HARDEST MMI QUESTION EVER.

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squidwardsquarepants

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So I'm sitting there wondering, how, what, where, when do I say the right things at the right time in the right tone? Why am I even in this situation? Am I really going to just walk in, read this script, then somehow act out that the lady just gave birth to a new born baby with complications??

So the prompt goes: A woman has just had a baby. The baby was born with the appearance of an African American. Both the husband and the woman are Caucasian. Please enter and discuss the next steps with the woman.


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I agree with the above. You act like you don't notice and then have a great laugh with your colleagues during lunch. Maybe give a few of the local divorce attorneys a heads up.
 
If this question is real, then it's pretty inappropriate for an MMI.

But if I were asked, I would say that I'd do a neuro check and pull her epidural. And then they'd trash my app for being a smart-ass.

My original point still applies: this prompt is inappropriate for a med school interview.
 
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Maybe they want to see how you would react- to see if you would say something to the wife and assume she cheated or something, assume maybe she was a surrogate for someone, or just assume nothing and just follow the normal role of a physician in terms of care etc
 
Giving it more thought... there might be a concern that the husband will attack the wife and/or baby under the circumstances.... this, I suppose, assumes that the father was not in the delivery room and has not yet seen the baby. There might be a need to assess the mother's response to seeing her new baby and determine if she has any concerns... if she has concerns, let them come from her rather than making assumptions but let her give voice to any concern she might have about being subjected to violence when her husband sees the baby. (This was an plot point in an episode of "Call the Midwife" and after much concern the husband seemed quite blind to the fact that the child did not share his milky white skin tone.)
 
Having retained very little from the genetics course I took awhile back, but in reading news stories about genetically AA males/females being able to pass off as Caucasians , isn't it possible that one or both of the parents are genetically AA?
 
Giving it more thought... there might be a concern that the husband will attack the wife and/or baby under the circumstances.... this, I suppose, assumes that the father was not in the delivery room and has not yet seen the baby. There might be a need to assess the mother's response to seeing her new baby and determine if she has any concerns... if she has concerns, let them come from her rather than making assumptions but let her give voice to any concern she might have about being subjected to violence when her husband sees the baby. (This was an plot point in an episode of "Call the Midwife" and after much concern the husband seemed quite blind to the fact that the child did not share his milky white skin tone.)
I see your point, but I maintain that this would be a more appropriate prompt for an oral boards grab bag question, not an MMI for people with no medical training.
 
isn't it possible that one or both of the parents are genetically AA?
White...maybe. Caucasian, no. So the wording of the prompt would rule that out, I feel. And in any case, answering that prompt with the extraordinarily unlikely assumption that this involves an African-American who could pass as white would be a no-go.
 
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Having retained very little from the genetics course I took awhile back, but in reading news stories about genetically AA males/females being able to pass off as Caucasians , isn't it possible that one or both of the parents are genetically AA?

Yes exactly. I'm pretty surprised we have people entertaining the idea that he's automatically not the father.
 
White...maybe. Caucasian, no. So the wording of the prompt would rule that out, I feel. And in any case, answering that prompt with the extraordinarily unlikely assumption that this involves an African-American who could pass as white would be a no-go.

Well, MMIs are based on providing scenarios to show how an applicant would logically think about all the possibilities, even extreme ones, and then explaining away those extremes to finally settle on an option that reasonable...
 
White...maybe. Caucasian, no. So the wording of the prompt would rule that out, I feel. And in any case, answering that prompt with the extraordinarily unlikely assumption that this involves an African-American who could pass as white would be a no-go.
The term Caucasian is a societal and eugenics construct. It's pseudoscience at best.
 
Well, MMIs are based on providing scenarios to show how an applicant would logically think about all the possibilities, even extreme ones, and then explaining away those extremes to finally settle on an option that reasonable...
This is way farther out into the ether than I think is appropriate for an MMI.

The term Caucasian is a societal and eugenics construct. It's pseudoscience at best.
Merriam-Webster gives a couple definitions for "Caucasian," including the commonly-used meaning of "referring to persons of European descent having usually light skin pigmentation." If we go with the colloquial definition, which I believe was the prompt's intent, the assumption of white-skinned African-Americans would be invalid. If we go with the more literal definition, "of or relating to the Caucasus or its inhabitants," the assumption is not necessarily invalid (black people may inhabit the Caucasus today) but is far-fetched enough that many interviewers would see it as unreasonable. And if we say that "Caucasian" is an artificial construct of pseudoscientific origin, then the prompt makes no sense. All of this bolsters my argument that this is an inappropriate MMI prompt.
 
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That prompt is frankly ridiculous. It's so far beyond even the most advanced and twisted standardized patient scenarios that actual medical students get that I think it's demeaning to ask an interviewee to respond to it. It's like the old trope of shooting the floor and making you dance to avoid the bullets.

To me this is about as reasonable an interview scenario as asking you to play the bassoon.
 
Check IDs, check the newborn baby over, make sure they’re warm and stable, maybe an SPO2 to make sure the dark coloration wasn’t from an undiagnosed cardiac defect, hand to Lactation nurse to give to mother. Done and out.
“Why doesn’t the baby look anything like me (dad)?” Genetics are unpredictable. Good luck with everything.
<exit stage left>



--
Il Destriero
 
I remember years ago when I was doing genetic testing in families that we saw that about 5% of kids were NOT the dad's.
Yo, that makes me disgusted. Do you remember what the sample size was- and was this in an area that was particularly promiscuous for example in a large city?
 
Some elephants in the room should be ignored, and IMO, this is one of them.

If the baby appeared healthy and the only "complication" was the infant's complexion, I'd show the baby to the mother, congratulate her on her new son/daughter and ask if she has any concerns or questions. There are many perfectly ordinary (though relatively uncommon) reasons why a baby born to two parents who appear white might appear more African -- one or both parents may have some portion of African ancestry, for example. Or the child could have (with the white male partner's full knowledge) a black biological father -- perhaps the woman's deployed military husband, and the white man in the hospital with her is her brother or gay best friend.

Many possible reasons with no plausible benefit to anyone to point out the obvious possibility.
 
Giving it more thought... there might be a concern that the husband will attack the wife and/or baby under the circumstances.... this, I suppose, assumes that the father was not in the delivery room and has not yet seen the baby. There might be a need to assess the mother's response to seeing her new baby and determine if she has any concerns... if she has concerns, let them come from her rather than making assumptions but let her give voice to any concern she might have about being subjected to violence when her husband sees the baby. (This was an plot point in an episode of "Call the Midwife" and after much concern the husband seemed quite blind to the fact that the child did not share his milky white skin tone.)

One of my favorite episodes <3

I needed something new to watch after I finished Genius last week (National Geographic's mini-series about Albert Einstein), so I watched the first episode of this last night. It was delightful. I love anything that manages to be realistic, gritty and inspiring. Thanks for the indirect recommendation.
 
I needed something new to watch after I finished Genius last week (National Geographic's mini-series about Albert Einstein), so I watched the first episode of this last night. It was delightful. I love anything that manages to be realistic, gritty and inspiring. Thanks for the indirect recommendation.

It’s good, but it gets repetitive.
 
I needed something new to watch after I finished Genius last week (National Geographic's mini-series about Albert Einstein), so I watched the first episode of this last night. It was delightful. I love anything that manages to be realistic, gritty and inspiring. Thanks for the indirect recommendation.

Glad you liked it! I've never made it through an episode without crying haha.
 
On the TV theme - who's watched Halt and Catch Fire?
 
Who knows. Maybe the 'Dad' knew. Maybe they simply couldn't have a child together and therefore had an amazing open relationship with another man. Possibilities are vibrant and endless. I'd ask how my patient(s) are doing and then reassess the situation from that point on.
 
That's what I was wondering about when I heard the premise. I've only seen the first episode though, so I'll wait and see.



Do it, it's really good.

By the end of the second season, it starts getting repetitive. The first two seasons are definitely worth a watch.
 
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