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Take it up with the FDA, or whoever else is in charge of making sure companies are accurately labeling their food products! Hot pockets are sandwiches!Hot Pockets are actually empanadas.
Take it up with the FDA, or whoever else is in charge of making sure companies are accurately labeling their food products! Hot pockets are sandwiches!Hot Pockets are actually empanadas.
I was actually given this scenario during an MMI interviewYou’re a physician and took an oath to do no harm. Your patient is a Jehovah’s Witness who refuses a blood transfusion. The patient is unconscious and rapidly bleeding out. In theory, the patient might not know if they ever received a transfusion. You also have reason to believe the patient was unduly influenced/coerced by family members into refusing blood. There isn’t time for a court order and guardian ad litem. The next of kin is unavailable. What would you do? Do you let the patient die? Do you violate patient autonomy? How would you decide?
What was your answer?I was actually given this scenario during an MMI interview
I don’t think they liked my answer because I was rejected...
Having lived through the 1980's, when suburban housewives of American generally believed that Italian food consisted of pizza and spaghetti, I acknowledge this labeling inertia but I do not accept it. Food naming theory has moved on, and we should embrace the progress.Take it up with the FDA, or whoever else is in charge of making sure companies are accurately labeling their food products! Hot pockets are sandwiches!
Pineapple is a better pizza topping than pepperoni. Fight me SDN
I said that I believe a physicians primary responsibility is to preserve health and save lives and that although I think that religion and politics are important considerations, my primary responsibility is to save the life of this patient regardless of what his family or religion might dictate.What was your answer?
I would have selected you based on that answerI said that I believe a physicians primary responsibility is to preserve health and save lives and that although I think that religion and politics are important considerations, my primary responsibility is to save the life of this patient regardless of what his family or religion might dictate.
Would your answer be the same if DNAJB6's question had the part about being "[potentially] unduly influenced" removed?I said that I believe a physicians primary responsibility is to preserve health and save lives and that although I think that religion and politics are important considerations, my primary responsibility is to save the life of this patient regardless of what his family or religion might dictate.
YesWould your answer be the same if DNAJB6's question had the part about being "[potentially] unduly influenced" removed?
It’s a noble answer, but I do see why adcoms might not like it. You’re openly admitting you would violate patient autonomy. Do you feel the same way about DNR’s?Yes
Obviously in a real life situation you try your best to respect the patients wishes- use crystalloid, cell-saver during emergency surgery, etc., but if it comes down to transfusing or letting the patient die, I would choose transfusion every time.
Did the patient refuse the transfusion and then become unconscious?You’re a physician and took an oath to do no harm. Your patient is a Jehovah’s Witness who refuses a blood transfusion. The patient is unconscious and rapidly bleeding out. In theory, the patient might not know if they ever received a transfusion. You also have reason to believe the patient was unduly influenced/coerced by family members into refusing blood. There isn’t time for a court order and guardian ad litem. The next of kin is unavailable. What would you do? Do you let the patient die? Do you violate patient autonomy? How would you decide?
anyone have advice on how to answer this one?You’re a physician and took an oath to do no harm. Your patient is a Jehovah’s Witness who refuses a blood transfusion. The patient is unconscious and rapidly bleeding out. In theory, the patient might not know if they ever received a transfusion. You also have reason to believe the patient was unduly influenced/coerced by family members into refusing blood. There isn’t time for a court order and guardian ad litem. The next of kin is unavailable. What would you do? Do you let the patient die? Do you violate patient autonomy? How would you decide?
While your answer is important, it's more important that you talk about how you arrive at your answer. For these MMI style questions, they're really looking to see that you're considering other perspectives and talking through the pros/cons of each side.anyone have advice on how to answer this one?
This is a pretty classic ethical scenario.anyone have advice on how to answer this one?
I had a friend tell me that someone in a residency interview got asked how many times they masturbate a day
I feel like that question is different connotatively for females; I would suggest, perhaps, rephrasing the question. A female could answer once, but since climax can be reached many times successively in one session, they have an advantage over a male who may have to masturbate several more times per day to reach the same result, given that there's typically a recovery period necessary (however long or short) to achieve a new erection. This gives females a more modest answer, even if the action produces drastically different results.That is honestly a very good question. Anyone answering zero is auto rejected as a liar.
Over you legal obligations and possibly license? Any "belief" in the underlying influence, intent or motivation of the family would not overcome hard evidence of, say, finding a patient-signed Christian Scientist member card on their person. Your duty to save life does not overcome their constitutional right to freedom of religion, and your intervening in that scenario could cause your losing a license to practice medicine.
I don’t know, this information wasn’t provided.Did the patient refuse the transfusion and then become unconscious?
No, a DNR is a signed legal document. In this scenario there was no such document.It’s a noble answer, but I do see why adcoms might not like it. You’re openly admitting you would violate patient autonomy. Do you feel the same way about DNR’s?
I liked these, so I'm going to answer them:Tell me about something you've done that makes you cringe to remember it.
If you could have one superpower, what would it be, and why? (Answers related to medicine not allowed).
Are you still friends with all your exes? Why or why not?
If you could re-live one day in your life, without changing anything, what day would it be?
(Oh man, I could go on and on....)
So does your respect for a patients autonomy only extend so far as a signed legal document? Otherwise you’ll treat patients as you see fit, regardless of their wishes?No, a DNR is a signed legal document. In this scenario there was no such document.
So does your respect for a patients autonomy only extend so far as a signed legal document? Otherwise you’ll treat patients as you see fit, regardless of their wishes?
I’m being intentionally hyperbolic here to highlight the problems with that answer.
While this is true, we don't expect interview candidates to have insider knowledge on the legal ramifications on the practice of Medicine. In fact, we avoid asking questions like that.Over you legal obligations and possibly license? Any "belief" in the underlying influence, intent or motivation of the family would not overcome hard evidence of, say, finding a patient-signed Christian Scientist member card on their person. Your duty to save life does not overcome their constitutional right to freedom of religion, and your intervening in that scenario could cause your losing a license to practice medicine.
Given the superfluity of candidates for a seat in medical school, I'd rather have students who can already think on the fly.Being able to think on the fly is a skill that can be developed with training.
If you give us your secrets, I'll give you my Xbox Live account where I'm a level 50 true skill on Halo 3No, I'm not not sharing!
Show me that you can use a panzer company to hold off an entire Soviet Guards tank division in Panzer Blitz and then I'll be impressed.If you give us your secrets, I'll give you my Xbox Live account where I'm a level 50 true skill on Halo 3
Yes but you arent neccesarily saying you’ll give us your secret, only that you’d be impressed!Show me that you can use a panzer company to hold off an entire Soviet Guards tank division in Panzer Blitz and then I'll be impressed.
How about both?Did the patient refuse the transfusion and then become unconscious?
the crux of it all is really just if they were competent when they refused, right? if they were, don't give the blood... if they weren't, give the blood?How about both?
Competency goes beyond whether the patient is demented or not. Was the patient coerced? That would seemingly be part of the calculus.the crux of it all is really just if they were competent when they refused, right? if they were, don't give the blood... if they weren't, give the blood?
What about soups or the popular college food ramen? Sandwich or salad??Fight me on my stance that all food is either a sandwich or a salad.
I'm trying to understand the sequence of events. EMS bringing in an unconscious Jehovah's Witness is a very different scenario than a Jehovah's Witness who arrives conscious and interactive and then becomes unconscious.How about both?
I had envisioned the latter but expanded the challenge of competency to go beyond AOx4 into whether the decision to refuse transfusion was done by pt's own free will and volition v. coerced by family members or members of his church. Think about refusal prior to THA followed by massive intraoperative hemorrhage in a geriatric patient...I'm trying to understand the sequence of events. EMS bringing in an unconscious Jehovah's Witness is a very different scenario than a Jehovah's Witness who arrives conscious and interactive and then becomes unconscious.
Major red flag.Idk
I should preface this comment by stating I am not a religious person, and that I would do what my conscience dictates.
As a (future) physician, I can’t just let an otherwise healthy person die because their religion refuses to allow a transfusion when my oath is to protect life and do no harm. Is it not harming someone to let them die when you could have saved them?
Sums up the human condition rather nicely.by pt's own free will and volition v. coerced by family members or members of his church.
This is a very good way to get sued. Successfully.Idk
I should preface this comment by stating I am not a religious person, and that I would do what my conscience dictates.
As a (future) physician, I can’t just let an otherwise healthy person die because their religion refuses to allow a transfusion when my oath is to protect life and do no harm. Is it not harming someone to let them die when you could have saved them?
In the biz we call that thing you violated right here “patient autonomy”Idk
I should preface this comment by stating I am not a religious person, and that I would do what my conscience dictates.
As a (future) physician, I can’t just let an otherwise healthy person die because their religion refuses to allow a transfusion when my oath is to protect life and do no harm. Is it not harming someone to let them die when you could have saved them?
I didn’t think about it that way but treating a pt against his will is common law assault and battery and a tort (and potential crime).This is a very good way to get sued. Successfully.
If a patient is part of a cult and wanted to die and had ingested toxic Koolaid (like the Jones Town Massacre except wittingly) would you accuse a doctor that resuscitates the patient against his will of lacking empathy?Major red flag.
Although you yourself might not be religious, you still need the understanding and empathy to care for those who are. Despite what you might think is best, many patients would rather die than diverge from their beliefs. Not your or my job to play "god" just because we think we know what's best.
Well blended fruit saladfruit smoothie?
If a patient has a serious disease but not terminal disease (and only the latter would allow physician assisted suicide in select states) and tries to hang himself, would you not violate pt autonomy to resuscitate him?In the biz we call that thing you violated right here “patient autonomy”
But a salad is a medley or mix of things. What if it is only one fruit? Similarly a bowl of chicken wings is not a salad. Amalgamation of homogeneous substances does not equal salad... Breadless foods are not sandwiches; ergo, not all food is a salad or a sandwich.Well blended fruit salad