Hard Inverview Question....

[pakidoc]

answer this one folks... someone i know was asked this:

"You are a doctor. A 12 year old girl comes to you asking for a prescription for birth control pills. What do you do?"

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[mrcdsbenz2000]

wheres the hard question? give them to her.
obviously with the spiel of risks, forms of contraception, etc etc etc

answer this one folks... someone i know was asked this:

"You are a doctor. A 12 year old girl comes to you asking for a prescription for birth control pills. What do you do?"

 

[Neuronix]

The answer depends on where you're interviewing. At Penn State, the correct answer would be "Call the parents!" At Temple, the correct answer would be "Give her some condoms too!"




PS: It's a joke. Laugh.

 

[jennyy]

if you give them to her: in a way you are telling her that it is okay have sex at such a young age. she may not be mature enough to make proper decisions.

if you dont give them to her: she will have sex anyway, and might end up becoming pregnant.

if you inform her parents: you are violating physician-patient confidentiality.


well.. i guess the best way to go about it might be to talk to her. my answer would be:

I would tell her that at 12 she may be too young to be having sex. That she is not mature enough to make decisions about her life. I would discuss the dangers of having sex, ie, unwanted pregnancies, stds, and time spent/wasted thinking about the opposite sex which could be spent doing something more constructive. I would tell her that I will not inform her parents and that she can discuss any problems with me. I would also tell her that in the end the decision is upto her. Life is full of choices. I have told you the dangers and now you must decide what you think is right for you. I would give the prescription, but only after this "talk".

 

[v-tach]

Is that still the case even with her being a minor?

 

[margerita]

Make sure you ask her who she is planning on having sex with! Since she is 12 years old, the issue of statuatory rape definitely exists and it is your responsibility as a physician to address this, notify social services, etc. She may be planning on having sex with a teacher for example...not necessarily with another 12 year old.

 

[Davina3000]

I think it is also very important to try and make her visit with you a positive one. Yes, you should counsel her on her options and talk to her about the negatives of having sex at such a young age. At the same time, you should applaud the fact that she is making the choice to talk to a physician about her decision and also that she is opting to use protection. 12 is certainly a young age to become sexually active, but by looking to start birth control, she's being more mature about the decision than some people are at twice her age.

I also agree that it's very important to find out the age of her partner. Even if the guy is under 18, you could offer to talk to him or the two of them together...try and give some of the responsibility to the young man!

 

[Neuronix]

Is that still the case even with her being a minor?

Yes, and you can bet when that 12yo becomes a 16yo and has an STD that she's going to delay treatment until she becomes infertile because she no longer trusts doctors at all. As for legally? You probably won't get into any trouble, since the 12 year old can't legally go against her parents.

 

[v-tach]

Make sure you ask her who she is planning on having sex with! Since she is 12 years old, the issue of statuatory rape definitely exists and it is your responsibility as a physician to address this, notify social services, etc. She may be planning on having sex with a teacher for example...not necessarily with another 12 year old.

That is an excellent point. As for the case in which it IS "another 12 year old", is there any good way to try to dissuade them from having sex at such a young age (short of simply telling the parents, which, while legally fine, has a good chance of breaking her trust in you and causing problems that way)? I wouldn't feel right about just giving her the prescription without seeing if I could get her to reconsider her choice to become sexually active at such a young age--that will just end up causing her all sorts of problems and pain in life that is completely unnecessary, even if she doesn't get pregnant (which is why she wants the pills). I just believe that it would be much better to really solve the underlying problem instead of just "putting a bandaid on it" by handing her a script for birth-control pills or giving her some condoms--these things may protect reasonably well against pregnancy and/or STD's, but they do nothing for any of the other problems that go along with having sex at a young age. Not to mention that the aforementioned protection isn't perfect...there's always the chance that it may fail and then she has even bigger problems.

 

[bananaface]

Birth control pills have uses outside of contraception. If this girl had severe dysmenorrhea and you made her suffer through that because you couldn't get past your moral issues, then I would say you were not practicing good healthcare. Also, if she was asking that it be given in conjunction with a teratogen like Accutant or Retin-A, it would be irresponsible not to prescribe. You don't really have enough information at this point to decide whether or not this is a moral dilemma.

But, let's say you presume she is sexually active (a leap) and are going to go ahead and address moral issues. To me, the basic issue I would address would be whether is it the role of the physician to make moral choices for patients. My personal position is that if this patient is not involved in incest and she doesn't tell you that sex is non-consentual, it's none of your business who she is having sex with. Patients who make adult decisions need adult resources.

If you won't help a patient because of a personal moral conflict, refer them to someone who will. Or, better yet, avoid putting yourself in a practice setting where you are likely to find a conflict of interest.

Interview questions aren't just there to screen your morals. You are going to be asked to explain your answers. You need to answer honestly and be able to state your reasons. What your position is is less important than whether or not you can defend it adequately, in my opinion. Certainly, narrow minded people may count honest answers against you. But, any school that is going to reject you on a moral basis is going to be a poor choice. So, I am in favor of not tailoring your answer to the AdCom.

On a side note, Group Health Cooperative treats all persons 12 and older as an adult, meaning they can access whatever care they choose, outside the supervision of their parents. It's a bit of an arbitrary line. I know of a case in which a 12 year old came in and recieved ECP accompanied by her boyfriend, who was old enough to drive her there. He was not reported. Realistically, had they called the police, the patient would have just said the whole thing never happened, gone home without ECP, and never trusted her healthcare providers again. There isn't always a way to find an ideal outcome. You just have to do what you think is best given the situation. In this case, dispensing ECP and not calling the police was determined to be in the best healthcare interest of the patient. Some may have differing opinions.

 

[Mr hawkings]

answer this one folks... someone i know was asked this:

"You are a doctor. A 12 year old girl comes to you asking for a prescription for birth control pills. What do you do?"

Tell her that girls who have sex b4 marriage will be condemned to eternal damnation.

 

[Neuronix]

Tell her that girls who have sex b4 marriage will be condemned to eternal damnation.

Correct answer at Loma Linda Maybe NYMC too given that thread about them forbidding a LGBT medical student group.

 

[bananaface]

Tell her that girls who have sex b4 marriage will be condemned to eternal damnation.

If she was 24, would you tell her the same?

 

[Khenon]

Interview questions aren't just there to screen your morals. You are going to be asked to explain your answers. You need to answer honestly and be able to state your reasons. What your position is is less important than whether or not you can defend it adequately, in my opinion. Certainly, narrow minded people may count honest answers against you. But, any school that is going to reject you on a moral basis is going to be a poor choice. So, I am in favor of not tailoring your answer to the AdCom.

I think all of these "hard" morally based questions are put out there so you can do just as bananaface said. You need to have an opinion, and have something to back that up. That's it. You shouldn't be answering on what you think an adcom wants. Granted I think there are exceptions to this rule. Some people have mentioned Christian based schools, and I'm sure they DO NOT want to hear that you're pro-choice, homosexual, for pre-marital sex, etc, etc. I guess in those cases you need to know who you're applying to. But I think most schools are just looking for your ability to articulate your thoughts, and base it on something more than "I saw it on TV" or "that's what my parents told me."

 

[leiface]

Is that still the case even with her being a minor?

I actually looked this up because I thought that physicians weren't allowed to treat minors without parental consent, and at least according to TX law, physicians do not require parent consent if they deem the minor capable of making an informed decision.

 

[v-tach]

I actually looked this up because I thought that physicians weren't allowed to treat minors without parental consent, and at least according to TX law, physicians do not require parent consent if they deem the minor capable of making an informed decision.

Well, even so, 12 years old is awfully young to be making a decision like that, let alone be able to make such a decision in an informed manner. I have a sister that age and certainly couldn't see her even thinking about something like that. The maturity just isn't there at that age.

 

[supersnuffles]

I have a feeling that informing the parents if she is a minor is a state law thing. It would depend on where you were practicing. This question I think is a first and foremost a legal issue. Do you have the responsibility of notifying her parents, what is the age of her partner in the case of statutory rape, if it is incest or abuse. These are all things to consider. Then I would probably hand her a pamphlet and explain issues regarding safe sex and precautions explaining unwanted pregnancy and STDs, and the risks from having intercourse. That is of course if she told me she wanted them to have the sex.

 

[Davina3000]

Well, even so, 12 years old is awfully young to be making a decision like that, let alone be able to make such a decision in an informed manner. I have a sister that age and certainly couldn't see her even thinking about something like that. The maturity just isn't there at that age.

Hey v-tach, I hear you. I have a 12 year old cousin and she definitely seems to be more a child than an adult. However, I think the situation will differ from case to case. How you deal with it will be based on the information you have. Part of the reason they say the patient is 12 is purely for shock value...I'm sure 10 years ago they were saying "a 15 year old" patient and that was shocking enough. The fact of the matter is, you cannot control what your patient chooses to do. Whether she is 12 or 26, she could be making a decision that you think is "wrong" for her...you can give her information, provide counseling and support, but if she WANTS to have sex, she will do so with her physician's support or not. So my two cents is, treat her as you would another teen patient. Provide the needed services and counseling and hope she makes the best decisions for her situation. Don't get fixated on the age.

 

[supersnuffles]

I found this link if you guys want to read, it might give a better idea of rights of minors state by state.

http://www.agi-usa.org/pubs/ib_minors_00.html

 

[the other Dr.]

The maturity just isn't there at that age.

Not necessarily true. Some 12 year olds are pretty mature, and as doctors we may have to deal with these depending on your specialty. I think it is extremely mature for a sexually active 12 year old to seek birth control.

 

[fotolilith]

But I think most schools are just looking for your ability to articulate your thoughts, and base it on something more than "I saw it on TV" or "that's what my parents told me."

Very smart answer - I got some similar questions at my last interview, and had fun with them (in a mature manner). A) don't give the answer you think they want to hear...it's usually wrong. B) there are rarely wrong answers to those things (except in the case of A).

I could not really figure out why my interviewer said I'd given the right answer on those things, but then I repeated the questions to other interviewees at lunch for feedback. They all started with answers that just seemed to be trying to figure out what would make them look smart, and I suddenly realized why my (different) answer was looked upon more favorably by my interviewer.

If all else fails MAKE IT PERSONAL! They don't care what you gleamed from cnn or some bioethics website right before the interview, just turn the question around and mention specifics from YOUR life. The more personal you make it, the more they relate to you, and the more you fit into their school.

Good luck!

 

[Fermata]

Is it even possible for a 12 year old girl to get knocked up?

 

[bananaface]

Is it even possible for a 12 year old girl to get knocked up?

If she has begun menstruation, yes.

Didn't you see that 12 year old girl on TLC's "A Baby Story"? You must live under a lillypad!

 

[Fermata]

If she has begun menstruation, yes.

Didn't you see that 12 year old girl on TLC's "A Baby Story"? You must live under a rock!

Please tell me she didn't willingly have sex and then have the child after being pregant.

Sigh.

Well, at least when I'm dictator of the universe such things won't happen.

 

[bananaface]

Please tell me she didn't willingly have sex and then have the child after being pregant.

Yep. She was 11 and a half when she got knocked up. Her boyfriend was 13. Her grandfather was raising her and he was just not aware that such a thing could happen at her age. I am not sure if they considered abortion at all in her case. My guess is that many girls who become pregnant at that age either don't realize it (menses can start out irregularly) or are too scared to tell anyone about it until they are too far along to have a choice in the matter.

 

[swifteagle43]

A. Ask her if she knows what birth control is and if she knows what it does

B. Ask her why she want birth control pills

C. Who told her to get the pills/told her what the pill is

Obviously if it is something serious like she is being raped by an adult then it is a VERY serious issue and the state must be contacted.


If it is something like she wants to have sex then you give her the pills but try to tell her about all the dangers of sex including STDS!

Its like MIB!! Remeber that innocent girl with the books on neuclear chemistry? Its kinda like that. WHY does that girl want the pills? Does a 12 year old girl want to have sex or she being forced into it? Who is she having sex with? Ask these question!!!

EASY ANSWER!....But i am not under the gun!

 

[Davina3000]

Is it even possible for a 12 year old girl to get knocked up?

There was a 13 year old mother in the "teen parenting" class at the clinic I used to work for. She actually got pregnant before ever having a period. She thought that she wouldn't get pregnant b/c she had never had a period so she never used protection. But guess what? She ovulated, and instead of having a period, she got pregnant! So it is possible, though obviously it is rare.

 

[leiface]

Is it even possible for a 12 year old girl to get knocked up?

My friend took a human birth class and the prof said that the youngest person to have a baby was 6 years old! The baby didn't survive, but can you believe it? Also I recall watching Montel once and there was a 2 year old who had started menstruating

 

[Stitch626]

This is NOT a difficult question. You just must abide by the laws of your state and policies of the establishment in which you work. The rest is up to your discretion as a physician. Whether or not you prescribe the BC would be done on a situational basis after careful consideration of the multiple factors discussed in previous posts (e.g. sexual history, risk, suspicion of abuse, etc)

 

[Kevbot]

answer this one folks... someone i know was asked this:

"You are a doctor. A 12 year old girl comes to you asking for a prescription for birth control pills. What do you do?"

If you think that's a tough question try this one: "What did it feel like when your friend died of cancer?"

After my answer this followed:"No but what were you feeling?"

Granted, I did write about my sick friend in my primary. Maybe a more tactful question would have been something like- how did that experience affect your decision to go into medicine, or - in what way did your friends illness change your views about medicine.

I always felt personal questions were the toughest. I humored him and answered as best I could.

 

[fielight]

there's nothing hard about this question. the law is very clear: when it involves STDs, HIV, sexual functions, and birth control, it is enough to treat the minor once she/he consents (i.e., parental consent is not necessary, and confidentiality applies). the textbook answer (per Bates' "Guide to Phys Examination and History Taking" and Feldman & Christenson's "Behavioral Medicine in Primary Care") is to advise the minor and try to get them to tell their parents, but the physician is not legally responsible for disclosure (as long as the patient's behavior does not lead to immediate harm for self or others). i suppose it can be difficult if you are taking a moral stance... but then, it comes down to a personal decision of whether you treat or you don't (i'm pretty certain that the law does not oblige the physician to treating everyone).

 

[Fermata]

The law is not always right.

The kid should be smacked and her parents should be notified.

 

[skoaner]

answer this one folks... someone i know was asked this:

"You are a doctor. A 12 year old girl comes to you asking for a prescription for birth control pills. What do you do?"

Call her a slut, kick her in the box, and push her over.

Or if she's irregular put her on the pill because it was invented for promoting regular menstrual cycles (but at 12 she likely hasn't gotten to that point yet).

 

[bananaface]

Or if she's irregular put her on the pill because it was invented for promoting regular menstrual cycles (but at 12 she likely hasn't gotten to that point yet).

In the late 1970s in the US the average age at onset of menses was 12.3 years. In early 1990s it was 11.5 years.

 

[45408]

My personal position is that if this patient is not involved in incest and she doesn't tell you that sex is non-consentual, it's none of your business who she is having sex with. Patients who make adult decisions need adult resources.

If she comes to me with an issue, I'm going to tell her what I feel. I don't think that there's a 12-year old on this green earth that should be having sex. I'd lay into the dangers of STDs, ever-present chance of getting pregnant, etc. Short answer - no, I don't think I'd give a 12-year old birth control.

 

[45408]

My friend took a human birth class and the prof said that the youngest person to have a baby was 6 years old! The baby didn't survive, but can you believe it? Also I recall watching Montel once and there was a 2 year old who had started menstruating

I've heard of newborns having "mini-periods" that somehow related to high levels of hormones present at birth. It stops though, but it's still a bit weird.

 

[tigress]

I've heard of newborns having "mini-periods" that somehow related to high levels of hormones present at birth. It stops though, but it's still a bit weird.

"Peruvian five-year-old Lina Medina, accompanied by her 11-month-old-son Gerardo, and Doctor Lozada who attended her son's birth, are shown in this 1940 file photo taken in Lima's hospital.

When her child was born by Caesarean section in May 1939, Medina made medical history, and is still the youngest known mother in the world.

Lina Medina's parents thought their 5-year-old daughter had a huge abdominal tumor and when shamans in their remote village in Peru's Andes could find no cure, her father carried her to a hospital.

Just over a month later, she gave birth to a boy.



Medina was born on September 27, 1933 in the small village of Paurange. She was only 5 years 8 months old at the birth of her child on Mother's Day, May 14, 1939.

Born at full term at Lima's maternity clinic, her child was taken through a caesarian operation (Dr. Lozada and Busalleu, operators, Dr. Colretta, anesthesiologist). The child (boy), weighing 2,700 grams, was well formed and in good health. Child and mother were able to leave the clinic after only a few days.

Doctor Lozada has conducted very detailed studies since the diagnostic of the pregnancy which aroused much curiosity in the country; he took an x-ray of the child and her baby, established a diagnostic of the fetal situation, observed the state of functionality of the little mother who had begun menstruating at the age of 8 months. At four years old she had already developed breasts as well as pubic hair, her body proportions were a bit amazing and her bone hardening a bit advanced, things that are often observed in cases of such premature pregnancy."

look it up, it's an actual documented case with pictures and everything...pretty frightening. I've read that they never found out who the father was but some suspected the girl's father. So yes, young children can, rarely, get pregnant. A friend from England remembers a story a few years back about an 8 year old girl getting pregnant by a 9 year old boy. Go figure

 

[bananaface]

If she comes to me with an issue, I'm going to tell her what I feel. I don't think that there's a 12-year old on this green earth that should be having sex. I'd lay into the dangers of STDs, ever-present chance of getting pregnant, etc. Short answer - no, I don't think I'd give a 12-year old birth control.

If you can educate her and convince her not to have sex on her own terms, without degrading her, great. That is definitely the best outcome for the situation. But, one thing that all healthcare providers need to realize is that patients will decide for themselves whether or not to follow your advice. After you talk to the patient, you need to assess whether or not she will take your advice. If you make her comfortable and acknowledge her autonomy, she is more likely to give you an honest response when you ask her if she still feels that she will be needing contraception. If she still feels that she needs the birth control pills, you could certainly speak with her further and see if there are any more aspects of the situation to address. But, in some cases, you will find that the patient has considered her options, understands the risks, and is simply making a decision that you disagree with. At that point, you have to make a decision. Do you send her away? Do you refer her? Do you prescribe? To me, the only wrong answer is to send her away not having convinced her to refrain from sexual activity. A 12 year old having sex and using contraception is better than a 12 year old getting pregnant.

side note: Telling the patient's parents is not a reliable way to ensure that she will refrain from sexual activity. Although your intentions may be good, it still leaves the possibility that she will have sex and become pregnant. Given that and the whole betrayal of trust issue, I would urge anyone who is thinking that they ought to notify the parents to reconsider, so long as the patient's age is the determining factor in your moral dilemma.

 

[the other Dr.]

If she comes to me with an issue, I'm going to tell her what I feel. I don't think that there's a 12-year old on this green earth that should be having sex. I'd lay into the dangers of STDs, ever-present chance of getting pregnant, etc. Short answer - no, I don't think I'd give a 12-year old birth control.

This narrow-minded attitude is exactly the reason why more young people are afraid to seek contraceptives and wind up getting pregnant. A 12 year old that is responsible enough to seek birth control should be respected and encouraged to return, not shunned. You will have a lot more influence on someone if you establish a trusting relationship. As a doctor you are going to be dealing with people who do things that you don't agree with and their automony should be repected!

 

[wonderkid]

HARD QUESTION, well at least for me:
tell me a day in your life 20 years from now, including what you will do each hour, who your wife will be, how many kids, what kind of car, what city, describe your house, clothes, etc. he wanted details.

im not joking. i got that question at a school in so cal. he also threw in a million other questions from the left, many of which were illegal. needless to say, i didnt get in.

another hard question, same interviewer: note, i am jewish.
he asked. if you were in a trauma room with resources to only cure one patient, but you have 2 patients come in. a rabbi and a priest. both have the same exact medical problem with the same probablity to survive if you treat them. who will you treat? he insisted that the patients had the same exact condition with the same exact prognosis.

he asked me riddles. he even made me email him the answer to one of his riddles.

he asked me about religion and who i would marry.

tons of stupid, irrelevant illegal questions. again, i didnt get in.

 

[45408]

This narrow-minded attitude is exactly the reason why more young people are afraid to seek contraceptives and wind up getting pregnant. A 12 year old that is responsible enough to seek birth control should be respected and encouraged to return, not shunned. You will have a lot more influence on someone if you establish a trusting relationship. As a doctor you are going to be dealing with people who do things that you don't agree with and their automony should be repected!

It's narrow-minded to have a moral opinion that preteens shouldn't have sex? Okay. I hardly think that they would be responsible merely for seeking out birth control. Responsibility at that age is abstinence.

I can respect their autonomy and refuse their prescription. They aren't mutually exclusive.

 

[the other Dr.]

It's narrow-minded to have a moral opinion that preteens shouldn't have sex? Okay. I hardly think that they would be responsible merely for seeking out birth control. Responsibility at that age is abstinence.

I can respect their autonomy and refuse their prescription. They aren't mutually exclusive.

It's narrow-minded to let your morals infleuence proper treatment of a patient. Your opinions do not relieve you of your responsibilites as a physician. Who's right is it to say that at that age you should be abstinent? At what age is intercourse acceptable? 16? 18? 21? Marriage? What litmus test must one pass in order to get birth control? And why would you refuse their prescription?

 

[bananaface]

I can respect their autonomy and refuse their prescription. They aren't mutually exclusive.

If your refusal results in a denial of service, then the two are mutually exclusive, because you are making the decision on her behalf. If the patient is able to obtain contraception elsewhere or you convince her to change her mind about having sex, they aren't mutually exclusive.

 

[acl3623]

Also I recall watching Montel once and there was a 2 year old who had started menstruating

man, i love montel! just thought you guys should know

 

[45408]

It's narrow-minded to let your morals infleuence proper treatment of a patient. Your opinions do not relieve you of your responsibilites as a physician. Who's right is it to say that at that age you should be abstinent? At what age is intercourse acceptable? 16? 18? 21? Marriage? What litmus test must one pass in order to get birth control? And why would you refuse their prescription?

There's no litmus test - there's a subjective sense of maturity. We are discussing birth control, not a life or death situation, and I think it's narrow-minded to think that the only proper course of treatment for this child is to hand them pills and telling them to run along.

 

[sdnstud]

I can see this one coming right at me:

One of the biggest news recently involves the use of steriods as a performance enhancing drugs by several well-know baseball players, if a profession athlete comes to you and ask for steriods, would you give some to him/her?

 

[bananaface]

TheProwler-

You seem to be worried that giving this patient BC pills would be equivalent to approving of the her situation. It's not. There is a difference between approving of her need for contraception, and acknowledging that the need exists. When you refuse to acknowledge that need, you set the stage for the situation to get worse than it already is. Getting pregnant at 12 would certainly not be in the best medical interest of the patient. And, it would be harmful in many other aspects of her life. I would argue that for a patient in need of contraception, a denial of service is maleficent, as it fails to prevent the risk of an unecessary harm. So, ethically, there would be a compulsion to prescribe.