You started your clerkship rotations coincidently with your best friend. In your conversations, he often mentions patients by name and gives details on their conditions as well as their behaviour. What are some ethical issues that may arise in such a situation?
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?
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?
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?
You have two patients who have been admitted after a serious accident. Both require immediate attention in order to survive. One patient is 20 years old; the other is 60 years old. Which life would you save?
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?
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?
Orphan diseases are diseases whose rarity means there is a lack of a market large enough to gain support and resources for discovering treatments for them.
What is your approach to treating orphan diseases?
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?
You are an attending physician who works at a busy hospital. Patient X frequently ignores the medical advice given by you and seems to dislike being in the hospital. How would you go about handling such patient encounters?
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?
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 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?
Can you tell me about an amazing adventure you had? Take a moment to really visualise it. Pause to feel the emotions you experienced during key moments and do your best to relive your story. I'd love to hear it!
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?
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?
People infected with COVID-19 variants are experiencing a spectrum of symptoms with some suggesting that it can be compared to the flu or common cold. Some believe that the risk of vaccination side effects (e.g. inflammation of the heart) may outweigh the risk of contracting COVID.
Discuss your stance on vaccination decision making when factoring side effects and contracting the disease.
A drug formulary is a list of generic and brand name prescription drugs covered by your provincial health insurance.
With a finite provincial budget, how would you determine which drugs should not be included in the drug formulary (not covered by health insurance)?
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?
In healthcare, mandatory vaccinations has been met with mostly support. With COVID-19, mandatory vaccinations and booster shots have been further explored ethically and pragmatically.
Discuss your perspective on mandatory vaccinations for COVID-19 compared to others (e.g. flu).
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 a 1st year med student and you are in the room with a small group of students, a doctor and a young female patient. The doctor tells the patient to remove her shirt to do a breast exam. The patient is visibly uncomfortable but does what she is told. The physician then performs the exam and tells you to do it as well. Discuss your reaction to this situation. An elderly woman has been admitted to emergency room with asthma/difficulty breathing. She refuses to allow a medical student to treat her. Discuss the ethical issues in this case and possible safeguards to protect patient and students/physicians.
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?
It has been suggested that in order to promote healthy lifestyles, medical schools preferentially admit students who do not smoke. Do you think this approach will be effective? Discuss the implications with respect to health and health care costs.
Dr. Cheung recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr. Cheung doesn't believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches and muscle aches, because he believes that it will do no harm, but will give them reassurance. Consider the ethical problems that Dr. Cheung's behaviour might pose. Discuss these issues with the interviewer.
At the beginning of your last year of undergraduate studies, the Dean of your Faculty has offered to all of you the opportunity to swallow a „red‟ pill. If swallowed, this pill would increase enormously your ability to „absorb‟ all the educational material being presented to you in all your courses. In fact, this pill would basically guarantee that you would receive an A+ in all your future courses with a significantly reduced workload. Would you take the red pill?
The City of Vancouver has taken great measures to increase accessibility to alternative forms of transportation (Canada Line, Hornby and Dunsmuir Bike Lanes, Proposed Evergreen Line, and Burrard Street Bridge closures). Discuss the impacts (both positive and negative) of these decisions?
You are a family physician. One of your patients, Mark, did not attend one of his classes and missed an important exam. He told you that his teacher would like a doctor's note explaining his absence from class; otherwise, he will receive zero, and all hell will break loose. He wants to you write a note for him, indicating that he was not feeling well enough to write the exam. Not able to find any physical symptoms, explain how you would deal with this. Enter the room and talk to Mark.
A message that recently appeared on the Web warned readers of the dangers of aspartame as a cause of an epidemic of multiple sclerosis. The authors claimed that aspartame remains on the market because the food and drug industries have powerful lobbies in Congress. They quoted Dr. Russell Blaylock, who said. "The ingredients stimulate the neurons of the brain to death, causing brain damage of varying degrees." Critique this message, in terms of the strength of the arguments presented and their logical consistency. Your critique might include an indication of the issues that you would like to delve into further before assessing the validity of these claims.
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.
The Canadian Pediatric Association has recommended that circumcisions "not be routinely performed". They base this recommendation on their determination that "the benefits have not been shown to clearly outweigh the risks and costs". Doctors have no obligation to refer for, or provide, a circumcision, but many do, even when they are not clearly not medically necessary. Ontario Health Insurance Plan (OHIP) no longer pays for unnecessary circumcisions. Consider the ethical problems that exist in this case. Discuss these issues with the Interviewer.
You are shift supervisor at McDonalds fast food restaurant. The owner of the franchise has called you over. He is very upset as he has received 3 complaints in the last 30 minutes about the meat in the hamburgers being poorly cooked. There are two people (one male, one female both 15 years old) who have been cooking the meat for the past two hours. The female is the owner‟s daughter. How would you handle the situation?
Imagine you are the principal of a full fee paying school. There has been an allegation by members of the public of an incident in a park in which at least two senior school students were seen verbally abusing a young person with intellectual impairment for the amusement of a group of other students. Two final year students are to attend a hearing with the principal to explain their actions in the incident. What are the issues the principal is likely to consider at the hearing?
Some people think that the new or younger generation of physicians are not as hard-working (i.e., wanting to leave right at 5:00 p.m., not wanting to put in as long of a work week) as previous generations. How do you feel about this perception?
Your friend Jason hasn't come to class for a few days. Being a hardworking premed student, he very seldom skips classes. You know that he is applying to medical school in the past several weeks. You called his house and he said you can visit him. You decided to pay him a visit after your classes. Enter the room and talk to Jason.
You are an emergency room physician at a local hospital. A patient comes in requesting painkillers for his back. Upon reviewing his file, you realize that he frequently comes to the hospital requesting painkillers and he has already capped his prescription for the month. Upon examination, you notice no new injuries to indicate an increase in painkillers. You politely tell patient that you will not increase his dosage or re-fill out another prescription for him. He tells you that he will go and inject himself with heroin right now if he does not get the painkillers. What do you say next? What do you do?
Your company needs both you and a co-worker (Sara, a colleague from another branch of the company) to attend a critical business meeting in San Diego. You have just arrived to drive Sara to the airport. Sara is in the room.
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.
You are a genetic counsellor. One of your clients, Linda, had a boy with a genetic defect that may have a high recurrence risk, meaning her subsequent pregnancies has a high chance of being affected by the same defect. You offered genetic testing of Linda, her husband, and their son to find out more about their disease, to which everyone agreed. The result showed that neither Linda nor her husband carry the mutation, while the boy inherited the mutation on a paternal chromosome that did not come from Linda's husband. In other words, the boy's biological father is someone else, who is unaware that he carries the mutation. You suspect that Linda nor her husband are aware of this non-paternity. How would you disclose the results of this genetic analysis to Linda and her family? What principles and who do you have to take into consideration in this case?
You are a physician who has finished his or her day and decide it's appropriate to leave on time for the first time in months. You have promised to meet your family for dinner. You suddenly receive a phone call from Mrs. Black, a 87 year old patient in a nursing home long time, who wishes that you attend to her long-standing condition. She has been patient of yours for 15 years and refuses to see another doctor. What issues are involved? How would you approach this situation?
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.
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?
You are a second year student shadowing a doctor in the O.R. Once the patient, an obese female has been given general anesthetic and the procedure is under way the doctors start to make comments about her weight and call her names that you find inappropriate but most of all unprofessional. Do you talk to the doctor about his comments or do you keep your comments to yourself? Why?
A patient has just been diagnosed with cancer. The patient takes the news very badly and is concerned with pain and the immediate treatment. You know that is it extremely likely that the patient will die within 9 months regardless of course of treatment. What do you tell the patient, what are your ethical obligations, your legal obligations?
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.
Your best friend and partner are undergoing in vitro fertilization to have a baby. The technique allows for the selection of certain characteristics for the child by identifying them in the embryo before implantation. Your friend asks for advice on the characteristics they should select. How would you respond to your friend?
You are sitting at a desk in front of the interviewer with a screen between you. You have a set of blocks in front of you and you have to set them up in a certain way. The interviewer knows the solution and you can't see them and can only ask them yes or no questions. Correctly assemble the blocks.
You are a third year medical student involved in the research of Dr. A, a senior physician. He is testing the efficacy of a new drug on lowering cholesterol. This drug is not yet known be more effective that existing drugs on the market. He insists that you recruit patients for trials even though the clinical risks of the research are still undefined. What are the issues involved for the patients? For yourself?
Your friend is of Chinese descent and fluent in Mandarin. You both want to get into medicine. She registers for Mandarin 101, a course in Chinese language for beginners. The course coordinator asks that students who can already speak just a little bit of Mandarin should leave because this is a course for beginners. Your friend remains but makes a sufficient number of deliberate mistakes in the classroom discussions, in the required homework and in the examinations that she will not be detected and yet still receive an excellent grade. What would you do in this situation?
You are presented with a list of 15 individuals, including details of their age, sex and occupation. You are being told that a nuclear attack is imminent and you are only allowed to save 5 of them from destruction. Which ones and why?
Mrs. Jones has signed a donor card indicating that she is willing to donate her body to science without notifying her husband and son. She gets into an accident and it is determined that she is brain dead. The family doctor, who is on call that afternoon, reviews the chart and determines that she would be perfect for medical students to practice the removal of organs for transplantation purposes. The doctor then talks to the family to discuss the procedure and to confirm their consent. They both oppose the procedure and refuse to allow their doctor to move forward. The doctor points out that Mrs. Jones could be helping hundreds of people by educating the medical students and that technically consent has already been provided. The husband understands how beneficial the educational experience is but is too emotional to allow them to continue. The son, a medical student, refuses because he knows the bodies are not treated with dignity. If you were the doctor, how would you proceed? Why?