Answer This MMI Prompt

Dr. A is an exceptional surgeon, with by far the best surgical outcomes in the country. However, Dr. A is also highly prone to inter-professional conflict and is frequently disrespectful to patients, hospital staff and students. Do you think exceptional results justify problematic behaviour? If Dr. A threatened to quit in response to any required professional-development or sensitivity training, do you think that this would do more harm than good to patients? Why or why not?

You are on clinical rotation with Dr. A and admire how highly professional and compassionate they are with patients. However, you notice that after patient interactions, Dr. A makes jokes about their patients with other physicians and residents. Dr. A notices your shock at this and mentions that "everyone does this” and “as long as you are good with the patients in person, it’s just private fun". Do you see any issues with this behaviour? Would you say anything to Dr. X? What would you do if Dr. A refused to change their behaviour?

You are a medical student. Another medical student, Sam, invites you to a study group with three other students. At the study group, you find that the students are using real cases from their clinical rotations. When you ask Sam about this, they explain that the group removes always patient identifiers and that they feel that current cases are a great way to learn medicine.What considerations should be made in this situation? Would you say anything further to Sam? Are there any other actions you would take?

You are a judge for a student competition on public health. Student competitors had to present on a current health topic, describing the health issue, current solutions, and possible other health solutions. You and the rest of the judging panel have narrowed down the submission pool to two presentations; one on lung cancer and the other on geographical inequalities in population access to primary care. You and the other judges believe that both projects are extremely well done, but they vary significantly in their subject matter. The competition rules are clear that there can only be one winner. How would you go about choosing a winner?

You are a member of a student leadership group. You feel that one of the other members of the group only joined to use the experience as a "resume booster". They contribute only the bare minimum to the group and participate just enough to make regular attendance. What would you do in this situation?

You are a resident under the service of Dr. A. A medical student currently on rotation with Dr. A confides in you that they simply “can’t get through to Dr. A” and that they feel like Dr. A doesn’t really care that they are there. The medical student says they feel like your relationship with Dr. A is much more cordial and asks your advice on how they can better interact with Dr. A. What do you say to them? Do you say anything to Dr. A?

Mistakes can occasionally go unnoticed, with parties involved remaining unaware that anything wrong ever occurred. Do you think it is ever appropriate to keep a mistake private? If so, when and why?

Discuss your perspective on shifting the COVID-19 crisis from a pandemic to an endemic. What are the positives and negatives? Who stands to benefit and face harm as a result of such a decision? What do you think is the best course of action going forward?

Medical school applicants come from a variety of different backgrounds, with volunteer and leadership experience ranging from small local initiatives to worldwide advocacy trips. Do you think medical schools can fairly compare volunteer and leadership experiences that are dissimilar? If you were in charge of medical school admissions, how would you evaluate applicants’ co-curricular experiences?

You are a medical student on rotation in the emergency department with Dr. A. A patient comes in complaining about pain in their hip. Dr. A gives them some medication and the patient very quickly appears to improve and leaves the hospital feeling better. After the patient leaves, Dr. A reveals that the drug was a placebo and that that particular patient comes in often with a pain complaint that "has no pathological basis". Dr. A says that in cases like that, a placebo can be enough to help patients feel better and that telling patient it is a placebo would ruin the effect. What ethical issues do you see here? Would you say anything to Dr. A? Should you report this behaviour?

You are a student in an advocacy group. You feel like another student in that group routinely dismisses the ideas of others and is often stuck in their own perspective of what is best. Do you say anything? If so, what do you say? What would you do if they left the advocacy group as a result of your discussion?

It is not uncommon for medications to have various adverse side effects. As a physician, how would you help your patients navigate those side effects? How would you determine whether a treatment option is worth any adverse effects or risks?

Do you think that physicians who, for personal reasons, feel uncomfortable with certain procedures (e.g. medically-assisted death, abortion) should be required to perform or refer for them? Why or why not? What ethical issues do you see in this situation?

Public celebrity cases like the recent Depp vs. Heard case have shown how powerful and biased the ‘Court of Public Opinion’ can be. What kind of effects do you think public opinion can have on the legal process, if any? Do you think that certain court cases should be kept private and out of public view? Why or why not?

Experimental medicine can introduce hugely effective new methods of treatment for pathologies that previously could not be treated. Do you think experimental medicine research should be done with children? Why or why not?

Is physician assisted suicide a potential asset or is it a liability to an effective healthcare system?

What responsibilities do physicians have in informing the general public about topics related to medicine?

Why is support for physician work life balance important for the care of patients?

What role do genetics and genetic testing have in the Canadian healthcare system?

What characteristics do you think are important for a physician to possess as members within a team and why?

What would you hope to achieve as a physician?

What are the three qualities you believe would make you a great physician?

When do laws deviate from ethics?

How has technology improved healthcare?

If you were the manager of a seniors home how would you address an employee coming to work with symptoms? What would you do if this was during an active outbreak?

What is one lasting effect on healthcare from the COVID-19 pandemic?

What is one major healthcare issue that you believe needs to be addressed in the Canadian healthcare system?

A friend who on the basis of religious beliefs is anti-abortion has just had an argument with their daughter who is pro-abortion rights and is asking you for advice on how to handle the situation what would you do?

How would you go about suggesting to a family member that they get vaccinated if they are anti-vaccine?

What role has the internet played in the aftermath of the COVID-19 Pandemic?

Describe a time when you made sacrifices to excel at something (can be any activity).

What is one currently feasible change you could make to improve the condition of indigenous and rural healthcare?

What problems lie at the intersection of indigenous people's relationship with government operated healthcare in Canada and rural communities?

What would you consider before moving your practice to a rural setting?

You are playing the card game hearts, and your partner is demonstrably less skilled and experienced than you. After a few hands, you both are down by over 100 points as a team, mostly because your partner keeps apologizing for making stupid mistakes during the game. What do you say to your partner?

It sounds really bad. You are on an airplane and after you have taken off for a 4-hour flight, a baby sitting right behind your seat starts to cry. As time goes on, even while you have earphones, the screams don’t stop. The parent accompanying the child keeps trying to quiet the baby down but to no avail. For every passing minute, the screams get louder and louder. What do you do?

A lot of people you work with have noticed that many random things which they own are going missing. It appears that some personal items that are not extremely valuable have gone missing over the course of the last two months. Regardless, many of your co-workers are concerned. What suggestions would you bring to an upcoming meeting with your co-workers about finding a way to address this issue?

You say you enjoy helping others. There are many other careers other than medicine where you can do that. Why medicine?

Who is your mentor?

Have you ever almost quit something but then changed your mind? Why? What did you learn?

Describe a time when you disappointed your parents/grandparents.

Describe a time when you were wrong about something very important.

Describe a time when you had to deliver bad news.

Describe a time when you felt excited. What happened?

Describe a time when you many have lost your temper.

Describe a time when you had to say “no”.

Describe a time when you found that you had “too much on your plate”.

Describe a time when you stood up to an authority figure.

Describe a time when you asked for help.

Describe a time when you improved on a weakness.

Have you ever doubted whether medicine is right for you?

Describe a time when you doubted yourself.

Describe a time when you were scared.

Describe a time when you stood up for someone.

Describe a time when you helped someone in need.

Describe a time when you felt ashamed.

Describe a time when you had to be a follower.

Describe a time when you felt you were treated unfairly. What did you do about it?

Describe a time when you learned something new.

Describe a time when you had to be a leader.

Describe a time when you did something you were not proud of.

Describe a difficult decision that you had to make.

Describe a time when you did something wrong.

What career would you choose other than medicine, and why?

What about our school appeals to you in terms of your medical education?

Why do you like our school over other schools?

From your file, I can see that you have a lot of experience doing 'x experience'. Please describe your strategy with 'x'. What is the most important lesson you learned?

Resident physicians are employees but also still completing their training. What are challenges that resident physicians face?

The Olympics is a global competition of sport and athleticism. Historically, there have been controversies in numerous Olympic Games. Select one of these controversies and discuss.

Recently truckers have gathered to form a convoy in protest of certain decisions made by the federal government. What are your thoughts on this demonstration?

What is the biopsychosocial model of medicine and what role does it play in the field of medicine?

How would you deal with the death of a patient?

A physician picked up a car accident victim from the street and brought him to the ER in his car. He did not want to wait for an ambulance because the patient’s condition was critical. Physical examination in the ER reveals quadriplegia. Is the physician liable for this consequence?

Your best friend tells you he is a compulsive gambler. He has lost all his money and he asks you for a loan in order to buy food, to pay back his loan sharks and then use the rest to try to win it all back. Discuss the broad implications of gambling on society.

Should there be legislation stating that a physician must report a gunshot wound of their patients to police? Discuss.

Many fire-related tragedies in Canada have been the result of children playing with fire. Discuss the roles and responsibilities of parents, lighter companies and society with respect to this issue.

A general principal in the pharmaceutical industry is that a drug is not real unless it has been tested in English speaking countries. A real drug is one that actually works and can be an economically viable product. Do you think this general principal is valid and/or acceptable? Discuss this question with the interviewer.

Should the government directly fund the education of medical students as opposed to funding other professions such as law and engineering? Discuss this question with the interviewer.

Discuss health care issues that have been in the news in the last month.

In your opinion, what is a primary flaw in the health care system? How would you address it?

As medicine advances with technology, what are the pros and cons? Discuss your experience with use of technology.

What is the difference between HMOs and PPOs?

In June 2011, the Vancouver Canucks lost the Stanley Cup and riots broke out in Downtown Vancouver. Discuss the impact on the community and the range of health care professionals at St. Paul‟s Hospital.

A Kootenay town runs a health-collective that provides various alternative and traditional forms of medicine. The physicians there encourage parents of small children not to vaccinate their children. Discuss the positive and negative impacts of this opinion.

Recently, the Prime Minister of Canada suggested the idea of deterrent fees (a small charge, say $10, which everyone who initiates a visit to a health professional would have to pay at the first contact) as a way to control health care costs. The assumption is that this will deter people from visiting their doctor for unnecessary reasons. Consider the broad implications of this policy for health and health care costs.

What is the difference between Medicare and Medicaid?

How does Canadian health care system compare to that of Britain‟s system?

Discuss one of these health care issues: human genome project, AIDS, abortion, the right to die, the cost of health care, and genetic engineering.

Discuss any topical health care issue that is unique to the Pacific Northwest region (or region for Med School you are applying to)?

Discuss the pros and cons of legalizing marijuana on the Canadian Health Care system. How does this impact a physician‟s present ability to write out prescription for „medical marijuana'? Would legalization cost the health care system more or less after it was passed?

Do you think medicine should be more about changing behaviour to prevent disease or treating existing disease?

In recent years, there has been an increase in popularity of full contact sports, such as Ultimate Fighting Championship (UFC) and boxing. Should doctors have a role in regulating such sports?

Recently, certain hospitals in the Vancouver Area have been charging patients $29/day for their hospital fee on top of the fees charged to MSP. What are the implications of this policy? Discuss both positive and negative impacts with the interviewer.

Due to a shortage of physicians in rural and Northern communities in BC, some policy-makers have suggested that medical programs preferentially admit students who are willing to commit to a 2 or 3 year tenure in rural areas after graduation. Consider the broad implications of this policy for health care and the costs associated. Will this policy be effective?

If the Prime Minister of Canada were to ask your advice on one change that could be applied to the healthcare system in Canada that would improve it enormously and have the greatest positive effect, how would you answer?

A Vancouver bio-tech company was hired by the US Military to develop a cure for Ebola. They successfully developed a vaccine to treat the symptoms of the virus and lowered the mortality rate for infected patients. Discuss the implications of this on a global scale.

What do you see as being the biggest issues/problems in health care now and in the future. What do you think are possible solutions to these issues?

Discuss the social, legal, medical implications of a needle-exchange program with the interviewer. (Consider a needle exchange program to be a free service in which screens for STIs are provided, along with immunizations, physician referrals, and exchanging used needles for new ones). Follow up question: What are some viable alternatives?

Deterrent Fees (Knowledge of the Health Care System) Recently, the Prime Minister of Canada raised the issue of deterrent fees (a small charge, say $10, which everyone who initiates a visit to a health professional would have to pay at the first contact) as a way to control health care costs. The assumption is that this will deter people from visiting their doctor for unnecessary reasons. Consider the broad implication of this policy for health and health care costs. For example, do you think this approach will save health care costs? At what expense? Discuss this issue with the interviewer.

Preferential Admission (Knowledge of the Heath Care System): Due to the shortage of physicians in rural communities such as those in Northern Ontario, it has been suggested that medical programmes preferentially admit students who are willing to commit to a 2 or 3 year tenure in an under-serviced area upon graduation. Consider the broad implications of this policy for health and health care costs. For example, do you think the approach will be effective?

Describe a time when you did something you were not proud of.

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