12 MMI Stations that come up EVERY YEAR | Medical School Interview Questions

is the NHS fit for purpose should doctors be able to strike how would you move a mountain what does informed consent mean to you those are just some of the questions that we're going to be answering hi guys my name is Yousef and I'm an Oxford medical student and the founder of the aspiring Medics we are the UK's leading Tutoring company helping students to get into medicine and in today's video we're going to be going through top medical school interview questions that come up year after the year so let's get into it should doctors be able to strike so this is a really interesting topic to cover because it's very current in the media with doctors voting to strike in January within their own Union and nurses doing the same recently I think that as with any of these situations there's two sides to the story in terms of the reasons why I believe doctors should be able to strike is essentially the fundamentals of any worker providing a service a public service particularly if there is a as a worker providing a public service they have a legal right to strike and they if they are providing a service they don't feel that they are compensated well enough or they feel as though um collectively their working conditions are not up to the mark it is their legal right to be able to strike to take action against that and on the other side of things you've got the arguments that are very much tailored to medicine as a profession and a vacation because it is the only public service that is provided whereby there is a direct impact on life and if these workers decide to strike and so you've got to think about the ethics there as well with regard to beneficence and non-maleficence they would definitely come into play with answering the questions so for beneficence we want to do the best for our patients and those around us and so in that that regard we wouldn't want doctors to strike as well as non-maleficence in the same reasoning that said there is something to consider with those pillars and that is the staff themselves who may or may not be striking the staff who would be stroking the doctors if they weren't to strike then you could argue that actually there's a bit of maleficence going on there because they are likely to see their conditions worsen over time and actually not improve and this is causing them harm you then also got to consider the staff who would be as essentially covering the doctors who would be striking so that's the nursing staff if it's Junior doctors striking then it's the senior doctors who are covering their workload and that's going to put an excess strain on them and you may be saying that actually you're causing some uh harm to them in terms of their workload and their um the stresses that are on are placed upon them already in terms of my personal opinion I believe that doctors should have the right to strike for the reasons that I listed earlier but given the reasons against it I think that any strike action that is taken should be kept to a minimum and it should be done in the safest way possible to allow for patient care to be maintained at the highest level possible in such circumstances you're working in an ICU and have one donated kidney available but three patients need it one is a 60 year old teacher with five days to live if he doesn't receive the transplant another is a drug addict in his 30s who has kidney failure due to drug usage and will die within two weeks without the transplant and lastly there is an eight-month pregnant woman with cancer in her kidneys whose baby Will Survive but she won't live much past its birth without the kidney transplant who would you give it to okay so this hypothetical question is really interesting we've got three patients all need a kidney transplant and we've only got one kidney to give to one of these patients I think in this sort of scenario you've got two ways to think about things you can either look at the three patients that you've got before you and you can also look at the medical ethics pillars that we use to help our decision making in these scenarios starting with the pillars we've got beneficence or we want to do well for all the patients and actually that isn't necessarily possible in this case in terms of non-maleficence well if we had no kidney we wouldn't have um anything to treat them with um in in terms of a transplant and so I'm not doing any non-malifications there's no maleficence going on here um because if we were to give it to someone else we wouldn't be causing anyone else harm and I think the most important pillar in this story is Justice um it's who is eligible for this one kidney between the three patients and essentially you're trying to think in the fairest way possible and that's the one that needs to be answered by looking at the other the other side of things and that's three patients that we have now with the information that you've given me today you've got three patients who would otherwise live for varying amounts of time without the transplant that said the time frames that I've been given for these two patients are all relatively relatively similar they're not um differentiated by years it's more days and so for that reason I don't think that I would place that factor too high up on uh the priorities I think when you look at the Patients individually you're starting off with the first one the 60 year old gentleman um and we don't have any other information on his State and honest condition um his lifestyle or anything like that we don't know what's led to him needing a transplant and so it would be difficult to say clinically how long the transplant would last or how lost they were they would live um with the transplant and so at that age um with the age being the only Factor you can really judge them upon you could say that actually um they've had a good Innings that argument could come into play um and say that actually other patients May benefit more from the from the the kidney transplant because there's um more years of life to be gained from having it now if we look at the second patient is a drug user and their their lifestyle habits have caused them to need this transplant and they are 30 years old so would they gain many years of life from the kidney transplant if they were to have it yes providing that they change their lifestyle factors if they didn't do this then really what they don't end up doing is needing another transplant a few years down the line that is also in the context of them needing immunosuppression because of the transplant and the drugs having an even greater effect on their body because of that and so for that reason you could probably argue that this person isn't the most appropriate for receiving the transplant given the addictive nature of drug use and their um smaller likelihood to change their habits now finally you've got this eight-month pregnant lady who um you can assume is a child-bearing age so that's probably in their 20s or 30s and so just like the second patient they've got many years of life to be gained from having their transplant and also they're bearing child so they are also by having a trust about going to have many years extended their life and they're going to provide be able to provide care to that child that is going to be born and so in this scenario I think my personal opinion would be to give the transplant to that final patient because you're benefiting two lives not just one within the transplants they have many years of life to be gained from having a transplant and their habits as far as we know are in accordance of someone who would be able to keep that transplant alive for as long as possible um thank you very much who is the most important member of the multi-disciplinary team okay so thank you very much for this question regarding uh members of the MDT um I believe that actually there is no one single member of the multi-disciplinary team that is more important than the others I think that actually um the purpose of the MDT is to bring everyone together Who's involved in the Care on patient that includes everyone from Radiology to surgeons Medics um OTS and PTs and nurses um such that we can carry out a shared decision making process that is the most holistic outcome for the patients and to say that one member of that team is more important than the others I believe personally I believe would be an incorrect thing to say should the NHS install fines for missing appointments thank you very much for this very poignant and relevant question with our prime minister recently going back on his pledge to charge I think it was 10 pounds for missed GP appointments I think that with this question in particular there's a couple sides to it that are really important to answer so in terms of the reasons why I think this is a good thing to uh to think about and to potentially put in place across the NHS for for all services of varying fine Amounts is because really reduce the amount of appointments that are missed firstly and that frees up a lot of slots for patients who really need the appointments it means that the doctors can see the the patients that I need that I needed to see and it also means that we can really help with funding the NHS over the last three or four years we've seen well over 100 billion pounds being pushed into the NHS and it always needs more and so this could be a really good source of funding for not only funding the treatments that the NHS provides and potentially providing better treatments for patients on the other side of it you've got to consider that actually this isn't very Equitable and it goes kind of against that medical ethics pillar of Justice you may find that actually wealthy patients don't mind booking several appointments in the hope that they can make one of them and they just pay fines for the for the others and this means that actually those patients in lower socioeconomic groups would struggle to find slots they would struggle to get appointments with their doctor and this could really start to evoke that medical ethics pillar of doing no harm non-maleficence and actually we could say that we're doing harm by not allowing certain groups of patients to uh to get an appointment and then you've also got to think about other groups of patients particularly those who struggle with Mobility those you struggle with getting the right transport to their appointments and some who struggle with their Emory so um patients with dementia with Alzheimer's could really struggle to make their appointments by struggling to to keep them and and keep note of them which would lead to them having massive bills and fines to pay off through no fault of their own it's just a product of their disease and also you've got child carers who may struggle to know when they're actually going to be available life is very unpredictable and you can't always plan ahead and so putting this system in place where we actually charge fines of this appointment could uh could mean that these patients are deterred from making the appointment in the first place whether or not they need the care or not in terms of my own personal opinion on this matter I believe that actually we could explore this this Prospect I think that as long as it's done in a very careful and particular and great gradual manner could find a way in which there is a Optimum middle ground that can be reached with this sort of it would just have to be very policed very carefully and put into place very gradually such that any negative effects that are produced are spotted early and can be can be rectified appropriately you are a medical student a patient Mr gamble confesses to you that he is no longer taking his prescribed medication as he has read a lot about Herbal Remedies online and wants to try them instead he mentions that he hasn't yet informed any doctors about this what would you do all right so thank you for the question I believe that in my position as a medical student I wouldn't be qualified to give firm medical advice to this patient regarding their medications and what they've read online instead what I'd like to do principally is ask them whether or not they're happy for me to talk to the medical team about what they've told me now confidentiality is kept within the medical team and as a medical student you are within the medical team that said we should really try to engage the patients in a shared decision-making process as much as possible and in line with this what I would like to do the situation is ask the patient if they're happy for me to talk to the medical team if they are then great we can discuss that as a group or if they want to talk to a doctor they can do that too however the case may arise whereby they are not happy for me to disclose the information to the medical team about what they've read online and how much or little they've been taking their prescribed medications in that instance you have to think about the medical ethics pillars of autonomy and of beneficence as well as well as non-maleficence so there's a lot to think about here in terms of beneficence we want to do the best for our patient and given evidence-based medicine that we know of taking the medications that they prescribed is in their best interests so that suggests that we should talk to the medical team about it in terms of non-maleficence we can agree that some of these medications these higher medications actually can cause some harm such as Saint John's Wards and so we'd argue that we are on the side of caution and say that we are actually non-maleficent suggests we shouldn't just do nothing again you should talk some medical team about it and finally autonomy is the one that we really have to consider because it goes against these other principles and suggests actually if the patient's asking us not to disclose the information to the medical team then we should keep their wishes in mind and keep the information confidential what would I do in this position well well I would think that the general public tends to be very level level-headed and this patient would likely be okay with me disclosing information within the medical team as it is confidential to that team and not just to myself as a medical student if that isn't the case and they want to keep it confidential I would encourage them to speak to the medical medical team about it but I wouldn't give any firm medical advice given my standing as a student rather than a qualified a doctor what do you understand about the phrase informed consent why is it important to make sure patients are providing informed consent and when might a patient not provide informed consent are there any instances in which medical staff may proceed with a particular action without obtaining informed consent all right so I believe the rest of my understanding informed consent means um consent that is gained from a patient who is in uh full possession of all of the risks and benefits associated with any diagnostic procedure or surgical procedure or medication that they have been prescribed and this allows them to make a balanced decision and providing they are of sound mind and so that they can actually make a um a call on whether or not this treatment procedure Etc is suitable for them and aligns with their wishes I think the reason why having consent again that is informed is so important is because if we don't do that then what we get into is a situation whereby patients are receiving treatments and they are exposed to negative outcomes they weren't really aware of before they signed the forms or gave the verbal consent and also just for medical legal reasons if we have patients who are disgruntled and happy or even harmed by risks that they weren't aware of that actually we can find some practitioners being sued by the the patients because they weren't aware of all of these risks before they had uh said procedure so whilst informed consent is really necessary and should always be sought out after when it is possible to do so there are quite a few reasons why informed consent may not be needed when treating a patient firstly there's those sort of scenarios where actually the patient is informed of all of the risks and benefits associated with you know the treatment or the medical procedure but actually they're not of sound mind and so they can't make that balanced decision for example those with dementia those with learning difficulties such as Down syndrome or even just someone who is normally of sound mind but potentially has an infection which is causing delirium which means that they are actually unable to make a balanced decision despite being able to retain some of the information presented to them and that would mean that essentially the consent isn't informed when it is given by patient and then you've also got those scenarios where you can proceed with a diagnostic test or a medical procedure or a surgery maybe you can proceed with them without consent entirely from the patient that is so for example if a patient has less lasting power of attorney and they wish for the patient to have to have the procedure or if it's a child and actually you can get the the parent or the guardian to provide consent or if a patients left an advanced directive which is that the directive left by them in a legal format stating their wishes should a certain situation arise and then you've also got those sort of emergency procedures so if there's a life-saving treatment that needs to be given and you don't have time or the means to gain that consent before it would be necessary to do the the procedure then that is a reason why you may go ahead without informed consent in some conditions such as mental health conditions um which are covered by the mental health act practitioners and clinicians can actually go ahead with certain treatments and tests um without informed consent the best of my knowledge that's most of the um the reasons why you may go ahead without it but as I said at the start it's something that we should really try to seek out when we care what is the next big medical advancement event across the Horizon so what I think of the medical advancements that are coming in the future there's two that really stick out in my mind firstly there's that of personalized medicine and whilst You could argue this is actually an advancement within the pharmaceutical sector and not within the clinical setting of the NHS it is very applicable it means that treatments that we give are going to be more and more tailored to individual patients it means that more of them are going to work more of the time and um by that work by that means we're gonna have a massive increase in efficacy of our medications however it does mean that actually some of them are going to be more expensive but with that increase in efficacy we we can see shorter stays in hospital stays for patients and their emissions and then with the other other one that really sticks in my mind is the current Trend to move away from secondary care and towards primary and tertiary care within our Healthcare System I think that by moving towards the prime primary care approach we can see more prevention of serious illness within our population with diseases such as obesity and diabetes and then with the move towards tertiary care instead of secondary care we can see more advanced treatments shorter stays in hospital and longer lasting treatments surgeries for our patients because of that extra degree of specialization of our clinicians what is the most important medical advancement in the last 50 years okay thank you very much for this question in my personal opinion I think the most important medical advancement in the last 50 years would be that of laparoscopic surgery so Keyhole surgery um I think there's been plenty of advancements in other areas such as the eradication of smallpox and our approach to vaccines as well as the diagnostic tests regarding polymerase chain reaction in PCR and how that helps us identify viral infections and viruses across the world but going back to my original point about the laptop with surgery it's a really key advancement in surgery with greater cosmetic results less bleeding and a pretty similar operation time on the operations table with shorter stays in hospital as a result of it so for that reason I believe that laparoscopic surgery would be a great candidate for the most important medical advancement in the last 50 years if you had to move a mountain how would you do it all right this is a very different question to um some of the ones I prepared for all but nonetheless I'll give it my best go I think that if I were to be tasked with the challenge of moving a mountain the first thing I'd want to do is ask some clarifying questions you know where is it is it literal metaphorical it's a big small how big and then once I've got all of the information I could possibly get I think you know assuming that actually it's a literal mountain and we've got to move it across Seas for instance I think that I'd take it in three steps I think that I would break it down into deconstruction into transport and into uh reconstruction I think with the deconstruction you probably use a few explosives you'd probably take a detailed schema before you dismantle the the mountain and that would allow you to rebuild at the other side in the exact same way if that was needed and then I think with the transport probably load it onto um some trucks some big trucks but load them onto a onto a shipping container in reverse order so that when you get to the other side and you're finishing that transport step you can then take them off in the the um the first to come for a Serv order and they can lay down their their parts of the mountain in the correct order and then you can reconstruct it at the other side alternatively if you wanted to move a mountain and you were a bit more lazy and you you just you wanted to live a long time you could come back in a couple hundred years tectonics would have probably moved and your Mountain would have undeniably also moved so that's slightly the more alternative answer to that question uh thank you very much is the NHS fit for Barbies for tomorrow's challenges so I think that the question is the NHS fit for purpose for tomorrow's challenges is a very interesting one and I think it's quite a important question that we have to be frank with answering when it comes to addressing this issue in the next sort of five years or so in terms of the reasons why I think it is fit for purpose I would say that actually the principles that the NHS was founded upon and is still built upon are the most Equitable and uh Justified principles that can be applied by a Healthcare System across the world I think that actually the NHS is the most Equitable system I think that it evokes the medical ethics pillars of justice and of beneficence and nomineescence as much as possible when you consider an entire population and I think for those reasons it's probably the most advanced Healthcare System by way of treating its entire population when you look at the other side of the coin and you look at the reasons why it maybe isn't quite fit for purpose for tomorrow's challenges well it's currently got a stopping crisis and there's a lot of things going on that could mean that actually the system starts to come to Breaking Point in the coming years and this is all really a trend of demand outstripping Supply and this trend that we're seeing to to cover that principle is that we're flooding the system with more and more funding each year when over 100 billion in the last uh sort of four years and so actually all that's happening is we're keeping the system keeping its head above water rather than advancing to that of a system greater in any aspect of a system across across borders I think that actually when you look at tomorrow's challenges one of the things you have to consider is that of climate change and actually when we remove the whole um sort of clinical side from things you realize that the NHS is one of the biggest polluters that the UK has and when we think about the future we've got to think about the environment and the NHS although it is like taking steps to be more environmentally friendly it's actually not that friendly uh in his current state and with the rate of progression it's not going to be very good in the future either in terms of my personal opinion I would say that actually the NHS isn't fit for purpose for tomorrow's challenges I think the challenges are only going to mount from here on out with the Staffing crisis that we currently have with the economic situation that we are currently stuck in and with the Aging populations that we're seeing the cost of treatments growing and so if there is going to be a system in the future for us to use and benefit from as an entire population we need to have drastic change more imminently than is currently uh being proposed the NHS should not be managed At All by elected politicians and should instead be managed by an independent body to what extent do you agree with this statement all right so with this question you've got a few things to consider um it would be a pretty major change to take the leadership of the NHS out of the hands of politicians and puts it in into an independent organization and body and there's reasons why you may want to do that and reasons why you may not want to do that firstly I think that in terms of the reasons why you would want to do it I think they're pretty obvious I think that actually you would remove a lot of the bureaucracy that comes with having to pass legislation in the Commons and the Lords with regards to making change within the NHS and that would mean that we're abled as a healthcare system to make scoping changes quickly when they are needed you also have a health secretary who is the leader essentially of all of the healthcare system and the social care system in the UK and they are a politician that is appointed by the Prime Minister and they're not elected by any clinician by any Royal College they are simply very able to be elected by the Prime Minister without any Healthcare experience at all and for that reason actually putting it in the hands of some experienced professionals who do know Healthcare Systems could be beneficial I think that in terms of the other other side of things with regards to reasons why you'd want to keep it within the political sphere would firstly be that actually by keeping the legislation within the commons you're opening up to a lot of debate and that scrutiny can really help to make sure that any legislation that is passed is beneficial for the system I think also by having the NHS under political control essentially what you are doing is you are bringing it into legislation manifestos of political parties when it comes up to election and that can drive political parties and prime minister this is to flood the system with more more funding in an alternative scenario where it's independent the system would have to ask for the funding from the government and actually they wouldn't be as willing to come forward with it maybe however when you take the whole system and the whole question as one in my personal opinion I think that actually we should move towards a system whereby the NHS and the healthcare system is governed by an independent board a single leader and a group of people who have a deep understanding of Healthcare systems and how they work and this could really allow for us to make significant changes when they're needed and it can mean that actually we can introduce some scoping change within the NHS and not have to leave it down to politicians who are too afraid to make drastic changes for fear of not being reelected do you think NHS waiting times are an accurate measure of NHS performance okay so I think this question about waiting times within the NHS and that being a measure our performance is a really critical one it's one that's been around for a while and there's many factors to consider in my personal opinion I don't believe that waiting times are the best measure of an interest performance by quite a long way I'll come on to the reasons why that is but uh firstly in terms of the reasons why it could be a good measure well firstly we do need a metric to use to determine how well the anxious is performing and it does provide somewhat of an insight as it stands I think that whilst we do need to measure it's not the best one but it does address how quickly patients are being seen and their needs addressed and it does give us an indication of how well the system is operating how quickly it's operating compared to how it is done historically and can give us an indication as to when it's coming under stress or when it's actually doing better than we expected now in terms of the reasons why I don't think it's a great metric I think that actually when you consider a lot of other factors you start to see the waiting times are not the most important say for example you had two different hospitals that both provide the same type of surgery now if you needed that surgery you would be driven towards going towards the hospital that has a shorter waiting time but actually if you scratch below the surface you may find that these the hostel the shorter waiting time their surgeries have a greater revision rate so they need to be done again essentially you may find that they have a greater rate of infection and the state hospital tend to be longer for that for that hospital and so once you start to get an insight into these metrics you may have said actually I'd rather wait a bit longer and go to the other hospital where these other metrics that are actually very important are more beneficial to me as a patient and so for those sort of reasons I don't think that actually waiting times are the best measure of the performance of our Healthcare System now in terms of how we could go about fixing that I think that actually what you've got to do is align the incentives you've got to align them with the the targets that were the setting for our Workforce and the ways in which they're measured when you don't have those aligned what you find is a classic case of of the workforce really finding ways around um the targets to hit them without really addressing what they're meant to address and I think the best example of this would be in a e but you've got essentially a Target to see a patient and decide what is going to happen to them within four hours now that sounds great on the surface of it but actually what you find is that you have doctors seeing patients deciding whether they need to be admitted or discharged but within those four hours they're not having a diagnosis they're not getting a a defensive management plan and actually treatment is delayed in the face of making sure a decision has been made about whether they're going to be admitted or discharged in those four hours all right so whilst the target is there to make sure various prompt delivery of care it can actually delay the care because you're too worried about hitting the metric now I hope that makes sense um thank you very much for the question so guys that brings us to the end of the video we hope you found it useful if you have don't forget to like comment and subscribe we also offer a bespoke personalized one-to-one tutoring service link is in the description below alright guys see you in the next video bye-bye

Channel: The Aspiring Medics

Views: 23,942

Keywords: Get into Medicine, Medicine Personal Statement, Medicine Personal Statement Oxford, Medicine Personal Statement Cambridge, Medicine Personal Statement Analysis, Medicine Interview, Medicine Medical Ethics, Medicine Current Afairs, Medicine Interviews

Id: cI6J7v6nTmE

Length: 32min 6sec (1926 seconds)

Published: Thu Nov 24 2022