Just a bit of intro for myself:
- I am an MD grad going for MPH
- I Have worked for a commercial MMI prep course
Inbox me if you need help with MMI prep
Let's look at one scenario that is posted in this forum:
QUESTION:
Mike, 9, is in need of a bone marrow transplant within 3 days or he will die. His twin brother, Jack, is a 6/6 donor ready to save his brother. Unfortunately, Jack comes down with an infection, which means he is not eligible unless cured (otherwise, the transplant will kill his brother). You are the attending in charge of figuring out what is ailing Jack and hopefully cure him in time.
After a day, you find out that Jack has an infested mistral valve. Standard treatments include giving him antibiotic for a month and he should be fine with no adverse effects. Mike, however, doesn't have a month. Within 2 days, only 4/6 bone marrow is available. Using that will put Mike in grave danger and a miserable life full of agony.
There is another option: do an open heart surgery to cure the infested valve then flush Jack's system with antibiotic to get him ready. The catch is that this will effectively put Jack on a life long regimen of blood thinners and other medicine. Jack is an aspiring athlete and this surgery will put an end to his hopes and dreams.
The twins' parents plan to consent to Jack's treatment without telling him, and even if they tell him, you have learned, they are unlikely to relent on the surgery regardless what Jack's consent. Again he is a minor, so technically, regardless of his feeling, he cannot consent to anything.
What should you do? Do you think this constitutes child abuse? You have an option to contact CPS to put an end to the entire venture.
ANSWER:
Sumarize the question in point form and organize your thoughts.
1) Mike needs a BM transplant, Jack is a suitable donor if his infection is cured first
2) Jack's infection can be treated with a standard 1 month antibiotic regiment
3) however, Mike will die in 3 days
4) Jack can clear his infection via a heart surgery that will leave him needing meds for the rest of his life and destroy his chances of being an athlete.
5) Parents want to consent to the surgery without Jack's approval.
***
Organize your answer
1) It is unethical for the parents cannot consent to the treatment for jack without telling him
2) different states and countries have different laws re: the age of consent in such a case (how old jack has to be to consent). Ie, in California, it is 15. In Canada it is 12 (mature minor), etc. The specific laws are not relevant to answer your MMI questions. They are looking for your *thought processes*. You can argue for or against any specific age although 9 is considered too young in every jurisdiction I can think of.
3) If legally allowed, must get full informed consent (esp as relevant to his dreams of being an athlete) from Jack. Remember informed consent is tested and determined by the physician
4) Note here that the parents is basically putting 1 child's health at risk to save another. This can't be forcibly done without the donor's consent regardless of legality.
5) Seek alternative donors
6) it is unlikely that the surgeon will agree to this surgery (it is the surgeon who oversees the consent forms) in this situation but say if it happens, then yes call CPS and they will decide what to do.
7) as in most cases, if you are going to report the patient to CPS or any other organization, tell the patient you are going to report and why -- don't do it behind their backs.
Some possible ways an interviewer can prompt you:
1) "how will you tell Jack what is going on?"
2) "would you persuade Jack to help his brother? his brother is dying, don't you think you should do everything in your power to convince Jack to undergo the procedure?"
3) "how would you confront the parents about your decision?"
4) "at what age do you think Jack should be able to consent and give rationale for that specific age you chose"
ALLOW the interviewer to prompt you.
Do not panic if you finish well ahead of time -- it means you did very well and the interviewer is pleased with what you said.
Inbox me for specific times for interview so I can fit you in with my schedule. I do Skype.
- I am an MD grad going for MPH
- I Have worked for a commercial MMI prep course
Inbox me if you need help with MMI prep
Let's look at one scenario that is posted in this forum:
QUESTION:
Mike, 9, is in need of a bone marrow transplant within 3 days or he will die. His twin brother, Jack, is a 6/6 donor ready to save his brother. Unfortunately, Jack comes down with an infection, which means he is not eligible unless cured (otherwise, the transplant will kill his brother). You are the attending in charge of figuring out what is ailing Jack and hopefully cure him in time.
After a day, you find out that Jack has an infested mistral valve. Standard treatments include giving him antibiotic for a month and he should be fine with no adverse effects. Mike, however, doesn't have a month. Within 2 days, only 4/6 bone marrow is available. Using that will put Mike in grave danger and a miserable life full of agony.
There is another option: do an open heart surgery to cure the infested valve then flush Jack's system with antibiotic to get him ready. The catch is that this will effectively put Jack on a life long regimen of blood thinners and other medicine. Jack is an aspiring athlete and this surgery will put an end to his hopes and dreams.
The twins' parents plan to consent to Jack's treatment without telling him, and even if they tell him, you have learned, they are unlikely to relent on the surgery regardless what Jack's consent. Again he is a minor, so technically, regardless of his feeling, he cannot consent to anything.
What should you do? Do you think this constitutes child abuse? You have an option to contact CPS to put an end to the entire venture.
ANSWER:
Sumarize the question in point form and organize your thoughts.
1) Mike needs a BM transplant, Jack is a suitable donor if his infection is cured first
2) Jack's infection can be treated with a standard 1 month antibiotic regiment
3) however, Mike will die in 3 days
4) Jack can clear his infection via a heart surgery that will leave him needing meds for the rest of his life and destroy his chances of being an athlete.
5) Parents want to consent to the surgery without Jack's approval.
***
Organize your answer
1) It is unethical for the parents cannot consent to the treatment for jack without telling him
2) different states and countries have different laws re: the age of consent in such a case (how old jack has to be to consent). Ie, in California, it is 15. In Canada it is 12 (mature minor), etc. The specific laws are not relevant to answer your MMI questions. They are looking for your *thought processes*. You can argue for or against any specific age although 9 is considered too young in every jurisdiction I can think of.
3) If legally allowed, must get full informed consent (esp as relevant to his dreams of being an athlete) from Jack. Remember informed consent is tested and determined by the physician
4) Note here that the parents is basically putting 1 child's health at risk to save another. This can't be forcibly done without the donor's consent regardless of legality.
5) Seek alternative donors
6) it is unlikely that the surgeon will agree to this surgery (it is the surgeon who oversees the consent forms) in this situation but say if it happens, then yes call CPS and they will decide what to do.
7) as in most cases, if you are going to report the patient to CPS or any other organization, tell the patient you are going to report and why -- don't do it behind their backs.
Some possible ways an interviewer can prompt you:
1) "how will you tell Jack what is going on?"
2) "would you persuade Jack to help his brother? his brother is dying, don't you think you should do everything in your power to convince Jack to undergo the procedure?"
3) "how would you confront the parents about your decision?"
4) "at what age do you think Jack should be able to consent and give rationale for that specific age you chose"
ALLOW the interviewer to prompt you.
Do not panic if you finish well ahead of time -- it means you did very well and the interviewer is pleased with what you said.
Inbox me for specific times for interview so I can fit you in with my schedule. I do Skype.
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