Sentry Page Protection

MMI Station Specific Techniques
Ethical Scenarios - 'Two Sorts, Two Sides'

Ethical questions and scenarios are widely used in medicine interviews and are very often the difference between an offer and rejection. Hence, an effective approach and significant practice is essential. There are two main types of ethical scenarios faced in MMI Interviews:

1) Ethical Dilemmas
2) Managing Errors

Ethical Dilemmas


These are 'classical ethical scenarios' where a dilemma is presented, often with the perception that there is a correct action/stance that one should take.

Ethical Dilemma Example Scenario

You are standing at a railway junction and you notice an oncoming train is approaching rapidly and is on course to hit a family of five who are crossing the same track. To your right, you notice a lever which can be used to divert the train to the parallel track, where you can see one individual standing on that track. You are aware that whichever track the train choses to follow, the individual(s) present will not have sufficient time to move out of the way, nor will the train have sufficient time to stop.
 
Explain what actions you would take in this scenario.
​

​With ethical dilemmas, there are two key factors to consider:​

There is no ‘right answer’: Avoid falling into the trap of believing that there is a ‘correct answer’; these questions are designed to test an individual’s ability to think and discuss under pressure, as well as understanding the validity of opposing views.
 
Always commence by acknowledging both sides to the discussion: Whilst most candidates appreciate the need to offer both sides to an argument, studies have found that only 20% of students effectively do so in an interview setting. This is most commonly due to students being interrupted by examiners before they are able to offer all of their desired points. Hence, in order to overcome this situation, it is essential that candidates start by stating ‘There are two sides to consider…’ or words to this effect.
​

Managing Errors


​These are scenarios that focus on your actions and considerations following an error, be it medical or otherwise. Detecting that an error has been made is often straightforward, however the emphasis is on managing the immediate risk as well as possible long term implications:

Managing Errors Example Scenario:
​
You are a third year medical student on a general surgery rotation and you have just observed Mr Martin, your senior registrar drinking a bottle of vodka. He is due to commence an emergency list shortly, and he has just asked if you would like to observe him in theatre.
 
Explain your actions in this scenario
​
​
Managing Errors (eg. Medication and other errors) – BlackStone Tutors 3 Step Approach

  1. Managing the immediate risk/harm and escalating if required eg. Prevent the patient receiving the incorrect medication.
  2. Preventing further short term consequences eg. Review other medication charts to ensure that the doctor has not made any other medication errors with other patients on the same ward.
  3. Investigating to prevent long term recurrences eg. Investigate why the doctor made the medication error and provide teaching/support etc. to all appropriate medical professionals in order to prevent a similar error from recurring in the future