Very hard interview question(s)...

[Gnomo]

x

---

Members don't see this ad.

 

[ShenanigansMD]

You also have to consider what it is that being insured actually guarantees you. Sure, it's nice to say that "everyone's insured," but if that same insurance requires a $500 deductible for every hospitalization that (shocker) the same people who could barely afford insurance before and certainly can't afford now, what service have you actually bought yourself, and how is this an improvement on our current state of healthcare?

Valid points. I'm just all about being responsible with your health, and not making others pay because you don't have coverage.

 

[abruzz75]

In regards to whether it's a right or a privilege -

We've all to some degree come to an understanding that some amount of inequity is going to exist in this country based on both the card we were dealt at birth and also the amount we've achieved on our own. That inequity is present, and will always be present. Not everyone gets to own a Lamborghini, and everyone understandably seems to be ok with that. It just seems sort of obvious why access to basic non-emergent healthcare is in a different category than these other privileges. Seems silly to me to have to give a reason.

 

[sinuous sausage]

Oh c'mon, young kids say "I don't need insurance" like all freedom lovers or whatever, and then they turn 50 and they need help, but they can't get insurance, and then there's this vicious cycle of more healthy people uninsured and more sick people insured.

Then the hospitals take care of these problems as required by law, and then we end up paying as tax payers any way.

I understand the argument. I do. Ppl young and old who opt out of purchasing health insurance are idiots. I think we're both in agreement there.

Where we differ is in whether or not the govt should protect them from their foolishness. In reality, because of how the laws are set up, the debate is whether the govt should protect all of us from their foolishness. It's a point not lightly taken--govt protects its citizens from delinquents all the time.

But the longer view also cannot be taken lightly. The idea that I am mandated to purchase something by the federal govt is spooky, I don't care what side of the debate you're on. This isn't car insurance, where I can choose not to drive. Simply by being alive in America today, I have to partake in a transaction. Then there's the whole First Amendment debate raging about the legality of what that product must entail. The gov't mandates I buy "health insurance" that covers a, b, and c. What if I have a religious objection to purchasing health insurance for a, b, or c? It's not just the Catholic Church and contraception, either. I can start up my own religion right now that objects to buying health insurance to see a urologist. This could have all been avoided if Obama had either sacked up and gone for a single payer system (which was politically untenable) or just stopped pissing away time and resources altogether and focused on not sucking on the economic front. Instead, this new deal seemingly solves nothing and manages to get religious groups rightfully stirred up about First Amendment rights.

I have a car, I buy car insurance. I want to use the US hospital system, I buy health insurance. Why is this totalitarian?

I don't see how those are related? You have to buy car insurance to operate a car on a public roadway. You don't have to buy health insurance to see a doctor.

 

[abruzz75]

But the longer view also cannot be taken lightly. The idea that I am mandated to purchase something by the federal govt is spooky, I don't care what side of the debate you're on. This isn't car insurance, where I can choose not to drive. Simply by being alive in America today, I have to partake in a transaction.

I really don't understand this argument. Citizens are required to pay taxes that go towards services that they don't have any plan to use but may desperately need at any point in time. I'm trying hard to understand why the individual mandate is something different.

 

[ShenanigansMD]

I don't see how those are related? You have to buy car insurance to operate a car on a public roadway. You don't have to buy health insurance to see a doctor.

I'm just getting at being responsible and taking care of yourself, while not relying on others to pay for a catastrophe when you show up at the hospital with empty pockets.

And largely, I just see the mandate as what it is: a tax to fund a public (or in this case a private) service. That's basically the premise, but I see where you're coming from on the constitutionality thing.

 

[ScholarStud]

Number 5 might cause me to chuckle on accident, since I would probably just be blunt and emotionless during an interview.

The rest of these is basically "how" you answer it, and not "what" you say.

Haha! Exactly. This is more appropriate to ask of someone in a soap opera audition.

 

[PremedGunner]

1. I'm not a medical actuary so don't ask me to do risk assessment.

2. It's a career, not an idiotic and romanticized divine-calling.

3. Intelligence, integrity, compassion. Medicine is driven by results. Stupid and presumably incompetent physicians have no place in medicine. Compassion has no influence on cold, hard results. Integrity falls somewhere between 'useful' and 'useless' and I'm too inarticulate to express myself, so I'll throw it in the middle.

4. Single payer health care. Rationed health care on the obese, drug addicts, and the elderly. Mandatory DNRs on the aforementioned classes of patients. A focus on minimal bureaucracy. Fair and reasonable salaries for physicians and other medical professionals.

5. You're going to die.

6. A right, as long as physicians and other medical professionals are provided reasonable compensation for their services.

waitlist

 

[LizzyM]

what would happen when the disable newborn/demented elder need a highly expensive procedure done? and they have no ability to pay. this is when i think healthcare is a privilege because everyone cant be entitled to the "maximum resrouces" because resrouces are not unlimited. Basic and easily accessible healthcare should be a right though. I would hate for someone to die from malaria because they cant pay for medication.

I'm saying it is a "right" in that it cannot be denied to someone who has the ability to pay on the grounds that they are not worthy of full-tilt medical care.



People do die of malaria in Africa because the drugs to treat them are unavailable (the hospital lacks the cash to acquire the drugs).

What is basic and easily accessible healthcare? Should this be defined and paid for by government using taxpayer dollars? Do these rights extend to the undocumented residents and visitors? Is our current system set up this way? It is for kidney dialysis but not for most other conditions.

 

[sinuous sausage]

In regards to whether it's a right or a privilege -

We've all to some degree come to an understanding that some amount of inequity is going to exist in this country based on both the card we were dealt at birth and also the amount we've achieved on our own. That inequity is present, and will always be present. Not everyone gets to own a Lamborghini, and everyone understandably seems to be ok with that. It just seems sort of obvious why access to basic non-emergent healthcare is in a different category than these other privileges. Seems silly to me to have to give a reason.

It costs a lot of money, and the whole house (including the present level of quality care) can come down because of it. A lot of these people made foolish decisions not to purchase health insurance when they could. We can't leave them out to suffer, can we?

But on the flip side, does forcing everyone into the system degrade the care for everyone else who has paid? A lady who has health insurance dies from heart disease because the system was spread too thin paying for the newcomers. Or maybe the quality and quantity of research plummets so now new treatments are being shelved that could have saved thousands.

 

[LizzyM]

All I'm saying is someone has to shoulder the cost. I don't see how insuring everyone is going to reduce the cost of healthcare in America.

If young, healthy people, a group that often deliberately go without insurance, are enticed/required to have insurance coverage, this group that is currently neither paying in nor getting payouts will pay in but are unlikely to generate many claims because they are young and healthy. Premiums >>> claims. It will not reduce the cost of healthcare but it will increase the pool of money available to pay for the care that is delivered. Furthermore, it will improve the access that otherwise uninsured people have to healthcare thus increasing the likelihood that they will seek care early in their serious illness, when it is often less expensive to treat.

 

[sinuous sausage]

I really don't understand this argument. Citizens are required to pay taxes that go towards services that they don't have any plan to use but may desperately need at any point in time. I'm trying hard to understand why the individual mandate is something different.

Hence the kerfuffle over Roberts' "taxing power" argument.

http://online.wsj.com/article/SB10001424052702303561504577496603068605864.html

It's a slog of a read and I hate legalese, but I took the important paragraph to be:

The result is that Chief Justice Roberts has created the only tax in U.S. history that exceeds its own constitutional limits and is meant to execute powers that the Court otherwise ruled were invalid. His discovery erases the limiting principle—apportionment—that constrains the taxing power for everything besides income and excises.

 

[greatnt249]

Valid points. I'm just all about being responsible with your health, and not making others pay because you don't have coverage.

I completely agree. The problem I see is in calling healthcare a "right" when I don't see much of the population placing a lot of value in their health until it reaches a critical point. People want the right to healthcare without committing the necessary investments like taking better care of themselves or accepting the fact that taxes will need to go up to finance the reform. If we truly valued our healthcare as a nation to the point where we believed it was our right to have it, we would do what was necessary as a society to make it available. I don't mean undermining its providers by slashing funding; I mean reallocating our money and doing what's necessary to make it happen and doing right by healthcare providers and patients alike.

 

[tn4596]

I'm saying it is a "right" in that it cannot be denied to someone who has the ability to pay on the grounds that they are not worthy of full-tilt medical care.
Agreed, healthcare is a right to those who can pay.

People do die of malaria in Africa because the drugs to treat them are unavailable (the hospital lacks the cash to acquire the drugs).
I obviously was talking about someone living in U.S.

What is basic and easily accessible healthcare? Should this be defined and paid for by government using taxpayer dollars? Do these rights extend to the undocumented residents and visitors? Is our current system set up this way? It is for kidney dialysis but not for most other conditions.

Quite frankly cheap healthcare and any emergency procedures needed to stabilize a patient conditions for further treatments/Yes/Yes/Pretty close

.

 

[JESSFALLING]

x

 

[Quizlet04]

Two stories:

1) When I landed in Paris, my first stop was the Charles de Gaulle Airport's medical clinic because I suddenly couldn't hear very well. Through broken French I discovered that I'd torn one eardrum during landing and that I was bleeding into my middle ear; I'd lost something like 40% of my effective hearing. 70 euros got me steroids, antibiotics, and painkillers. What can we do so that most Americans have access to that basic level of care? Had I been a French citizen, it would be a cost/benefit analysis: the cost required to treat the eardrum then was far less than dealing with someone who might end up partially or totally deaf.

2) At the time I met my wife, she was so depressed that she couldn't work more than 20 hours a week, barely above minimum wage. Her medication made it so she wasn't actively suicidal, but it wasn't doing enough. I made her find a doctor who would try different meds until she could function well enough to get a full-time job with health insurance. Now, though, she has MS and takes a drug that costs 40,000 a year, paid for by insurance. What would the state's responsibility be in either case? MA paid for generics and basic doctor's appointments when she was underemployed. If she had MS and were still on state insurance, would she get the MS drug or would we just gamble and hope she doesn't have another attack?

I'm curious, though, what she should have done to "fix" the problem. Because when you say

If everyone has health insurance like responsible citizens, then this wouldn't be a problem.

Where was she supposed to get that healthcare to make her functional? It's not like the depression could be magicked away. Hell, her brother blew his head off in March after a lifetime of depression.

 

[greatnt249]

Furthermore, it will improve the access that otherwise uninsured people have to healthcare thus increasing the likelihood that they will seek care early in their serious illness, when it is often less expensive to treat.

If everyone (theoretically) has the ability to pay for basic healthcare, how does this improve their access to the system? I understand that you're saying they would now be able to pay for their care, but surely you can't purchase time. There are only so many doctors and only so much time in a given day. This also supposes that just because you give someone money to go see a doctor that all of a sudden they will care more about their health.

 

[LizzyM]

I completely agree. The problem I see is in calling healthcare a "right" when I don't see much of the population placing a lot of value in their health until it reaches a critical point. People want the right to healthcare without committing the necessary investments like taking better care of themselves or accepting the fact that taxes will need to go up to finance the reform. If we truly valued our healthcare as a nation to the point where we believed it was our right to have it, we would do what was necessary as a society to make it available. I don't mean undermining its providers by slashing funding; I mean reallocating our money and doing what's necessary to make it happen and doing right by healthcare providers and patients alike.

In my opinion, Americans embrace a philosophy of rugged individualism although we can not function independently within modern society in the 21st century. That rugged individualism means that people do not want to pay in unless they are going to get out in equal measure and the reason they often give is that others are mooches. Frankly, if you are paying in more than you are getting out, you should be thankful you have your health and you don't need more than your proportional share of health care.

We love to blame the victim who had poor health habits but even those who practice "clean living" get sick or injured at some point in their lives and need medical care (or only an autopsy ). That said, Americans love to complain that they act wisely and responsibly but are left paying for those who are irresponsible (unwed mothers) or who are taking advantage of the system (welfare queens).

 

[ShenanigansMD]

Where was she supposed to get that healthcare to make her functional? It's not like the depression could be magicked away. Hell, her brother blew his head off in March after a lifetime of depression.

I'm just talking about covering costs, and whether we do that through taxes or private insurance is ultimately going to be decided by US citizens. I want everyone to be covered by something, so I don't see how I'm the enemy here.

 

[sinuous sausage]

I completely agree. The problem I see is in calling healthcare a "right" when I don't see much of the population placing a lot of value in their health until it reaches a critical point. People want the right to healthcare without committing the necessary investments like taking better care of themselves or accepting the fact that taxes will need to go up to finance the reform. If we truly valued our healthcare as a nation to the point where we believed it was our right to have it, we would do what was necessary as a society to make it available. I don't mean undermining its providers by slashing funding; I mean reallocating our money and doing what's necessary to make it happen and doing right by healthcare providers and patients alike.

But don't I have a right to bear arms, even if I don't think anything of it? Just because I don't utilize my rights doesn't mean they go away, yeah? I don't have to invest in it to still have it.

So wouldn't healthcare, if it is a right, be exempted from my having an interest in it until I'm sick? That's the same for freedom of speech, freedom to assemble, etc. I don't have to take any interest in those rights until I need them.

Maybe healthcare disqualifies itself as a right because I would have to take an investing interest in it for it to remain a right.

 

[sinuous sausage]

Two stories:

1) When I landed in Paris, my first stop was the Charles de Gaulle Airport's medical clinic because I suddenly couldn't hear very well. Through broken French I discovered that I'd torn one eardrum during landing and that I was bleeding into my middle ear; I'd lost something like 40% of my effective hearing. 70 euros got me steroids, antibiotics, and painkillers. What can we do so that most Americans have access to that basic level of care? Had I been a French citizen, it would be a cost/benefit analysis: the cost required to treat the eardrum then was far less than dealing with someone who might end up partially or totally deaf.

2) At the time I met my wife, she was so depressed that she couldn't work more than 20 hours a week, barely above minimum wage. Her medication made it so she wasn't actively suicidal, but it wasn't doing enough. I made her find a doctor who would try different meds until she could function well enough to get a full-time job with health insurance. Now, though, she has MS and takes a drug that costs 40,000 a year, paid for by insurance. What would the state's responsibility be in either case? MA paid for generics and basic doctor's appointments when she was underemployed. If she had MS and were still on state insurance, would she get the MS drug or would we just gamble and hope she doesn't have another attack?

I'm curious, though, what she should have done to "fix" the problem. Because when you say


Where was she supposed to get that healthcare to make her functional? It's not like the depression could be magicked away. Hell, her brother blew his head off in March after a lifetime of depression.

But the Frenchies pay much, much higher taxes than we do. The average Frenchman's purchasing power isn't the same as an American's--the govt takes more of his cut to subsidize any minor health fracas he might endure. Busted eardrums aren't exactly highly critical care, however. What happens when an individual needs a surgery? Does the French system have the technology as widely available as the US? Do I have to wait much longer for the procedure? How about the quality of the surgeon? They're recompensed much less than in the US (they're viewed more as tradesmen), so is it possible the lower wages have discouraged quality applicants from applying to med school, pursuing a demanding specialty, etc? Then add in the fact that French defense costs are essentially subsidized by the US govt. I dunno what the right answer is, but I also dunno if it's necessarily as simple as your story.

Very sorry to hear about your wife :-(

 

[LizzyM]

If everyone (theoretically) has the ability to pay for basic healthcare, how does this improve their access to the system? I understand that you're saying they would now be able to pay for their care, but surely you can't purchase time. There are only so many doctors and only so much time in a given day. This also supposes that just because you give someone money to go see a doctor that all of a sudden they will care more about their health.

Let's say someone has symptoms, is seen in a community clinic and diagnosed with lung cancer. My nurse practitioner friend tells me that she can not get her patients into my academic medical center for lung cancer treatment because the practitioners won't give them appointments.

True you can't buy time but there are under-utilized facilities and under-utilized practioners. On the flip side, as it stands, the government funded hospitals for the poor do have a backlog of patients because the demand can not be off loaded onto the fee-for-service hospitals.

If someone has health insurance, they can afford to care about their health and get things taken care of. When you are uninsured and have a cough that won't go away, or painful joint damage or some other terrible problem, you'll find door after door slammed in your face.

The US gov't does require hospitals to provide emergency care to stabilize a patient but the government does not pay for that care unless the patient is indigent and qualifies for Medicaid or is elderly and qualifies for Medicare. Being stabilized does not mean being treated to the extent necessary to regain one's health. My broken ankle was stabilized in the emergency department but I did not require emergency surgery to save the leg. I did require "elective" surgery if I was ever going to walk again and that's the sort of thing that someone without insurance will find to be unavailable to them.

 

[greatnt249]

But don't I have a right to bear arms, even if I don't think anything of it? Just because I don't utilize my rights doesn't mean they go away, yeah? I don't have to invest in it to still have it.

So wouldn't healthcare, if it is a right, be exempted from my having an interest in it until I'm sick? That's the same for freedom of speech, freedom to assemble, etc. I don't have to take any interest in those rights until I need them.

Maybe healthcare disqualifies itself as a right because I would have to take an investing interest in it for it to remain a right.

The difference between free speech and free healthcare is that one is a concept, while the other is a service. It is also a service that operates on limited resources. Your right to free speech didn't come free, by the way; wars were fought to make it happen. When push comes to shove, making healthcare a right will require resources (money). You can't make it free; no one would want to provide the healthcare. Therefore, to make universal healthcare happen will require us all to make some form of sacrifice, whether it be increased taxes, delayed access to healthcare providers, or a reduction in the current quality of care, depending on your level of commitment to the idea of universal care.

 

[sinuous sausage]

Therefore, to make universal healthcare happen will require us all to make some form of sacrifice, whether it be increased taxes, delayed access to healthcare providers, or a reduction in the current quality of care, depending on your level of commitment to the idea of universal care.

I think you've found it, mate.

I would maintain that even if universal healthcare came to be in the US, it still couldn't properly be considered a "right," short of a constitutional amendment.

 

[Quizlet04]

We love to blame the victim who had poor health habits but even those who practice "clean living" get sick or injured at some point in their lives and need medical care (or only an autopsy ). That said, Americans love to complain that they act wisely and responsibly but are left paying for those who are irresponsible (unwed mothers) or who are taking advantage of the system (welfare queens).

The welfare queen is, more or less, a myth conjured up during the Clinton administration. Yes, I saw a girl of around 18 trying to get a very early pregnancy test so she could show that she was pregnant and qualify for better housing. However, if you look at stats, a lot of people who are receiving welfare are able and willing to work; they're just at a lower level of education, which does not enable them to make a living wage.

When you're raised in a culture in which responsibility is not enforced by either family or your social paradigm, planning before having sex isn't something that will occur. Who will make entire swaths of people responsible?

 

[sinuous sausage]

When you're raised in a culture in which responsibility is not enforced by either family or your social paradigm, planning before having sex isn't something that will occur. Who will make entire swaths of people responsible?

hella ill Q, brah. I personally think we could all start taking religion seriously, which is a strange thing for an agnostic to say.

 

[circulus vitios]

waitlist

Obviously I would lie and tell them what they want to hear if this was real life.

 

[Ironmandoc]

Question I heard last cycle:

Why do you want to be a doctor rather than a nurse, PA, NP, etc. ?

 

[ShenanigansMD]

 

[circulus vitios]

Question I heard last cycle:

Why do you want to be a doctor rather than a nurse, PA, NP, etc. ?

Wait, this isn't an interview for PA school?

 

[ShenanigansMD]

Also, I believe this is what we'll face at Harvard, maybe Johns Hopkins...

 

[PreMedOrDead]

Wait, this isn't an interview for PA school?

I wonder how an interviewer would take that. I know it'd be person-dependent, but is it frowned upon to make suck light-hearted jokes? Of course, as long as you get back onto topic immediately and take the rest seriously?

I figure if you could alleviate the tension in the room somehow it'd be nice...

 

[mehc012]

You don't expect your auto insurance to cover basic repairs and maintenance on a regular basis like you expect your health insurance to cover office visits and prescriptions. The systems are entirely different.

While I don't necessarily disagree with your overall point, I think it's important to note that while a good health insurance plan may cover those things, the monthly cost of those plans is higher, and therefore you are paying for them to a certain extent. A typical, cheaper health insurance plan will have a very large deductible, which essentially means that all health costs are covered by the patient unless some accident or severe illness causes them to spend thousands within a year.

So really, unless you're paying for it in high-premium health insurance, you're likely paying for your office visits and prescriptions yourself! (the obvious exception being gov't-based healthcare).

The part that I completely don't comprehend is when the insurance company sets the price for the doctor's office. For example, if I go to my doctor, and he sends my insurance a bill for $500, they're likely to send him a letter saying 'haha, funny...we think you should get $150' and then somehow that's all I'm required to pay. This makes zero sense to me.

 

[Gut Shot]

The part that I completely don't comprehend is when the insurance company sets the price for the doctor's office. For example, if I go to my doctor, and he sends my insurance a bill for $500, they're likely to send him a letter saying 'haha, funny...we think you should get $150' and then somehow that's all I'm required to pay. This makes zero sense to me.

The insurance company does not send him a letter after-the-fact. They pay according to a pre-negotiated fee schedule for the services provided. The physician has the option of accepting the fee schedule or refusing to take patients from that insurer. These negotiations usually happen on an annual basis.

The reason the doctor generates exorbitant bills is because certain payors include a reimbursement formula in their fee schedule, stating they will pay $X or a certain percentage of the billed amount, whichever is lower. Hence, we all bill at levels much higher than what we actually recoup.

 

[La Presse]

These are pretty straight forward questions. Not really tricky. They have right and wrong answers (multiple of each) and do not particularly depend on who is interviewing you. I have answered all of these at least once on the interview trail, or a similarly worded question...

1. If you had the choice of giving a transplant to an elderly woman with various health problems or a 20-year-old drug addict, how and who do you choose? Why?

Purpose: Attempt to trap applicant into comparing elderly vs. young + drug addict. Hard route - picking one and justifying. Easier and generally more fluid - Redirect. Convince the interviewer that the question is invalid, stupid, moot, take your pick.

Personal take: I would attack the simplicity of the descriptions of the patients. No person can be or should be simplified down into "elderly female" or "drug addict". In each of those groups there is a huge variation.

2. What is your "cause/purpose"?

Purpose: Sell yourself. Can also be translated into, "Why should I invest resources in training you?" Or, "Medical training is long and hard. What makes you wake up every day and strive to achieve X, Y and Z?" This is probably the fairest question an interviewer can ask. It is the simplest, most direct and probably one of the most useful questions. If you do not get this while interviewing for medical school, you WILL get it interviewing for residency. Of the 18 programs I interviewed at this Spring, I was asked at 10+ some derivative of this question.

Personal take: You can not fake this question. It is obvious and transparent if you do. When you put a person's answer in the context of their application you can easily derive the sincerity of all the other answers that an applicant gives. It all comes down to having a theme to your application. Activities complimenting a personal statement which in term is reflected in your answer to this question. An ego helps when answering this question as long as it doesn't get out of hand.

3. Rank intelligence, compassion, and integrity in the order of importance to you.

Purpose: Nobody actually cares how you rank these. None are less important than the others. The trap is diminishing the importance of any of them. You should be able to answer the question, "Why is _________ important to the practice of medicine?" Where the blank is filled with intelligence, compassion or integrity. You should also have a specific example or two for each. You can make some arbitrary order if you choose, but in the end you can't order these entities.

Personal take: I would never provide the evidence unless provoked by this type of question, but I can and have easily provided examples for interviewers of how I exemplify each of those. Again, goes along with being able to sell yourself. You have to be able to self promote when asked to.

4. If you had a magic pen, what would you do to remedy health care in America?

Purpose: Translation: "How close do you follow the political atmosphere and the world outside of your little bubble?" There are a lot of ways to answer this. The way you shoot yourself in the foot is going for too much. The second part of that is that you need to be humble when answering. If American health care could be solved that easily, it would have been done. Pick a pet issue, promoting preventative medicine, mandating standardization of EMRs, etc. And propose a solution. Do not try to fix the entire country.

5. I am a dying patient, and you are my doctor. Tell me that I am going to die.

Purpose: Weed out the sociopaths. Do not tell people you know how they are feeling. You don't. Even if you have a closely related experience, you don't know how they are feeling/responding. Do not use words like expire, pass away etc. They are going to die. That has to be crystal clear and up front. What comes after is the important part. Offer support, personal and then in the form of palliative care/hospice as well as grief counseling.

Personal take: I told a 25 year old that they were going to likely die in the next 2-3 months last week. I have told 10+ patients that they are going to lose anywhere from a toe to 50%+ of their leg in the last 6 weeks. The formula for dealing with these issues is among the simplest out there. The hard part is actually seeing someone who is actually going to be in a body bag in a couple months and being able to follow through. As an interview question this is fairly straight forward.

6. Do you think health care is a right or a privilege?

Purpose: Weed out people who have never thought about the question. This is an easy question to answer. Both are easily justifiable. You can easily flip-flop in your opinion between interviews. Which side you fall on does not matter. Having a reasonably thought out answer as well as counters to the basic counter arguments is what is required.

Very informative and well thought out. I read some similar answers in Dr. Iserson's book.

 

[PreMedOrDead]

 

[LizzyM]

The welfare queen is, more or less, a myth conjured up during the Clinton administration. Yes, I saw a girl of around 18 trying to get a very early pregnancy test so she could show that she was pregnant and qualify for better housing. However, if you look at stats, a lot of people who are receiving welfare are able and willing to work; they're just at a lower level of education, which does not enable them to make a living wage.

When you're raised in a culture in which responsibility is not enforced by either family or your social paradigm, planning before having sex isn't something that will occur. Who will make entire swaths of people responsible?

You are too young... Welfare Queens go back to at least the Reagan administration... anyway, welfare reform during the Clinton administration changed the qualifications for welfare that moved more people into work. That said, there is the perception that there are families that grow so as to qualify for more benefits.... the point is that some taxpayers are angry when asked to pay for the support of those who appear to take advantage of the system.

 

[WTEngel]

You are too young... Welfare Queens go back to at least the Reagan administration... anyway, welfare reform during the Clinton administration changed the qualifications for welfare that moved more people into work. That said, there is the perception that there are families that grow so as to qualify for more benefits.... the point is that some taxpayers are angry when asked to pay for the support of those who appear to take advantage of the system.

I miss Bill...

 

[circulus vitios]

I wonder how an interviewer would take that. I know it'd be person-dependent, but is it frowned upon to make suck light-hearted jokes? Of course, as long as you get back onto topic immediately and take the rest seriously?

I figure if you could alleviate the tension in the room somehow it'd be nice...

I don't even know how to answer that question without being vague or an arrogant jerk.

I considered other careers but medicine is the best fit because blah blah blah
vs
I want to be captain of the ship (really, I'm too arrogant.)

I'll have to start memorizing and rehearsing interview responses, when I apply.

 

[SrootsWwings]

Let me get my trident. The complexity of the situation precludes any simple solutions, unless those simple measures are fundamental. The ACA is analogous to expensive treatment and drugs for symptomatic treatment vs. a cure.

One side's stance is philosophically based on what is often called (and LizzyM referred to as) rugged individualism. This, on a microcosmic scale is impossible to argue against - personal accountability = a righteous life. The macrocosm being one of economy, those who are leading a righteous life should not suffer the economic hardships brought forth by those leading non-righteous (i.e., irresponsible financially and/or healthily) lives. To sum, first principle = individual accountability & economic proportionality. This does not consider the fact that in any economy or system, statistical variation all but deductively ensures a non-righteous population; this side does argue that there is nothing stopping that population from converting itself to the righteous side.

The other side's stance is based on this assuredness of a variation of the populace, and aims to perform damage control on it. Since there is always going to be a population that needs more than it has, the responsibility falls on any proper (i.e., soul-possessing) populace to mind theirs who sees to it they are taken care of until they can recover. Their microcosmic and valid view is a person working as hard as they can, but still not able to make their healthcare needs' ends meet, as insurance does not fit into their budget on a basic level. The macrocosmic perspective holds that not only would it be inhumane to ignore our fellow man/woman's quandary, but it will ultimately cost the economy more in the long run regardless. To sum, first principle = guarantee that there will be a populace in need, and this need must be accounted for on some basic level both morally and economically. This side ignores the fact that any such basic provision will be manipulated as fully as it can be, which is economic fact.

This is a legitimate problem, and one that is only worsened by the dichotomous approach we have taken to it: healthcare is a Chinese fingertrap, and we are just yanking the hell out of this thing. It's become as contentious as abortion or the death penalty, but there is NO reason it should be that divisive, because its complexity allows for a spectral merging of the philosophical topics at issue. Respect and desire for personal accountability must be cultivated in a population, as it is a learned trait - it's not a memo on the TPS report, so people can't be held accountable if they grew up in an environment with little to no personal accountability. Support for a population in need, alternatively, cannot assume that people are going to take what is needed only - it's healthcare, not a penny or two at the gas station.

A good solution will not be easy, but the first step must be recognition of the validity of the two sides and actual conversation, not media-encouraged five-year-old screaming at each other AAAAAAAAHHHHHH YOU BROUGHT THIS ON YOURSELF, NOW YOU HAVE TO DEAL WITH IT AAAAAAAAAHHHHHH YOU HAVE NO SOUL AND ARE GREEDY!!!!!

 

[Quizlet04]

You are too young... Welfare Queens go back to at least the Reagan administration... anyway, welfare reform during the Clinton administration changed the qualifications for welfare that moved more people into work. That said, there is the perception that there are families that grow so as to qualify for more benefits.... the point is that some taxpayers are angry when asked to pay for the support of those who appear to take advantage of the system.

Yes, during the Reagan administration I was anywhere from 1 to 9, so my politics are a bit newer. Some families do grow for benefits, but most grow from ignorance and lack of planning.

People in the US, as you mentioned, hate collective responsibility as much as they love to blame whole groups for certain failings.

 

[UrshumMurshum]

These are pretty straight forward questions. Not really tricky. They have right and wrong answers (multiple of each) and do not particularly depend on who is interviewing you. I have answered all of these at least once on the interview trail, or a similarly worded question...

1. If you had the choice of giving a transplant to an elderly woman with various health problems or a 20-year-old drug addict, how and who do you choose? Why?

Purpose: Attempt to trap applicant into comparing elderly vs. young + drug addict. Hard route - picking one and justifying. Easier and generally more fluid - Redirect. Convince the interviewer that the question is invalid, stupid, moot, take your pick.

Personal take: I would attack the simplicity of the descriptions of the patients. No person can be or should be simplified down into "elderly female" or "drug addict". In each of those groups there is a huge variation.

2. What is your "cause/purpose"?

Purpose: Sell yourself. Can also be translated into, "Why should I invest resources in training you?" Or, "Medical training is long and hard. What makes you wake up every day and strive to achieve X, Y and Z?" This is probably the fairest question an interviewer can ask. It is the simplest, most direct and probably one of the most useful questions. If you do not get this while interviewing for medical school, you WILL get it interviewing for residency. Of the 18 programs I interviewed at this Spring, I was asked at 10+ some derivative of this question.

Personal take: You can not fake this question. It is obvious and transparent if you do. When you put a person's answer in the context of their application you can easily derive the sincerity of all the other answers that an applicant gives. It all comes down to having a theme to your application. Activities complimenting a personal statement which in term is reflected in your answer to this question. An ego helps when answering this question as long as it doesn't get out of hand.

3. Rank intelligence, compassion, and integrity in the order of importance to you.

Purpose: Nobody actually cares how you rank these. None are less important than the others. The trap is diminishing the importance of any of them. You should be able to answer the question, "Why is _________ important to the practice of medicine?" Where the blank is filled with intelligence, compassion or integrity. You should also have a specific example or two for each. You can make some arbitrary order if you choose, but in the end you can't order these entities.

Personal take: I would never provide the evidence unless provoked by this type of question, but I can and have easily provided examples for interviewers of how I exemplify each of those. Again, goes along with being able to sell yourself. You have to be able to self promote when asked to.

4. If you had a magic pen, what would you do to remedy health care in America?

Purpose: Translation: "How close do you follow the political atmosphere and the world outside of your little bubble?" There are a lot of ways to answer this. The way you shoot yourself in the foot is going for too much. The second part of that is that you need to be humble when answering. If American health care could be solved that easily, it would have been done. Pick a pet issue, promoting preventative medicine, mandating standardization of EMRs, etc. And propose a solution. Do not try to fix the entire country.

5. I am a dying patient, and you are my doctor. Tell me that I am going to die.

Purpose: Weed out the sociopaths. Do not tell people you know how they are feeling. You don't. Even if you have a closely related experience, you don't know how they are feeling/responding. Do not use words like expire, pass away etc. They are going to die. That has to be crystal clear and up front. What comes after is the important part. Offer support, personal and then in the form of palliative care/hospice as well as grief counseling.

Personal take: I told a 25 year old that they were going to likely die in the next 2-3 months last week. I have told 10+ patients that they are going to lose anywhere from a toe to 50%+ of their leg in the last 6 weeks. The formula for dealing with these issues is among the simplest out there. The hard part is actually seeing someone who is actually going to be in a body bag in a couple months and being able to follow through. As an interview question this is fairly straight forward.

6. Do you think health care is a right or a privilege?

Purpose: Weed out people who have never thought about the question. This is an easy question to answer. Both are easily justifiable. You can easily flip-flop in your opinion between interviews. Which side you fall on does not matter. Having a reasonably thought out answer as well as counters to the basic counter arguments is what is required.

This was impressive. Did you think of these things on the fly or is there a resource you use to prepare for this type of stuff? Reading these questions I fell into every trap part.

Keep in mind even doctors struggle with the telling a patient they're going to die part. That's not easy for anyone.

I don't expect many pre-meds to have this good of interview skills. There will be, but not the majority.

 

[PreMedOrDead]

This was impressive. Did you think of these things on the fly or is there a resource you use to prepare for this type of stuff? Reading these questions I fell into every trap part.

Keep in mind even doctors struggle with the telling a patient they're going to die part. That's not easy for anyone.

I don't expect many pre-meds to have this good of interview skills. There will be, but not the majority.

Thank God for mock interviews at my undergrad.

 

[sinuous sausage]

I wonder how an interviewer would take that. I know it'd be person-dependent, but is it frowned upon to make suck light-hearted jokes? Of course, as long as you get back onto topic immediately and take the rest seriously?

I figure if you could alleviate the tension in the room somehow it'd be nice...

I'd go for the fart right out of the gate. Lets 'em know I am human under that demigod physique I've got going on.

 

[mimelim]

This was impressive. Did you think of these things on the fly or is there a resource you use to prepare for this type of stuff? Reading these questions I fell into every trap part.

Keep in mind even doctors struggle with the telling a patient they're going to die part. That's not easy for anyone.

I don't expect many pre-meds to have this good of interview skills. There will be, but not the majority.

It comes with practice. Keep in mind, I just finished interviewing for residency 6 months ago. That was 75+ interviews at 18 hospitals in the span of 8 weeks. There are only so many questions one can ask.

 

[Gut Shot]

Yes, during the Reagan administration I was anywhere from 1 to 9, so my politics are a bit newer.

Your politics might be newer, but the facts are not. Reagan essentially coined the term "welfare queen" in an apocryphal story contained within a 1976 campaign speech.

 

[UCFKnight]

I really didn't mean to start any debates, but thank you everyone for all of your responses. They helped me more than I ever thought possible.

A special thanks to: drkennyj, SBuck53, LizzyM, mimelim, greatnt249, and SrootsWwings. (Sorry if I am leaving anyone out and hurting feelings, but the responses by these people seemed to be the most constructive/helpful for me.)

I'll be sure to post more difficult questions I have after my next couple of mocks (I know I know, I'm doing a lot of them).

 

[sinuous sausage]

A special thanks to: drkennyj, SBuck53, LizzyM, mimelim, greatnt249, and SrootsWwings. (Sorry if I am leaving anyone out and hurting feelings, but the responses by these people seemed to be the most constructive/helpful for me.)

you bastid

 

[UCFKnight]

you bastid

Hahah in retrospect, sinuous sausage offered some pretty legit points as well. So a special thanks to sinuous sausage as well

 

[pre med 2014]

I understand the argument. I do. Ppl young and old who opt out of purchasing health insurance are idiots. I think we're both in agreement there.

Where we differ is in whether or not the govt should protect them from their foolishness. In reality, because of how the laws are set up, the debate is whether the govt should protect all of us from their foolishness. It's a point not lightly taken--govt protects its citizens from delinquents all the time.

But the longer view also cannot be taken lightly. The idea that I am mandated to purchase something by the federal govt is spooky, I don't care what side of the debate you're on. This isn't car insurance, where I can choose not to drive. Simply by being alive in America today, I have to partake in a transaction. Then there's the whole First Amendment debate raging about the legality of what that product must entail. The gov't mandates I buy "health insurance" that covers a, b, and c. What if I have a religious objection to purchasing health insurance for a, b, or c? It's not just the Catholic Church and contraception, either. I can start up my own religion right now that objects to buying health insurance to see a urologist. This could have all been avoided if Obama had either sacked up and gone for a single payer system (which was politically untenable) or just stopped pissing away time and resources altogether and focused on not sucking on the economic front. Instead, this new deal seemingly solves nothing and manages to get religious groups rightfully stirred up about First Amendment rights.





I don't see how those are related? You have to buy car insurance to operate a car on a public roadway. You don't have to buy health insurance to see a doctor.

Actually you don't have to start a religion that objects to buying health insurance. Christian scientists don't see doctors and they've been around for a while so they have the best shot at being exempt from the mandate, you know, given that they don't use doctors.