EVMS interview questions

[booswim542]

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So I am a little worried for EVMS, I have read some of the interview questions on the feedback site, and there are some I just don't know how I would answer. If I don't really think about them, I know I would blurt out something stupid, then spend the next five minutes rambling trying to justify my answer....basically, dig myself a hole and get stuck in it.

There are 4 questions I saw that scare me:

1. A 14-year-old girl comes to you wanting an abortion, and she does not want her parents to know. How would you handle this?

2. How would you fix healthcare in this country? (really? the experts even have no clue)

3. You accidentally and inadvertently chance to see the file of the husband of a family you've known for a long time, but are not his primary provider. The chart shows that he has HIV, and his wife later comes to you for a physical.

4. You have one liver for transplant. The two candidates are: a rich, 80-year-old widow with 10 years to live or a 60-year-old inmate serving a life sentence with no possibility of parol. Also, the inmate has a family with young children. Who gets the liver? Depending on who you chose, either the inmate's wife or the widow's son comes to beg for the liver. How do you defend your choice?

I know EVMS is kind of known for these questions, but does anyone know a really good place/places to look for answers or ways to reason through these things? Anyone have enough time to answer any of these questions with their own opinion?

 

[Robizzle]

14 yr old. check for why she's pregnant (who's the father, might be rape). check why she doesn't want to tell her parents. explain all other options available. if she is competent and has weighed all her options and still wants the abortion you do it without telling her parents.'

as for healthcare question #2. seriously im freaked about that too man...

3) right after the wife checkup, call the primary care provider and ask if the wife and husband both know. if not, have the husband tell his wife. if he won't, you tell his wife yourself asap because she is at risk. patient-doc confidentiality can be breached at times that you know a life is in danger.

4) whoever is higher up on the UNOS list. you have no right to decide who should get it based on who they are as people.

 

[Haemulon]

Question number 2 is the only really difficult one here. The other one's are pretty clear cut if you do your homework. I floundered about how to fix healthcare ... and if you flounder its like blood in the water. They WILL keep asking follow up questions. The whole point of that question though is to see that you are well read and current with relevant health care issues. They know that no one has a simple solution.

 

[Robizzle]

by the way folks those are answers that i gathered from this site, some ethical sites, and my own thinking. so if i were you i would change it around a bit because you know like 80% of kids will use those now.

 

[tacrum43]

EVMS does ask some relatively tough ethical questions, but the key is just to be prepared with a thoughtful answer.

This is a good site to read through for an overview of medical ethics topics: http://depts.washington.edu/bioethx/topics/index.html

I was also really afraid of the "How would you fix our healthcare system" question, because I had no clue. So I read a book about it, "Healthcare Meltdown". That book is most definitely biased towards universal healthcare, but it makes strong points, and it defintely gave me plenty to talk about for that question.

 

[alwaysaangel]

1. A 14-year-old girl comes to you wanting an abortion, and she does not want her parents to know. How would you handle this?

In California you can't tell her parents about it - only she can by law. So for me I would mention that. Otherwise I'm prolife and would refer her to another doctor because while I believe patients deserve all their options explained to them I will not perform abortions. I would also counsel her on why she feels she can't tell her parents and encourage her to tell them for the emotional support needed for such a big decision.

2. How would you fix healthcare in this country? (really? the experts even have no clue)

Ok there are tons of things wrong with healthcare: access, rising cost, decreasing compensation for doctors, increasing influence by private companies/pharmaceuticals, etc. etc. etc. Mention that you know about all of them and then pick the one you know most about and mention what YOU could do to fix that aspect. Or thats how I'm answering - there is no way I know how to fix healthcare - I'm not a polisci major or a public health major, I don't understand all the idiocyncricities. But I have worked in a free clinic for 4 years and passionately want to donate a lot of time to them in my career. So ACCESS is something I can personally have a lot of influence on. So I would fix healthcare by doing my best to work for/fund/start/run/recruit other doctors for free clinics in areas that have the highest need for low-income/no-insurance healthcare.

In other words, pick something you know about and run with it. They KNOW you don't know how to fix healthcare - but they want to know that you are aware of the problems that exist and that you have a passion about something that can contribute.

3. You accidentally and inadvertently chance to see the file of the husband of a family you've known for a long time, but are not his primary provider. The chart shows that he has HIV, and his wife later comes to you for a physical.

Patient-doctor confidentiality DOES NOT fall apart in this case. I've seen it at the clinic I work at and the doctor COULD NOT tell the patients SO. I would probably convince her it would be good to do a routine blood check-up and include HIV in the mix. Then I would be able to inform her that she does or does not have it. I would also speak to the husbands physician about counseling him to tell her.

4. You have one liver for transplant. The two candidates are: a rich, 80-year-old widow with 10 years to live or a 60-year-old inmate serving a life sentence with no possibility of parol. Also, the inmate has a family with young children. Who gets the liver? Depending on who you chose, either the inmate's wife or the widow's son comes to beg for the liver. How do you defend your choice?

Assuming all other things equal (ability to accept the liver, ability to refrain from alcohol and other harmful substances, etc.) I would give it to the 60-year old inmate. He can get more use out of the liver than the 80 year old and would probably be much more able to handle the surgery. If the widow's some came to beg for the liver I would explain that not only are transplant surgery's dangerous for someone his mother's age but that I could not in good conscious give someone that much older a liver when a younger person could get more use out of it. (I think this question is silly)

This is fun, I want an interview at EVMS 🙁

 

[Haemulon]

In California you can't tell her parents about it - only she can by law. So for me I would mention that. Otherwise I'm prolife and would refer her to another doctor because while I believe patients deserve all their options explained to them I will not perform abortions. I would also counsel her on why she feels she can't tell her parents and encourage her to tell them for the emotional support needed for such a big decision.


Ok there are tons of things wrong with healthcare: access, rising cost, decreasing compensation for doctors, increasing influence by private companies/pharmaceuticals, etc. etc. etc. Mention that you know about all of them and then pick the one you know most about and mention what YOU could do to fix that aspect. Or thats how I'm answering - there is no way I know how to fix healthcare - I'm not a polisci major or a public health major, I don't understand all the idiocyncricities. But I have worked in a free clinic for 4 years and passionately want to donate a lot of time to them in my career. So ACCESS is something I can personally have a lot of influence on. So I would fix healthcare by doing my best to work for/fund/start/run/recruit other doctors for free clinics in areas that have the highest need for low-income/no-insurance healthcare.

In other words, pick something you know about and run with it. They KNOW you don't know how to fix healthcare - but they want to know that you are aware of the problems that exist and that you have a passion about something that can contribute.


Patient-doctor confidentiality DOES NOT fall apart in this case. I've seen it at the clinic I work at and the doctor COULD NOT tell the patients SO. I would probably convince her it would be good to do a routine blood check-up and include HIV in the mix. Then I would be able to inform her that she does or does not have it. I would also speak to the husbands physician about counseling him to tell her.

Assuming all other things equal (ability to accept the liver, ability to refrain from alcohol and other harmful substances, etc.) I would give it to the 60-year old inmate. He can get more use out of the liver than the 80 year old and would probably be much more able to handle the surgery. If the widow's some came to beg for the liver I would explain that not only are transplant surgery's dangerous for someone his mother's age but that I could not in good conscious give someone that much older a liver when a younger person could get more use out of it. (I think this question is silly)

This is fun, I want an interview at EVMS 🙁

You would probably do well, although I disagree with a few of the particulars in your answers. (There is already a system in place that objectively ranks people for priority of receiving organs.) I feel that it is unethical to discriminate based on age, it is more objective to evaluate priority based on medical need and chances for success. It may very well be that an elderly person is less likely to have a positive chance for success due to health conditions associated with their age, which would bump them down the list though. Either way though, the whole point is to be able to talk about the subject and defend your point of view with reasoning, no matter what it is.