn't choose would remain on dialysis and the transplant list until a new kidney match was available." In response to the anonymous answer example, here is what Rachelle Enns said: Awesome! It's great to see that you find the Mock Questions example answer helpful, yet you make it your own. Way to go!16. Talk to me about one crucial healthcare issue that is unique to your region. First, you need to decipher if 'your region' is referring to the place you call home, or the area in which you will be attending medical school. Once you decide on this factor, be sure to address your direction in your response. Take the time to think about a crucial healthcare issue in your region of choice. Put effort into finding an answer that will be unique to you, including statistics and an action plan. Choosing an 'easy' path may mean that your solution is similar to other candidates, so beware of falling into this trap. Example #1: "My home state of Ohio reports drug use as the most urgent health problem. In fact, in 2017, Ohio had the second-highest rate in the U.S of drug overdose deaths involving opioids. More specifically, Ohio has seen a significant boost in deaths due to synthetic opioids such as fentanyl. This opioid use puts a strain on the state in many social and economical ways. As a healthcare professional, I desire to make a difference by creating community coalitions to focus directly on the opioid crisis. I plan to recruit members from the healthcare community, faith community, schools, public health, and law enforcement to commit to recovering communities. These coalitions will join forces and provide information, implement action plans, and conduct educational sessions for youth, campaigning through high-risk communities before youth become too far involved in opioid drug use."17. How does the American healthcare system differ from the Canadian healthcare system? The interview panel is looking for your level of understanding when it comes to global approaches to healthcare. The way you answer this query will show the panel that you have an interest in learning about topics outside of your immediate realm. Speak about what you know when it comes to the differences in the Canadian and American health care system. Be sure to approach the pros and cons of each. Example #1: "There are many significant differences between the American and Canadian healthcare system, a topic I have studied extensively after living temporarily in Canada. The biggest difference is that Canadian healthcare is primarily publicly funded, where in the US, healthcare is heavily private. In Canada, there is equal access to healthcare regardless of job, income, or financial position. Overall, people in Canada may be healthier than in the U.S., but outcomes for those with severe disease are not as positive. Canadians face very long wait lists for services such as surgery, where in the US surgeons call quickly and perform many more operations in a year. With all of this said, it is essential to remember that a country's approach to healthcare is reflective of its views of society and government responsibility. Canada as a whole is has a more socialist viewpoint than the US, meaning that the Canadian approach in America would likely not be as impactful."18. How do you feel about stem cell research using fetal tissue? Ethical based questions require you to look at an issue in a multi-faceted way. The panel of interviewers wants to see that you have an understanding of all sides, whether or not you agree with them. State your opinion on the topic, while also incorporating facts where you can. This approach shows that you have thoughtfully considered all sides of a controversial issue. Example #1: "In the US, there are no laws against stem cell research, although many parties still oppose the idea. I fully understand that stem cells are the body's raw materials, and these cells can help us to understand how diseases work. This practice is truly valuable to medical research. We can use these healthy cells to replace diseased cells and even test drugs to see if they are safe and effective. Embryonic stem cells, in particular, are obtained from early-stage embryos. These stem cells come from embryos fertilized outside of the womb, and not from a pregnant woman. These embryos are harvested specifically for research. In the process, these early-stage embryos are destroyed, which is where the controversy comes to play. Many people against this practice approach the situation with the same arguments around abortion because the practice prevents an embryo from becoming a baby. In my professional understanding, I do not consider an embryo to be human life yet, but rather a bundle of cells. The scientific gains from this practice are critically important, and will save millions of lives."19. Discuss the Human Genome Project. Policy-based MMI questions like this one mean to uncover your current level of knowledge on particular medical-related topics. Take some time to reflect on what you know regarding the Human Genome Project. Discuss the project, its pros, its cons, and any known issues related to the project. Example #1: "I can best explain the Human Genome Project as an initiative led by an international team of researchers looking to sequence and map all of the genes of the human species. This project ran from 1990 to 2003, giving humans the ability to read the complete genetic blueprint of a human. This international effort sequenced 3 billion DNA letters in the human genome and is considered to be one of the most ambitious scientific undertakings of all time. Thanks to the Human Genome Project, we now have coverage of about 99 percent of the human genome's gene-containing regions, with an unprecedented accuracy of 99.99 percent. Of course, scientific undertakings as large as this do not come without controversy. One of the most positive outcomes of the Human Genome Project is that healthcare professionals, policymakers, students, and the public now know so much more when it comes to genetics and complex genetics-based disease. On the flip side, the project also raised ethical issues surrounding the design and conduct of genetic research, including privacy and consent. All in all, I believe the Human Genome Project to be an incredible scientific feat, helping medical professionals to understand the human genetic blueprint better."20. Hippocrates said, 'Let food be thy medicine and medicine be thy food.' What does this quote mean to you as you pursue a career in healthcare? Since this question is surrounding your opinion of a well-known quote, there will not necessarily be a right or wrong answer. What is most important when approaching this question is that you show insight and also some understanding of who Hippocrates was, as he is a significant figure in the history of medicine. Show that you have your unique perspective and an ability to take an age-old quote and give it meaning in today's context. Example #1: "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."21. As a physician, do you feel a responsibility to be a healthy role model for your patients, or is your medical training and knowledge more than enough when it comes to counseling your patients on lifestyle changes? The way that you answer this question will give the panel an idea of how involved you are in your health, and how you believe your approach to health directly impacts the health of your patients. Many healthcare professionals feel that passing on their knowledge to patients is enough where others think you must 'practice what you preach.' Be prepared to defend your stance. Example #1: "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."22. If an alternative treatment existed for a terminal illness, would you recommend it to a patient, even if there were no scientific evidence to support its efficacy? Opinions drastically vary when it comes to the way we approach traditional and 'alternative' therapies. Some medical professionals feel that the two therapeutic approaches can work hand-in-hand, while others believe that alternative therapies can be dangerous and do not hold enough scientific merit. The panel wants to know where you would stand when it comes to treatments that are not yet supported by medical evidence. How would you approach this situation? Example #1: "I recently read a piece of research stating that nearly 70% of cancer patients use alternative therapies in conjunction with their traditional treatment. As most physicians know, many of these alternative therapies can be dangerous, even if they are 'natural.' Some specific herbs and supplements can interfere with chemotherapy and reduce its efficacy. There is no way I could ever know all the causes and effects of alternative treatment, so if there were no scientific evidence to support its effectiveness, I would not recommend it."23. If you could have any superpower, what would it be? What is the very first thing you would do with this superpower? There is no wrong answer to this personal-based MMI question, but you must offer up an intelligent, engaging response that highlights your best human characteristics. Share details about who you are as a person, through this unique storytelling opportunity. Don't be afraid to have fun with this one, and make sure your response is memorable! Example #1: "I would love to read minds in any language. As a physician, I could help nearly anyone if I could read their mind and communicate with them no matter the language barrier. Last summer, I spent three months traveling the world where I met many amazing people but noticed that the language barrier was a huge challenge. If I had this particular superpower, I could meet anyone where they were and begin helping them without the roadblock of language or miscommunication. I would begin by visiting villages where medical care was not available, and providing care to them in a way that nobody in western medicine has been able to do before."24. Pharmaceutical companies largely influence the medical profession through lobbying. What do you believe is the impact? Lobbying is 'an attempt by individuals or private interest groups to influence the decisions of another group.' Pharmaceutical lobbying is when pharmaceutical drug companies work to have the medical industry, medical professionals, or politicians act in favor of the pharmaceutical industry and its products. According to CNN Health, one well-known pharma lobbying group spent around $27.5 million on lobbying activities in one year alone. Be prepared to speak about lobbying and the impact it has on the medical industry. Example #1: "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."25. An underage patient asks you for a birth control prescription but asks that you not tell her parents. What do you do? The way you approach this question will vary, depending on the region where you are interviewing or practicing medicine. You will want to consider privacy laws and the age of consent. Show that you would ask the right questions and take the time to lay down proper groundwork before prescribing anything to your patient. For instance, it would be essential to find out why your patient wants birth control and why she does not want to tell her parents. Example #1: "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."26. What would you do if your mother decided to rely only on alternative medicine to treat a critical illness? The way you approach a patient about alternative medical therapies, and the way you would approach your parent may be the same - or entirely different. Whatever your thoughts on alternative treatments, the panel wants to see that you have an educated approach versus a biased opinion. Show that you can be collaborative without dropping your scientific ways but also remaining open to new ideas. Example #1: "If my mother wanted to treat a critical illness using alternative medicine, I would first ask how she came to her conclusion. I would ask what particular therapies she was interested in and how much research she has conducted. Many people believe that because a treatment is natural, it can do no harm, so it would be important to me that I dispell that belief as much as possible. Mainly, I would not be judgemental and would be sure to come from a respectful point of view. I would want my mother to receive honest advice, whether that advice comes from another Ph.D. or me. If she were adamant about these alternative therapies, I would offer to go with her to a naturopathic practitioner where we could find a compromise of some sort - where traditional and non-traditional treatments could meet."27. Your sister brings her new boyfriend home for the holidays. You recognize him as a patient you treated for herpes simplex type 2. What do you do? Naturally, in this hypothetical situation, you would want to warn your sister about this particular individual. However, what you want to do and what you are legally allowed to do in this situation are two very different things. When you answer this question, you must consider privacy laws in your region. Show that you are capable of maintaining professionalism, even if the situation becomes somewhat personal. Example #1: " I know that medical ethics rules, state laws, and the federal law clearly state that a doctor must keep patient information confidential with very few exceptions. I have studied HIPAA (Health Insurance Portability and Accountability Act). I know that I am obliged to keep a patients' medical records confidential unless the patient allows the doctor's office to disclose them. For that reason, if my sister brought home a former patient with an STI, I would not inform my sister but trust in the fact that I would have educated my patient well enough on matters of safer sex and the prevention of infecting a partner."28. In 2019, the Reproductive Health Act expanded abortion rights. What were these changes, and how do you feel about them? The Reproductive Health Act, enacted in 2019, expanded abortion rights and eliminated several restrictions on abortion in the state of New York. You may not be from New York, so depending on your region, you will personalize this answer for your specific MMI situation. The takeaway from this question will be to show that you are in-the-know when it comes to female reproductive rights and approaches to abortion in the area where you live, where you desire to attend medical school, and where you plan to practice medicine. Example #1: "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."29. Many pediatric associations recommended that male circumcisions no longer be routinely performed. Do you agree with this recommendation? The practice of male circumcision began with rites and religion, making it an important topic to discuss today, as male circumcision has become standard practice even among those who do not hold the original religious or societal beliefs. Talk to the panel about the arguments against routine male circumcision, and what you understand members of the medical community to be saying. Next, discuss your thoughts and ideas from a medical point of view. Example #1: "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."30. If you were given the opportunity to change one thing about the healthcare system, what would you choose to do? Another policy-based question, this query also looks for your professional perspective. The panel wants to see that you are knowledgable on the healthcare system in your region, showing a keen understanding of the challenges you might face as a medical provider. It is easy to spend time picking apart the healthcare system; however, this question also urges you to take time for reflection and give your perspective and ideas on how to create positive change. Pick your topic of choice and be ready to provide a balanced view of what you would do to create change. Example #1: "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." Here is an anonymous answer example: "i think if i could change one thing about the healthcare system, i would try to contribute to a change from a treatment system to a prevention-based system in regards to the united states healthcare. healthcare spending is increasing in the us at an unsustainable rate, outpacing gdp growth. one of the reasons is the rise in chronic health conditions, which can be costly to treat. i would try to increase access to healthcare so that patients can address their health issues sooner from a more prevention standpoint rather than later from a treatment standpoint. while working in my parents' post office, i saw many vietnamese immigrants that spoke little or no english. although i am not fluent in vietnamese, the amount i knew helped ease their confusion about shipping. there is a large vietnamese immigrant community where i live, and the doctors are filled with vietnamese patients. i want to increase my community's access to healthcare, improving the vietnamese along the way to better communicate with vietnamese patients. language barriers can be a significant barrier to healthcare, and i want to alleviate that problem." In response to the anonymous answer example, here is what Rachelle Enns said: Prevention is a crucial factor to consider. Your response shows a lot of thought and a firm understanding of treatment approaches vs. prevention approaches. I felt a bit lost when you started to discuss your experiences at the post office. I recommend reworking the last half of your response by making a more immediate connection between language barriers and a prevention-based system. Here is an anonymous answer example: "while many issues are present, i believe it is necessary to shift to a system that reimburses based on outcome rather than based on the fact that a procedure was formed. while i do knw the prevalence of the issue, i do understand that sometimes people are designated for procedures or medications that are medically unnecessary. in such instances where the procedures are unnecessary, there is the risk of both physical and financial harm to patients. regarding financial harm, the price of insurance for other patients may increase due to higher than necessary expenditures by insurance companies. regarding prescriptions, sometimes medications that are significantly more expensive may be prescribed without having palpably higher efficacy than cheaper meds. by switching to results-oriented reimbursement, we can deter the prescription of unnecessary procedures and medications. we will also incentivize medical decision making that puts the patient's wellness first. the primary downside for results-oriented reimbursement is that sometimes a procedure or medical decision is contested amongst professionals, and therefore determining whether the result was optimal relative to other procedures or patients can become subjective. additionally, sometimes difficult decisions need to be made with urgency and may not allow for ideal preparations and option weighing, though the patient would still benefit from such procedures relative to no medical treatment in those instances. additionally, hospitals could become strained if they are to receive fewer finances for procedures performed. however, the benefit of placing a priority on patient wellness makes this the one thing i would change in healthcare, and with proper legislation, this could be implemented effectively to improve patient outcomes and reduce the financial strain on patients." In response to the anonymous answer example, here is what Margarita Clarke said: You seem to have a lot of knowledge about the healthcare system, that's great! However, if your answer is too wordy, it can tire out the interviewer, and they will eventually stop reading. Try to keep your answer at 2-3 sentences max. You discussed a couple of points; 1. basis of reimbursement, 2. cost of medication, 3. decision making for procedures, 4. the effect on hospitals. Hone in on one point so you can answer the question with focus. Lastly, in the second sentence, you used the word shortcut "knw". Although this is ok for informal texting, be sure to write out all your words to keep it professional.

5. 5.

   Talk about physician-assisted death. When is this an appropriate solution?
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6. 6.

   Which would you choose: To travel 1,000 years into the past or 1,000 years into the future? Choose your preference and discuss.
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7. 7.

   Under what circumstances would you recommend a homeopathic approach to treatment?
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8. 8.

   Do you believe a family doctor is obligated to report their patients' infectious disease to their public health agency? Why or why not?
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9. 9.

   Which is more important to you; changing behavior to prevent disease or working harder to treat existing disease?
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10. 10.

    Share your thoughts on gender selection and the topic of family balancing in the in vetro fertilization process.
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11. 11.

    An emergency room patient will die without a blood transfusion. The patients' medical records state refusal of blood transfusions due to religious reasons. What do you decide to do?
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12. 12.

    What experiences and qualities lead you to believe that you will be an excellent physician?
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13. 13.

    Discuss the pros and cons of legalizing marijuana. Would you ever prescribe or encourage the use of legal cannabis? Why or why not?
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14. 14.

    A fellow medical student often shows up on rotation hung-over and smelling like alcohol. You decide to talk to them in private. Enter the room and have this conversation.
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15. 15.

    You have two patients who need a kidney transplant. One patient is an elderly physician with kidney failure; the other is a 20-year-old high school dropout brought in again for binge drinking. You have only one kidney. Who do you give the kidney to?
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16. 16.

    Talk to me about one crucial healthcare issue that is unique to your region.
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17. 17.

    How does the American healthcare system differ from the Canadian healthcare system?
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18. 18.

    How do you feel about stem cell research using fetal tissue?
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19. 19.

    Discuss the Human Genome Project.
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20. 20.

    Hippocrates said, 'Let food be thy medicine and medicine be thy food.' What does this quote mean to you as you pursue a career in healthcare?
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21. 21.

    As a physician, do you feel a responsibility to be a healthy role model for your patients, or is your medical training and knowledge more than enough when it comes to counseling your patients on lifestyle changes?
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22. 22.

    If an alternative treatment existed for a terminal illness, would you recommend it to a patient, even if there were no scientific evidence to support its efficacy?
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23. 23.

    If you could have any superpower, what would it be? What is the very first thing you would do with this superpower?
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24. 24.

    Pharmaceutical companies largely influence the medical profession through lobbying. What do you believe is the impact?
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25. 25.

    An underage patient asks you for a birth control prescription but asks that you not tell her parents. What do you do?
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26. 26.

    What would you do if your mother decided to rely only on alternative medicine to treat a critical illness?
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27. 27.

    Your sister brings her new boyfriend home for the holidays. You recognize him as a patient you treated for herpes simplex type 2. What do you do?
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28. 28.

    In 2019, the Reproductive Health Act expanded abortion rights. What were these changes, and how do you feel about them?
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29. 29.

    Many pediatric associations recommended that male circumcisions no longer be routinely performed. Do you agree with this recommendation?
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30. 30.

    If you were given the opportunity to change one thing about the healthcare system, what would you choose to do?
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