In an ethical scenario like this, it is best to focus your answer on doing what is best for the patient first. Your research into available resources before your medical school interview will pay dividends as you present them to your evaluator during this hypothetical scenario in your multiple mini interview.

For this particular scenario, your interviewer at this MMI station will be keying in on your ability to maintain patient confidentiality and work to do what is right for that patient. Taking an empathetic and helpful approach is your first duty for your patients in any situation, including this one. Reporting illegal activity like this isn't a requirement of the law and could breach patient confidentiality, but allowing others to be in danger in the situation isn't the right thing to do either. This is where you need to fully assess the situation and make your best judgment on how to handle it.

"First and foremost, I would start a conversation on the negative effects that the drug could have on their physical and mental health, and I wouldn't hesitate to be very blunt with the patient. Since they were open enough with me, I would see that as a call for help and be very open with them. During my exam, I would take extra time to monitor their heart, skin, and any other systems that could be impacted by their drug use. From there, I would turn my focus to treatment. While I'm not an expert in this area, I try to be as resourceful as possible. If my health system has an AODA treatment center, I make him aware of it and the process for admission. If applicable, I also educated him on all available treatment options. But I feel involving family and friends in the treatment is most important in any drug addiction situation, and I strongly encourage them to do so. Maybe some are aware of their drug use. I would urge the patient to come clean to their loved ones and ask for any help they need. But in the end, this is ultimately up to the patient to decide if it's a path they want to take, and I try my best. Of course, I assess for any danger to people like children or anyone else under the patient's care. If I think there is potential harm to others based on the drug use, I follow state protocol on reporting to the proper authorities."