There is making a mistake and then there is learning from a mistake. This experience sounds formative, but what did you learn from it other than to quadruple check that you are sending information to the correct patient? Yes the consequences are dire with violating HIPAA, but the mistake is a simple one. Next time, double check. I would encourage you to think of another moment in which you made a mistake, maybe one that is more complex in nature. Applicants are asked to reflect because ADCOMs want to know that you have sufficient life experience that has helped you develop moral reasoning. Think about a time you had to make a judgement call, and hindsight suggests that it was a "mistake." Describe your rationale, your feelings at the time, and why you now consider this decision a mistake. How will this method of reflection inform your decision making process as a physician? This is what admissions committees want to hear and what patients expect from their providers.
The context for this particular error is that the patient was an older, rather technology-averse gentleman who has been seeing the physician I'm scribing for (I think) longer than I've been alive. This physician is a pretty relaxed sort of guy, and the small clinic I was part of had been bought by a much larger, more stringent company recently, so we were both kind of used to just sending emails back and forth. The patient told me he didn't like the new EMR messaging system we were using and preferred to communicate with email, so I thought to myself, why not just keep things as similar as possible for him? I've worked with older folks as a caregiver before and know how difficult it can be for them to adjust to change, so I thought that it would realistically just be a small favor--not likely to lead to serious harm--and that the good of keeping things as "smooth" as possible for this patient ultimately outweighed what I thought was a small risk. So I learned not to let personal sentiment cloud my judgement. Even if there's a 1% chance that something might go awry and a 99% chance that it'll just be a feel-good story, defending against that chance is paramount.
I also hadn't really internalized this before, but after the mistake became real and not just a possibility, I also reflected that this small "favor" to him came as an unacceptable risk to the rest of the patients in our system. In that sense, a "kindness" to him was an "unkindness" to everyone else... And so, in the grand scope of things, I hadn't really been as generous as I thought I'd been. Reflecting further, I realized I must also have unconsciously presumed too much upon my own competence; otherwise, why would I have taken such a risk? So I thought about how I should examine my character every so often. Am I getting too confident about something? What are the downsides of taking this or that action, and is there an alternative that respects the system (put into place specifically because of clumsy people like me) while honoring the patient's needs as an individual within that system? When I talked to the patient afterwards, he said he might need my assistance with the messaging system, but he was happy to learn. (He ended up receiving the medical record after all, and sent me a thank you message in the portal.) So my very goal of keeping things smooth for him might even have been misguided to begin with, while starting off by saying, "No, but I can help you if you feel like the system's hard to manage", would have been a better option because it would both prevent me from risking other patients' PHI, and help him acquire a skill that could transfer into better care with other providers too (as most, I imagine, would balk at his request to obtain medical records via email, and simply ask him to communicate via secure messaging systems). So I guess I also have a somewhat strong case of tunnel vision, which is actually a... recurring theme of mine, I guess. I plan to work on that as well.
My surmise is that your example will not go over well with some adcoms and therefore I would not risk it. Do you have a more benign example, such as failing to read instructions on a test carefully, where you can show that you've learned the from the mistakes--without admitting that you made a greivious error?
Yeah... I do have a lab error I could talk about, where I realized I ordered the wrong primer which my postdoc was going to use for. I told her pretty much immediately, because I really didn't want to cost both her and the lab because of a mistake I made. Class-wise... Eh. I've made my mistakes, but they're mostly pretty boilerplate things, I think? Stories a lot of people have, I imagine. For what it's worth, I'm definitely leaning away from using this example based on the feedback I've received so far, which is a shame because I feel like I learned quite a bit from it. I have a feeling that I would have to read the room before knowing whether it would be a good card to play, though I'm quite hesitant about trusting my gut with something this important. Maybe if I get a lot of IIs and sense I need a Hail Mary for some dragging interview, haha.
I definitely liked how that response was crafted. I am sure many times people make small mistakes and errors when it comes to privacy of health information. You'll get many a stern lecture about it once you get into medical school too (not to mention the various PREvieiw situations that could have been written up about it). You just don't know who you would be talking to in an interview; I would prefer one talks about those mistakes once they are medical school as a warning to other students who may not have had that problem before.
Something that is a mistake: I would suggest something where you assumed incorrectly about someone else's situation or condition (as an example). It could be improperly calling someone (Shannon instead of Dr. Shannon) or by improper pronouns if they are sensitive to it. You can make a mistake by not following directions (forgot to add salt) and problem-solving your way to figuring out why something went wrong. Failures to me is doing something by the book but you got a result that you did not expect; the cake was underbaked even though I set the oven at 350... turns out the thermostat was broken when I problem-solved...).
I concur that the important part is describing the growth and learning from those mistakes and failures. It's just my preference but introducing a medical ethics issue to the situation could bias some interviewers. This risk is taken by many applicants who feel every answer needs to have a medical "spin."
You can better control the response if this were a written question (supplemental/school-specific) as you have written here. Again, my opinion only.
Thank you so much for your feedback! I've gotten comments from you before (though a while back, I think), and your responses have been so helpful to me. I'll take note of what you said about mistakes... Most of my memorable errors have unfortunately fallen into the category of this experience (I guess a mistake?), where I've deviated from protocol because I try to be spontaneously "humanistic", whether in healthcare or otherwise. (I've noticed my backbone can be a little weak. I hate being someone's "bad guy".) But this one was real flashy, so I thought I'd get some other eyes on it. I have made less legally serious mistakes along the lines you're talking about, though, which I think I'll probably default to in an interview. One example comes to mind regarding another role where I spoke to a client's friend first instead of her, and said friend pointed this out to me. I did some reflection on why I didn't default to her (she was a rather elderly, taciturn woman compared to her younger, more outspoken male friend), and I've made sure to properly address everyone since then. (I think I can draw a connection to people who are overlooked in healthcare here--if I were a physician, this could have been an example of how systemic disparities manifest on the individual level. So I've tried to examine why I make certain choices, and I'm pretty glad someone pointed this out to me this early on in my career. He's a nice person, too. Very helpful to his neighbors.)
Failure-wise, I guess I have one notable story where I spent too long on a lab project trying to get the protocol right, and only got results after asking my PI for fresh new ideas, scrapping the original project altogether. I guess the lesson here would be to learn when to look up instead of hunkering down, or alternatively-phrased, to keep my mind open. I was wondering how to avoid being generic, though... One worry of mine is that I'm just going to bore the interviewer/AO if I share something that's too common. Like, with the example I mentioned, I've heard that lab projects change completely in their course all the time. Hopefully I'll think of a more interesting takeaway. Or it'll sound better when it's showtime.
