The Medicine Interview Preparation Megathread 2012 Entry

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OK, here you go:

Imagine you are in a GP surgery. A 15 year old girl comes in alone. She tells you that she is pregnant, and wants a termination. From calculating her dates you think she is about 9 weeks. She begs you not to tell her parents. Her mum rings up later in the day, having found out she has been to see you, and demanding to know what went on - "She's under 16 so it's my right to know what she said to you."

What issues does this raise, and how do you think you will tackle them?

There is alot of ground to cover with a question such as this, but my advice would be to ensure you get the bigger picture of the scenario. Consider possibilities such as abuse and seual assualt or vulnrabilities due to age or enviroment. Would also suggest an understanding of the legal concept of competence (fraser competence), namely is she of the right level of competence to be able to make this descision? If she is then your duty of confidentiality comes into play.
Hope that gives people food for thought...

Reply 21

rapidresponse

Original post by FrenziedPenguin

I think things are a bit more complex and also that before you start talking about abuse there are many other "normal" things to consider.

1 - The issue of the termination itself. If she is competent she would be entitled to it but there may be long term consequences to the procedure, both physical and psychological. If she is competent, ie she can make her own decisions because she understands the facts) then she can go ahead with one provided doctors feel it is a viable option.

2 - YOu would need to consider why she can't tell her parents. She may need their support. YOu should try to get her to think about involving them. If you are a male doctor you may want to get the girl to talk to a female doctor or nurse, or psychologist or anyone who can discuss these things at a more personal level. If she still refuses you can't force her, but you would need to seriously consider what support mechanism she has. You might to put her in touch with harity organisations. She has some time to decide if she is only 9 weeks pregnant.

3 - Other factors such as child abuse, prostitution, age of the sexual partner are important considerations once you have dealt with the first line issues.

4 - You should also think about educating her on sexual health, contraception etc

You cannot tell anything to the mum just because the girl is a minor (in fact that is what the Gillick case was about). Everyone is entitled to confidentialiyy, even if minor, unless there is a serious risk of harm (e..g if the girl was being prostituted, or part of a gang,)

(edited 12 years ago)

Reply 22

Doctor.

rapidresponse

4 - You should also think about educating her on sexual health, contraception etc

I really liked the response!

But I feel that this point it would be....just not really the right time to be mentioning it. I mean like the girl is pregnant, too late for that. Your other points I would agree 100000% :smile:

(edited 12 years ago)

Reply 23

dunnicare

Original post by TooSexyForMyStethoscope

Erm not really since I haven't been in any of the teams that you were in...

Haha. OK, can I get some advice on how to give an affective answer? :colondollar:

Reply 24

Doctor.

anyone got a clue what kind of questions Liverpool ask? :tongue:

Reply 25

rapidresponse

Original post by Doctor.

Its not too early in the sense that
(i) you might never see her again
(ii) you can be pregnant and still have sex so the risk of STIs is serious
(ii) once she has had the termination she can well fall pregnant again.

Reply 26

Seb

I am dreading the Manchester-like interviews (Not assuming I'll even get one, of course) with the group discussion, before the MMIs

Reply 27

Normandy114

Original post by Seb

I am dreading the Manchester-like interviews (Not assuming I'll even get one, of course) with the group discussion, before the MMIs

Really? I don't see why people dread that part so much, I really like the idea of openly discussing a scenario and weighing up the pros and cons of the situation.

Reply 28

Seb

Original post by Normandy114

Really? I don't see why people dread that part so much, I really like the idea of openly discussing a scenario and weighing up the pros and cons of the situation.

Because I'm scared I'll be in a room filled with people like you. Who claim to really enjoy the discussion. I don't know who's genuine, and who's just a prick like Keir from junior doctors...

Reply 29

Helenia

Original post by Seb

Because I'm scared I'll be in a room filled with people like you. Who claim to really enjoy the discussion. I don't know who's genuine, and who's just a prick like Keir from junior doctors...

He's actually alright IRL.

Essentially, in group situations, you don't want to be the gobby one who won't shut up and who everyone's glaring at, but you don't want to be the one who sits back and doesn't say anything at all. You need to be assertive enough to get your opinions heard, and if you can encourage/facilitate the whole group discussion (referring back to a point someone else made, or asking another candidate what they think) then so much the better.

dunnicare

Haha. OK, can I get some advice on how to give an affective answer?

Give us an idea of what you were thinking first, and people will be able to guide you from there.

FWIW, I still hate that question.

Reply 30

Annora

Original post by ScheduleII

I'm anti-abortion, what is the best way to explain my view if asked about it? When I was getting my PS reviewed and UCAS sent off today the guidance officer asked me how I'd respond to something that was against my faith.
Would saying it was the unjust annihilation of human life and thus against the principles of medicine (specifically non-maleficence) be a suitable way of phrasing it? I wouldn't use words like "murder" or "sinful" in case I got a pro-choice interviewer who put a huge red flag against my name.

Presumably, you'd refer a patient on to someone more appropriate and not speak to them in a way that is judgemental or directive.

And can they ask what you would do about suspected child abuse? I've heard of similar questions being asked.

If someone is in danger you'd be under obligation to report it.

Reply 31

Helenia

Original post by Doctor.

Although the first consultation might not be the best time to raise it, discussing contraception around the time of a termination absolutely IS appropriate. There are quite a few places who will put in a coil or implant at the same time as performing a termination.

Good responses so far, keep them coming!

Reply 32

aljabiraa

interview thread already? wow.

anyone know what sort of science question Cambridge ask?

Reply 33

LHC

How long do you think it'll take for universities to give out interviews? I've read on some that interviews can be as early as the end of october which is bizarre. Also does anyone know how much notice the university gives you for interviews? I'd hope a month :L

Reply 34

hslakaal

Original post by aljabiraa

interview thread already? wow.

anyone know what sort of science question Cambridge ask?

Yeah, I've been wondering too. Mine's on the 27th Oct, one day before my A2s...

Good luck in yours!

:s-smilie:

Reply 35

Helenia

Original post by aljabiraa

interview thread already? wow.

anyone know what sort of science question Cambridge ask?

Vazzyb did a thread of sciencey Oxbridge style questions a while back but I can't seem to find it. Have a search through the forum and you'll probably find some stuff though.

Reply 36

Venomilys

Original post by Helenia

tell the mum that the daughter has kwashiorkor :biggrin:

Then she starts laughing and everyone is happy.

Reply 37

Normandy114

Original post by aljabiraa

interview thread already? wow.

anyone know what sort of science question Cambridge ask?

Emmanuel college have done videos where they recorded mock interviews using current students. Scroll down to where it says "Rebeka – Medicine", and click on it to see the video, I've not seen the entire thing but watch from 30s onwards, they start with the science questions.

http://www.admin.cam.ac.uk/offices/admissions/toolkit/interviews/videos.php

Reply 38

CpnCornetto

Original post by Helenia

Fraser competence?
Is she like mature enough to cope with the issue herself, make rational choices about the life that she could potentially bring into the world or if she want's to terminate the pregnancy.
If she's not mature enough then a doctor would be obliged to tell the mother.
If the doctor were not to tell the mother the doctor would have to be 100% sure that the girl completely understood the consequences.
Also patient confidentiality, a patient (regardless of who they are) has asked you specifically to keep all the details confidential. Is it right then to breach that confidentiality. I mean in situations where the patient is at risk you are allowed to breach confidentiality, but if the patient is fraser guidline competent or gillick or whatever we're meant to call it then the doctor shouldn't breach the confidentiality as the patient isn't at enough risk to warrant telling the parent.
Also potentially lying to / witholding information from the mother, She is after all legally responsible for her daughter in most ways. She'll be the one who'l have to support the baby (probably) for a good while financially for example. Baby's are expensive, knowing before hand could help the mother plan for the process.
The daughter could also get moral support from the mother through this difficult time, or it could cause a huge family paddy, potentially causing friction within the family putting stress on the patient.

I need to do a bit of reading up don't I?

Oh btw how are we meant to pronounce non-maleficence? I've only ever seen it written down, on here or wikipedia or books etc.
didn't get any practice interviews etc last year, also didn't get any actual interviews.

(edited 12 years ago)

Reply 39

Annora

Original post by joemullally

Oh btw how are we meant to pronounce non-maleficence? I've only ever seen it written down, on here or wikipedia or books etc.
didn't get any practice interviews etc last year, also didn't get any actual interviews.