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.
"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."
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Anonymous Answer
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.
Rachelle's Feedback
Awesome! It's great to see that you find the Mock Questions example answer helpful, yet you make it your own. Way to go!
Anonymous Answer
As a PA I expect to get difficult decisions like this in the future. By choosing the elderly physician, I would get the added benefit of helping the physician's patients, but they are much older so the kidney would not benefit them for as long. If I gave it to the younger person then the kidney could help them for a long life. I know that in order to qualify for the transplant list you need to have shown the ability to recover from substance abuse and live a healthier lifestyle. If the younger person has shown they have tried to abstain from drinking then I would award the kidney to them.
Marcie's Feedback
In all reality, a physician's assistant likely wouldn't be placed in the position to make this decision (kidney matches are generally decided according to medical urgency, blood type, antibody matching, time with kidney failure, organ size, etc. - in other words, whichever patient is the best match). But the interviewer clearly wants to see how you would handle this type of dilemma. You are very logical and balanced in your response, which is great. As long as you provide a sound explanation for your choice, the interviewer will be satisfied. Great job!
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