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chrisxcal

Bringing up Four Pillars of Medicine in MMI

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Hey everyone,

I was wondering what everyone's thoughts are on mentioning the four pillars of medicine (beneficence, autonomy, etc..) 

I've heard varying opinions, some suggesting it is good to bring up these buzzwords, while others think it is unncessary and perhaps make you seem a bit more stiff/unnatural.

What are everyone's thoughts on this?

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First, they're not pillars of medicine, they're ethical principles. I usually teach people to say them, but don't just blurt them out. Use them to demonstrate a logical thought process. If u can't say them without sounding unnatural, then don't use them.

 

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57 minutes ago, PhD2MD said:

First, they're not pillars of medicine, they're ethical principles. I usually teach people to say them, but don't just blurt them out. Use them to demonstrate a logical thought process. If u can't say them without sounding unnatural, then don't use them.

 

Would running through them in your head after hearing each ethics question and then starting off you answer by saying that "The ethical principals involved hear are...", be natural enough?

It's good that we have spent time studying and thinking medical ethics right? 

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28 minutes ago, Zuk said:

Would running through them in your head after hearing each ethics question and then starting off you answer by saying that "The ethical principals involved hear are...", be natural enough?

It's good that we have spent time studying and thinking medical ethics right? 

No, don't explicitly state you're referring to them. Integrate them into your response

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13 minutes ago, LloydRedStan said:

No, don't explicitly state you're referring to them. Integrate them into your response

Thanks for the advice! I will definitely integrate them into my response. I never would have guessed that mentioning them explicitly also would be regarded negatively, since that is the way that people think about them. 

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2 hours ago, LloydRedStan said:

No, don't explicitly state you're referring to them. Integrate them into your response

 

2 hours ago, Zuk said:

Thanks for the advice! I will definitely integrate them into my response. I never would have guessed that mentioning them explicitly also would be regarded negatively, since that is the way that people think about them. 

It's not regarded negatively, it's part of a very strong response IF you can learn to use the words in a way that doesn't sound artificial. There has been a pendulum swing/backlash against using them for the last little while because to many people use them very poorly, and it just makes people cringe and roll their eyes. Best thing to do is learn how to use them naturally, but if you can't consider avoiding naming them directly.

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14 minutes ago, PhD2MD said:

 

It's not regarded negatively, it's part of a very strong response IF you can learn to use the words in a way that doesn't sound artificial. There has been a pendulum swing/backlash against using them for the last little while because to many people use them very poorly, and it just makes people cringe and roll their eyes. Best thing to do is learn how to use them naturally, but if you can't consider avoiding naming them directly.

This makes sense to me. Thank you. 

 

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6 hours ago, PhD2MD said:

First, they're not pillars of medicine, they're ethical principles. I usually teach people to say them, but don't just blurt them out. Use them to demonstrate a logical thought process. If u can't say them without sounding unnatural, then don't use them.

 

Thanks for the clarification and reply, I appreciate it. To me, talking about autonomy seems alright because you can just say "to respect the patient's autonomy, we should ______" but I am having more difficulty incorporating the other ones like beneficence... is it alright to say "To follow the principle of beneficence and promote the best well-being of patient"? Or does that sound unnecessary? 

As well, do you think it inadvisable to say things like "The patient's autonomy is at conflict with the principle of non-maleficence. etc"? 

Would it hurt more to mention them or to not mention them at all? I do find that thinking through the principles helps my thought process but some people have mentioned that it might sound cheesy, so I am a bit conflicted.

Thanks 

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19 minutes ago, chrisxcal said:

Thanks for the clarification and reply, I appreciate it. To me, talking about autonomy seems alright because you can just say "to respect the patient's autonomy, we should ______" but I am having more difficulty incorporating the other ones like beneficence... is it alright to say "To follow the principle of beneficence and promote the best well-being of patient"? Or does that sound unnecessary? 

As well, do you think it inadvisable to say things like "The patient's autonomy is at conflict with the principle of non-maleficence. etc"? 

Would it hurt more to mention them or to not mention them at all? I do find that thinking through the principles helps my thought process but some people have mentioned that it might sound cheesy, so I am a bit conflicted.

Thanks 

I'd advise you against using them explicitly, unless it is a  clear medical ethics situation. 

I interviewed twice, the first year I stated the medical ethics and the ethical problem, and was rejected ( due to poor advice I got from MMI prep company). In my second trial, I did not do that and was accepted at several schools. I'm only telling you what worked for me,  but it may not necessarily work for you. 

Be careful about who you take advice from . You never know why someone was accepted into medical school. For instance, a person maybe in medical school because they have a Phd, or they have perfect GPA, or they have 7 publications ( and not necessarily because of their MMI performance). 

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18 minutes ago, chrisxcal said:

Thanks for the clarification and reply, I appreciate it. To me, talking about autonomy seems alright because you can just say "to respect the patient's autonomy, we should ______" but I am having more difficulty incorporating the other ones like beneficence... is it alright to say "To follow the principle of beneficence and promote the best well-being of patient"? Or does that sound unnecessary? 

As well, do you think it inadvisable to say things like "The patient's autonomy is at conflict with the principle of non-maleficence. etc"? 

Would it hurt more to mention them or to not mention them at all? I do find that thinking through the principles helps my thought process but some people have mentioned that it might sound cheesy, so I am a bit conflicted.

Thanks 

You would risk sounding robotic or rehearsed. It's better to paraphrase, that way you also show that you understand the principles, rather than just say the names. 

ex. "You have to balance not harming the patient and respecting their medical wishes." 

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2 hours ago, PhD2MD said:

 

It's not regarded negatively, it's part of a very strong response IF you can learn to use the words in a way that doesn't sound artificial. There has been a pendulum swing/backlash against using them for the last little while because to many people use them very poorly, and it just makes people cringe and roll their eyes. Best thing to do is learn how to use them naturally, but if you can't consider avoiding naming them directly.

There is a backlash against using them because a lot of the MMI prep companies charge students money to teach them poor strategies ( such as the above mentioned strategy)... absolute rip off... This strategy erase the personality of the candidate because they just have to follow whatever script they are told to follow.

It is worrisome to me that these companies try to convince applicants that there is some formulaic way of approaching an MMI station that will maximize success. There is NOT!!  

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5 minutes ago, #YOLO said:

as a practicing physician wtf are the four pillars of medicine.

exactly.. beneficience, nonmaleficience, autonomy, justice.

A lot of people interviewing you will not understand what you are talking about if you start talking about non-maleficience...

Your interviewer will just think you are awkward and can't speak normally.

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3 minutes ago, medicine2019 said:

exactly.. beneficience, nonmaleficience, autonomy, justice.

A lot of people interviewing you will not understand what you are talking about if you start talking about non-maleficience...

Your interviewer will just think you are awkward and can't speak like a normal human being.

As someone that has interviewed and been on Adcoms I cant stress this enough. Make things flow and easy to follow. That plays such a big role. I want to feel like I can have a normal conversation with you. 
I remember we had some guy overcompensating about being passionate about a topic that he pretty much was yelling at us....we all red flagged him. 

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Thanks for the response everyone, so as I understand it is better to just talk naturally along the lines of the principles without explicitly forcing these terms in. I will keep that in mind, thanks!

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17 minutes ago, medicine2019 said:

exactly.. beneficience, nonmaleficience, autonomy, justice.

A lot of people interviewing you will not understand what you are talking about if you start talking about non-maleficience...

Your interviewer will just think you are awkward and can't speak normally.

You would never mention any of the principals without explaining what they mean in general and in the example at hand. So and interviewer not understanding shouldn't be a problem. Isn't this how they are going to teach us to approach ethical problems in medical school? I guess it is just difficult for me to understand why someone would regard it as unnatural. But it seems like that is the way some people feel about it. 

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On 2/10/2019 at 3:17 PM, medicine2019 said:

 Be careful about who you take advice from . You never know why someone was accepted into medical school. For instance, a person maybe in medical school because they have a Phd, or they have perfect GPA, or they have 7 publications ( and not necessarily because of their MMI performance). 

I naturally assume that you're referring to the PhD in my name, haha. I'm sure my PhD helped, but I also received compliments on my interviewing style at almost every school. I've also trained 30 applicants over the last couple of years as a side-hustle. 28/30 of my students were accepted, and all of them adopted my style of boldly using the ethical principals (when they fit naturally, obviously you can't ALWAYS incorporate them well). It could be that my sample is biased/confounded, but I'm just speaking from my/my students experiences.

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