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Difficult Medical School interview question

"You have one dialysis machine to share between three patients with equal medical need. One is a 17-year-old drug addict who has just overdosed, one is a 40-year old woman with terminal breast cancer and only 6 months of life expectancy, the third one is a 70-year old marathon runner. Who gets the machine?"

How would you answer this?

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Stupid question, people aren't hooked up to them 24/7. They can share.
Original post by ThrillSize
"You have one dialysis machine to share between three patients with equal medical need. One is a 17-year-old drug addict who has just overdosed, one is a 40-year old woman with terminal breast cancer and only 6 months of life expectancy, the third one is a 70-year old marathon runner. Who gets the machine?"

How would you answer this?


The trick with these sorts of questions is to show the interviewers that you've considered all sides to the story. There is no right or wrong answer per se and as such the interviewers don't particularly care about what your opinion is. They just want to see that you've considered it from every aspect.

So instead of saying something like "I would give it to the 17 year old because she's got the most years left to live" and leaving it at that, you should present the ethical arguments for and against each of those individuals getting the machine (I'll leave you to think about these yourself) and then at the end summing it up with your personal opinion by saying something like "so with all things considered I would give it to...".

Though as Hippokrates says, these questions are usually a bit rubbish since real life medicine isn't so black and white. The point of them is to just make you think about things from different angles.

Hope that helps.
Reply 3
Original post by Democracy
The trick with these sorts of questions is to show the interviewers that you've considered all sides to the story. There is no right or wrong answer per se and as such the interviewers don't particularly care about what your opinion is. They just want to see that you've considered it from every aspect.

So instead of saying something like "I would give it to the 17 year old because she's got the most years left to live" and leaving it at that, you should present the ethical arguments for and against each of those individuals getting the machine (I'll leave you to think about these yourself) and then at the end summing it up with your personal opinion by saying something like "so with all things considered I would give it to...".

Though as Hippokrates says, these questions are usually a bit rubbish since real life medicine isn't so black and white. The point of them is to just make you think about things from different angles.

Hope that helps.


Thank you so much! That seems like the best approach to take for this question. What would you think if someone were to answer "I would give it to the first person on the waiting list" ?
Reply 4
Original post by Hippokrates
Stupid question, people aren't hooked up to them 24/7. They can share.

It is pretty stupid, but it has been asked before :s-smilie:
Original post by ThrillSize
Thank you so much! That seems like the best approach to take for this question. What would you think if someone were to answer "I would give it to the first person on the waiting list" ?


Just that? Or that as your personal opinion at the end when you're summing things up?

There's no right or wrong answer as I say; that would certainly be a fair, non-discriminatory way of doing it i.e. the person with the greatest medical need gets it irrespective of their personal circumstances and background. No one could fault you for that, assuming you've explored the other ethical viewpoints too.
Not once in 2 and a half hours of interviews did a question like this come up for me...


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Reply 7
Original post by MrSupernova
Not once in 2 and a half hours of interviews did a question like this come up for me...


Posted from TSR Mobile


Well that's a relief! They didn't ask you any scenario questions? If you don't mind me asking, where did you get interviewed and how do you think you did? :biggrin:
Reply 8
Original post by MrSupernova
Not once in 2 and a half hours of interviews did a question like this come up for me...


Posted from TSR Mobile


I got something a little like it at one of mine but instead of a dialysis machine it was a student advisors time that was limited and 4 students needing to see the advisor. So it isn't unheard of.

Posted from TSR Mobile
Original post by ThrillSize
Well that's a relief! They didn't ask you any scenario questions? If you don't mind me asking, where did you get interviewed and how do you think you did? :biggrin:

I did get some scenario questions, but they were things like "What would you do if you thought your consultant has a drinking problem that is endangering patients?", "What would you do if you found out your best friend cheated in final exams?" or "What would you do if you found out your patient was continuing to drive even though his condition means he isn't allowed to, because he says he would lose his job if he didn't?"

I was interviewed at Oxford, Nottingham and Newcastle. I got offers from all three so I must have done reasonably well... Despite my phone going off at Newcastle and me losing the article I was supposed to bring to one of my Oxford interviews :redface:
(edited 9 years ago)
Reply 10
Original post by MrSupernova
I did get some scenario questions, but they were things like "What would you do if you thought your consultant has a drinking problem that is endangering patients?", "What would you do if you found out your best friend cheated in final exams?" or "What would you do if you found out your patient was continuing to drive even though his condition means he isn't allowed to, because he says he would lose his job if he didn't?"

I was interviewed at Oxford, Nottingham and Newcastle. I got offers from all three so I must have done reasonably well... Despite my phone going off at Newcastle and me losing the article I was supposed to bring to one of my Oxford interviews :redface:


:eek: "Reasonably well" is an understatement here.. that's amazing! which one will you most likely be going to?

Is there anything you wish you'd known before the interviews? Any advice you'd like to give me as you've already been successful in the interviews? How did you prepare? Hope you don't mind answering these :colondollar:
Original post by MrSupernova
Not once in 2 and a half hours of interviews did a question like this come up for me...


Posted from TSR Mobile


Questions like that can come up, so it's worth it for applicants to think about how they'd approach them.
I believe that this question does in fact have a simple answer, although you would be unwise to simply state it in an interview.

In situations like this, no judgement is made about the situation of each person but rather resources are allocated on the basis of medical need alone.

If this were a liver transplant - the original and 'more difficult' version of this question - rather than dialysis machines, then the drug addict and cancer patient may well not be eligible for the transplant, but even so they are still ranked by medical need after those factors have been taken into account.

In an interview, you are not being tested on giving the 'right' answer but rather your thought process behind it. Verbalise whatever comes to mind - that's what they want to hear.
Original post by ThrillSize
Thank you so much! That seems like the best approach to take for this question. What would you think if someone were to answer "I would give it to the first person on the waiting list" ?


That answer is likely to be followed up with "and what if there wasn't a waiting list?" :tongue:
Original post by em.d_4
I got something a little like it at one of mine but instead of a dialysis machine it was a student advisors time that was limited and 4 students needing to see the advisor. So it isn't unheard of.

Posted from TSR Mobile

Was the question about who needed to see the advisor most urgently, i.e. a question about clinical need under a different guise?


Original post by Chief Wiggum
Questions like that can come up, so it's worth it for applicants to think about how they'd approach them.

I've seen things like it in interview help books and the like, it's just that I've not known of anyone who's been asked something similar to it, or at least not recently. It just seems like a really strange question to ask, considering that in point 57 of Good Medical Practice, the GMC says:

"The investigations or treatment you provide or arrange must be based on the assessment you and your patient make of their needs and priorities, and on your clinical judgement about the likely effectiveness of the treatment options. You must not refuse or delay treatment because you believe that a patient’s actions or lifestyle have contributed to their condition."

I'm not really sure how a decision could be made in this scenario without doing exactly what doctors are advised not to do...
Original post by MrSupernova



I've seen things like it in interview help books and the like, it's just that I've not known of anyone who's been asked something similar to it, or at least not recently.


Right, that must be definitive proof that it never gets asked then...

Obviously people cannot predict what questions they'll get asked, but questions like the one in the OP are certainly not unheard of.
Reply 16
Original post by MrSupernova
Was the question about who needed to see the advisor most urgently, i.e. a question about clinical need under a different guise?


Yeah it's essentially the same as the question the OP described but a little less direct on the medicibe front. A little more generalised


Posted from TSR Mobile
Original post by ThrillSize
:eek: "Reasonably well" is an understatement here.. that's amazing! which one will you most likely be going to?

Is there anything you wish you'd known before the interviews? Any advice you'd like to give me as you've already been successful in the interviews? How did you prepare? Hope you don't mind answering these :colondollar:


I meant reasonably well on each individual interview; obviously I was over the moon to have so much choice in where to go! I firmed Oxford back in May and found out the week before last that I've got my grades, so I start there at the end of the month :biggrin:

I'd definitely say double, triple then quadruple check that your phone is off... Don't be afraid to take a few seconds to think before answering the interviewers' questions, and take your time when speaking as well. Obviously don't go overboard with this, but being able to think as you speak helps stop you from talking nonsense and allows you to think as you're speaking.

Don't necessarily view it as a bad thing if you get interrupted or if you feel like you're being interrogated - they're short on time and are just trying to get as much out of you as they can. Even before the phone incident I felt like my Newcastle interview was a horror show, as they cut me short halfway through what I'd thought was a really good anecdote about how my volunteering had strengthened my resolve to do medicine, and at the time I was worried they just weren't interested, but they have a strict schedule to keep to. They also kept asking tricky follow up questions to the standard "Why do you want to do medicine?" question they asked at the start, which made me think I was giving bad answers, but I guess they were just trying to get to the root of my motivations and seeing how I coped under pressure.

I just used this book:
http://www.amazon.co.uk/gp/aw/d/1905812051?pc_redir=1408122732&robot_redir=1
which was pretty good. Definitely get a practice interview from someone who knows that they're doing if you can (and get them to be as mean as possible), because I didn't and, although it didn't matter in the end, I still think it would have helped. If you're applying for Oxbridge, UCL or Imperial, read over everything you've done at AS and so far in A2, because it'll really help in the science-based questions they ask. Read plenty of articles about recent or major historical medical developments too, because I imagine that'd have helped in my Oxford interview... I didn't really do enough of that, and was very lucky that I got asked a lot about the two things I'm most interested in.

If you want to ask anything else, feel free :smile:
Reply 18
Original post by ThrillSize
Thank you so much! That seems like the best approach to take for this question. What would you think if someone were to answer "I would give it to the first person on the waiting list" ?


Waiting lists mean jack all when it comes to clinical need :smile:
Reply 19
Original post by MrSupernova
I meant reasonably well on each individual interview; obviously I was over the moon to have so much choice in where to go! I firmed Oxford back in May and found out the week before last that I've got my grades, so I start there at the end of the month :biggrin:

I'd definitely say double, triple then quadruple check that your phone is off... Don't be afraid to take a few seconds to think before answering the interviewers' questions, and take your time when speaking as well. Obviously don't go overboard with this, but being able to think as you speak helps stop you from talking nonsense and allows you to think as you're speaking.

Don't necessarily view it as a bad thing if you get interrupted or if you feel like you're being interrogated - they're short on time and are just trying to get as much out of you as they can. Even before the phone incident I felt like my Newcastle interview was a horror show, as they cut me short halfway through what I'd thought was a really good anecdote about how my volunteering had strengthened my resolve to do medicine, and at the time I was worried they just weren't interested, but they have a strict schedule to keep to. They also kept asking tricky follow up questions to the standard "Why do you want to do medicine?" question they asked at the start, which made me think I was giving bad answers, but I guess they were just trying to get to the root of my motivations and seeing how I coped under pressure.

I just used this book:
http://www.amazon.co.uk/gp/aw/d/1905812051?pc_redir=1408122732&robot_redir=1
which was pretty good. Definitely get a practice interview from someone who knows that they're doing if you can (and get them to be as mean as possible), because I didn't and, although it didn't matter in the end, I still think it would have helped. If you're applying for Oxbridge, UCL or Imperial, read over everything you've done at AS and so far in A2, because it'll really help in the science-based questions they ask. Read plenty of articles about recent or major historical medical developments too, because I imagine that'd have helped in my Oxford interview... I didn't really do enough of that, and was very lucky that I got asked a lot about the two things I'm most interested in.

If you want to ask anything else, feel free :smile:


Should have gone Newcastle... your missing out on a free bar every friday!

Congratulations though!

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