Correct Answer?

[MedPR]

For the interview question "What would you do if your patient requested a procedure you are morally against?"

My answer was basically that I would refer them to a physician I knew was excellent at performing that procedure. My reasoning was that if I am morally against something, I likely have not performed it since residency and therefore am not skilled or up to date on it. I transitioned that into thinking that patients deserve the highest quality of care and that working together as a team (e.g with other physicians) is an important part of the profession.

I've been waitlisted at both schools I gave this answer to and I can't help but think it is "wrong".

Help please?

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[1289]

i said something along those lines at an interview where I was accepted. I don't think that's a wrong answer at all.

 

[ShenanigansMD]

I would have said the same.

 

[IncognitoGuy]

I'd refer. But if it was something I had umbrage with, I'd take the opportunity to talk to the patient and see why they want to have something done that is morally gray. Chances are, if morality is involved, I'd want to learn from somebody else's perspective, if only so that I can inform myself more should I encounter a similar ethical dilemma in the future.

That and the patient might want to talk about it too - their psychological health is as important as physical health, but you don't need to be a psychiatrist to listen.

 

[red7]

If it occurred to me while I was responding, I would also have added something like "it depends what type of moral issue it is" - i.e. if it was a dangerous procedure or something I felt was not well-enough studied then I might try to inform the patient of all the risks vs. if I was just personally unwilling to do something then I might just refer.

Your answer seems well thought-out and level-headed, which I think is basically what they look for in these types of questions.

Edit: Seriously though, I also was agonizing over my answers to interview questions for weeks afterwards. I think the most productive thing to do is to write down your initial impressions while they are still fresh in your mind, and then just use that to improve your responses in future interviews - worrying about it too much just became unproductive and pointless for me.

 

[487806]

For the interview question "What would you do if your patient requested a procedure you are morally against?"

My answer was basically that I would refer them to a physician I knew was excellent at performing that procedure. My reasoning was that if I am morally against something, I likely have not performed it since residency and therefore am not skilled or up to date on it. I transitioned that into thinking that patients deserve the highest quality of care and that working together as a team (e.g with other physicians) is an important part of the profession.

I've been waitlisted at both schools I gave this answer to and I can't help but think it is "wrong".

Help please?

Your answer is perfectly right. Those schools probably waitlisted you for other reasons, since it's actually unethical to be forced to do a procedure you're against.

If those schools actually waitlisted you for that answer, I would be hesitant to go there.

 

[PreMedOrDead]

Your answer is perfectly right. Those schools probably waitlisted you for other reasons, since it's actually unethical to be forced to do a procedure you're against.

If those schools actually waitlisted you for that answer, I would be hesitant to go there.

Interviews alone are only a small portion (varies in weight) of your application. A single question response that is clearly not offensive, and even seems well thought-out, would definitely not be the concern.

 

[487806]

Interviews alone are only a small portion (varies in weight) of your application. A single question response that is clearly not offensive, and even seems well thought-out, would definitely not be the concern.

Right, but once you got the interview, the chances for acceptance should be significantly higher. Since OP got waitlisted, I guess the application was reviewed again for some minute details? Or maybe the "too many qualified applicants" syndrome?

 

[xroc]

Right, but once you got the interview, the chances for acceptance should be significantly higher. Since OP got waitlisted, I guess the application was reviewed again for some minute details? Or maybe the "too many qualified applicants" syndrome?

Schools still interview anywhere from four to ten times more applicants than their actual class size. Sometimes I think that there are cases when there really is no clear reason why you are waitlisted / deferred / rejected ...

 

[earf]

At my UW interview, the person who helped me prepare (who is also on the admissions committee) says that they don't want a straight answer such as "I'd give him dialysis" or "I'd refer them". They want problem solving: identifying what the problem is, restating the problem, getting more information about the patient and circumstances, what info are you missing, and providing several alternatives.

You could have answered that you would talk with the patient about what they're worried about and why they want to get a controversial procedure, give your recommendations and thoughts about the procedures, and provide several alternatives.

Think about it in context. If a patient came to you and wanted you to help him commit suicide (physician aid in dying), would you quickly refer them to another physician that was excellent in doing that?

EDIT: Or maybe you can also ask them why they think the procedure you're morally against would be better than alternative or what their perception of that procedure is.

 

[xXIDaShizIXx]

Your answer is perfectly right. Those schools probably waitlisted you for other reasons, since it's actually unethical to be forced to do a procedure you're against.

If those schools actually waitlisted you for that answer, I would be hesitant to go there.

No kidding, I don't see the problem with your answer.

 

[chemsmith]

Hmm, I would have answered very differently. I would have said that I would not allow my own moral beliefs to alter or forbear care of the patient. If I deemed the requested procedure to be in the patient's best interest - taking into account that it is what they want but not basing my decision solely on this request - I would do it.

 

[music2doc]

For the interview question "What would you do if your patient requested a procedure you are morally against?"

My answer was basically that I would refer them to a physician I knew was excellent at performing that procedure. My reasoning was that if I am morally against something, I likely have not performed it since residency and therefore am not skilled or up to date on it. I transitioned that into thinking that patients deserve the highest quality of care and that working together as a team (e.g with other physicians) is an important part of the profession.

I've been waitlisted at both schools I gave this answer to and I can't help but think it is "wrong".

Help please?

Good answer.

Some mention of pt counseling might have strengthened it, but a referral is most appropriate. I would personally want to find out more of what the pt's needs were (i.e., why pursuing this procedure, what expected from it); inform the pt of any risks involved (i.e., make sure the pt receives unbiased information on the procedure in the form of educational materials, since practitioners of said procedure may be more likely to assess a need for the procedure than is appropriate for economic/financial reasons or may be less likely to thoroughly go over risks, including mental and physical health risks); and, finally, assess the pt for appropriateness for said procedure prior to referring (back to the health risks issue) with the caveat, of course, that even if, in my judgement, the pt does not seem to be in a condition that would make said procedure appropriate if the pt wants the procedure despite my recommendation, I would ultimately refer (and let the other physician make the final call).

 

[chemsmith]

But also I do not mean to say that your answer was wrong at all. I think that the allowance of one's morals to enter into practice is in itself a very subjective issue.

 

[lovesfall]

The only thing I see that is potentially a little bit strange about your answer is that you don't really seem to give much weight to your moral stance. Instead, you focus your answer more on being out of practice than your moral opposition to it. The transition into teamwork and quality of care could potentially be seen as continuing to minimize the moral dilemma behind the question. I can't see anyone disagreeing much with the answer itself, but your justification seems to demonstrate some discomfort with the idea of holding a moral position on something. Obviously, there is a line somewhere between being appropriately committed to your own values and encroaching upon others', but you shouldn't need to concoct an excuse ("Sorry, out of practice!") for why you won't perform a procedure. I probably wouldn't have even thought about it that way, though, unless someone asked me to be extra critical (like you did in the thread title), so most likely waitlist was due to other factors and this is reading far too much into it.

 

[ClemsonFirst]

Your answer sounds fine to me. Since they are moral/ethical questions, there is no supposed right or wrong answer (but of course everyone has their own predisposition). I think they more want to see you would make some sort of moral decision, and you can make an argument to defend your decision.

To add to this question, would it would it be inappropriate to lay out the medical and social concerns about the procedure and suggest the patient seek a different option? I assume it would be okay to suggest a different course, but is there a point where you are pressing your views onto the patient and encroaching on the patients opinion?