Am I Answering The Prompts Properly?

[easytiger]

Ok, I'd like to start by saying that it's a little too easy for people critiquing your responses (myself included) to find things they don't like simply because your answers are written out. In a conversational style interview a lot of the things that have been pointed out might not really be that bad. However there are a few problems I have with this latest answer:

 

First, there's an incorrect assumption right off the bat. The prompt says your grandfather wants to have the procedure, and your first sentence is that he likely feels conflicted and doesn't want to be a burden. What this prompt is asking you to do is find out why your mom doesn't want him to have it, why your grandfather wants to have it, and get them to agree (mediate).

 

That bring me to my second issue. For a number of reasons, you shouldn't be suggesting that either the grandfather or mother go and do literary reviews on this procedure so they can become better informed. That is the job of a doctor, who then relays this information in an understandable manner to his or her patients. Or in this particular case, you, as the plucky young pre-med with an interest in health related research, could suggest doing this research yourself (you could then side note to insert an anecdote about how you love doing research projects just for fun in your spare time) and thus put yourself into a reasonably informed position from which you can then mediate this discussion on whether or not he should have the procedure.

 

There are some good points here as well, like ensuring he understands the risks associated with his decision, and the fact that he should have the right to make his own choice. Overall I'd say your answers are getting better. Keep it up!

[ArdentMed]

Thank you very much for the feedback. I definitely need to be more prudent when reading the questions before delving into an answer. Also, incorporating a side note on my past experience in research seems to be an excellent idea that I will definitely incorporate.

 

For the next prompt, I believe that my answer may be missing a possible viewpoint or alternative solution. What do you guys think? Thanks again for the feedback.

 

Prompt

You are a genetic counselor.  One of your clients, Linda, had a boy with a genetic defect that may have a high recurrence risk, meaning her subsequent pregnancies has a high chance of being affected by the same defect. You offered genetic testing of Linda, her husband, and their son to find out more about their disease, to which everyone agreed. The result showed that neither Linda nor her husband carry the mutation, while the boy inherited the mutation on a paternal chromosome that did not come from Linda's husband. In other words, the boy's biological father is someone else, who is unaware that he carries the mutation. 

You suspect that Linda nor her husband are aware of this non-paternity. How would you disclose the results of this genetic analysis to Linda and her family? What principles and who do you have to take into consideration in this case?

 

Pros

-As a medical professional, our job is to ensure the utmost quality of care for our patients. This includes psychosocial care. Although it would be immoral to hide the finding that the son does not belong to the father, it does not need to be hyperbolized.

-We do not yet know whether the father has had previous knowledge of the situation. He may very well be aware of past partners. This ambiguity provides all the more reason to use calm resolve to present the findings of the disease and treatment options and leave the interpretation of the information of the boy’s genetic heritage to the family.

-At the same time, empathy must be expressed. When the couple does show a reaction, we may consider offering a re-test or alternative tests in the case that the results were possibly a false-positive.

-To accomplish this, we could consider presenting all that is known about the disease itself based on past literature. In passing, it may be mentioned that the origin of the boy’s gene is unknown. However, it should not be delivered in an emotionally charged matter.

 

Cons

-Once again, psychosocial health is vital and must be preserved for the mother, father, and boy. If the father was unaware of the fact that he may not be the father, potential disputes may result and the family structure may become perturbed. This, however, is out of the scope of the physician’s care. Indeed, this is a difficult decision.

-It would be preferable for the boy’s psychosocial wellbeing to frequently see both his mother and father when growing up. Discuss options that the couple might have such as psychological counseling if needed. These are decisions that the patients themselves may decide on.   

-(Discuss the negative effects of single-parent homes and a recent experience volunteering at a low SES Elementary School.)

 

Decision

-Before considering presenting the fact that the boy’s paternal lineage differs, prudence must be practiced in order to prevent a calamitous end result. In other words, we do not know how the father or mother would react to the revelation. It would be best to remove emotionally charged phrases from the conversation and present the findings in an evidence-based manner that is all the same sympathetic and not aloof.

-We must express empathy and compassion when discussing the information and treatments for the child. The interpretation and decisions that result from the information are for the patients to make.

[crystal93]

I scrolled through some of the previous posts, so I haven't read all of them, but I had a few things to add -

 

The majority of questions are not medically-related and don't focus on medical ethics/ethics of healthcare in general - I've done 8 MMIs (not med though, for PT and OT) . I recall someone posting about that earlier, and I just wanted to reiterate how true it is. While it's a pro for an applicant to be knowledgeable regarding such issues, it's not required. In medical school you'll be taught medical ethics. I did practice many medically-related MMI questions, but I also did a lot of creative MMI practice and situations where you're with an actor/s.

 

MMIs are more for evaluating your soft skills and seeing how you demonstrate the essential competencies of that healthcare profession 

[crystal93]

The feedback you've been receiving so far is great and very helpful - I didn't mean to imply that this thread isn't beneficial. You'll be extremely prepared for medically-related questions and know how to structure answers  Just keep in mind that there are so many different types of MMI questions, and that admissions wants to see how you think on your feet. Best of luck with your preparations!

[nbgirl93]

I've done 4 MMIs and would also agree that there aren't an overwhelming number of these super medically-relevant scenarios - I had acting stations, collaborations with another applicant, as well as some really strange (seemingly completely unrelated to medicine) scenarios. Like the kinds of MMI practice questions you see and think "ok this is dumb I'm not wasting my time on this question." They do exist and you'll more than likely get one or two per MMI. So it's worthwhile to practice some of the more "out there" questions because they'll throw everyone off and you can make yourself stand out by having already practiced similar scenarios 

[ArdentMed]

I've done 4 MMIs and would also agree that there aren't an overwhelming number of these super medically-relevant scenarios - I had acting stations, collaborations with another applicant, as well as some really strange (seemingly completely unrelated to medicine) scenarios. Like the kinds of MMI practice questions you see and think "ok this is dumb I'm not wasting my time on this question." They do exist and you'll more than likely get one or two per MMI. So it's worthwhile to practice some of the more "out there" questions because they'll throw everyone off and you can make yourself stand out by having already practiced similar scenarios 

Would you happen to have a list of these types of questions? I have compiled all of the sample MMI questions from universities across Canada and am answering 1-2 per day in a timed setting (1:15 seconds to prepare and 7:40 to write).

 

Thanks for the feedback, guys.

 

Here is another prompt that I answered today. I am incorporating soft skills as opposed to knowledge as suggested. Any thoughts?

 

Prompt

A woman enters the emergency room with stomach pain. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm. The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. The woman is an exotic dancer; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. Even after much pressuring from the physicians, she adamantly refuses surgery. Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. They anesthetize her and surgically repair the aneurysm. She survives, and sues the hospital for millions of dollars.  Do you believe that the physician's actions can be justified in any way?  Is it ever right to take away someone's autonomy? 

 

 Cons

-The choice of life and undergoing surgery is for the patient to make. The physician’s duty as a health practitioner is to ensure the utmost quality of care for the patient. But care in itself encompasses a vast array of factors. In performing the surgery, did the surgeons truly exhibit “care”? Perhaps physically, they saved the patient’s life. Yet, from a psychosocial standpoint, perhaps the patient’s quality of life was lowered after receiving the surgery. She may have felt violated and her capacity to decide for herself was taken away from her. The surgeons did not act with all variables in mind and this does not exhibit the role of an ideal physician who should be considering all social factors of health before making a decision of this caliber.

-The mental health of the patient actually may have suffered after the surgery. The post-surgical anxiety and stress that may ensue was detrimental to her health. 

-“Feeling” that the women was not in the right state of mind is not enough to impose surgery on the individual. Metrics were not applied and no legal documentation transferred the women’s’ capacity to decide to the surgeons. An ideal physician would respond with empathy and compassion to the situation and consider the possibility that, although the patient states her uncertainty about the surgery due to it affecting her job, that there are unvoiced thoughts that have not been communicated.

-(Relate to experience at senior care home – many seniors had do not resuscitate orders and chose their own fate irrespective of the physician’s decision).

 

Pros

-One may argue that the surgeons saved the patient’s life despite the 50% mortality rate. However, regardless of whether or not one believes that the duty of the physician is to preserve life, a decision entailing a 50% mortality rate should not be taken lightly. The surgeon’s may have potentially expedited the patient’s death since the timing for the aneurysm’s occurrence is unknown.

-This question begs a question similar to one raised by the debate over euthanasia, how much control does the patient have in deciding their fate? Euthanasia is, indeed, legal in countries such as Sweden but outright banned in others. This demonstrates the disparities in decision-making capacities given to the patient in various countries. If a patient is given complete choice in the matter, then there may be a scenario where they lack choice entirely as well. Clearly, just as euthanasia is a contentious matter and is only allowed in certain countries, the scenario is also a difficult decision to make as laxity of laws differ between nations.

 

Decision

-The choice of preserving one’s own life is one that the patient themselves should have a say in. Regardless of one’s opinion on the matter, the surgeons overlooked far too many factors. The patient’s psychosocial state, worries, and anxiety over the surgery may not have been fully considered or communicated. Even from a biomedical standpoint, the decision to operate with a 50% mortality rate was also questionable. Ultimately, the patient’s actions were unconscionable. Unless the surgeons had a proven metric for measuring the patient’s inability to make her own decisions, then taking away her autonomy was also questionable.

[next.med88]

Would you happen to have a list of these types of questions? I have compiled all of the sample MMI questions from universities across Canada and am answering 1-2 per day in a timed setting (1:15 seconds to prepare and 7:40 to write).

 

 

 

I definitely think its smart that you are not using the full two minutes to think of an answer because typically you won't get the full two minutes to prepare since you need time to walk from room to room.

However, you should start practising speaking and not writing. You can film yourself talking. This is because writing is very different than speaking out loud, I find that when writing I can organize my answer better (at least for myself anyways), additionally, writing may take longer then actually talking so you can get a better idea of the timing of your answers!

[_ _]

I definitely think its smart that you are not using the full two minutes to think of an answer because typically you won't get the full two minutes to prepare since you need time to walk from room to room.

However, you should start practising speaking and not writing. You can film yourself talking. This is because writing is very different than speaking out loud, I find that when writing I can organize my answer better (at least for myself anyways), additionally, writing may take longer then actually talking so you can get a better idea of the timing of your answers!

.

[_ _]

I definitely think its smart that you are not using the full two minutes to think of an answer because typically you won't get the full two minutes to prepare since you need time to walk from room to room.

However, you should start practising speaking and not writing. You can film yourself talking. This is because writing is very different than speaking out loud, I find that when writing I can organize my answer better (at least for myself anyways), additionally, writing may take longer then actually talking so you can get a better idea of the timing of your answers!

I second this! 

 

Writing is totally different than speaking, and may be either much easier or (commonly) more difficult to do effectively in a high-pressure situation. I wouldn't suggest practicing any more writing because it's largely irrelevant to the actual interview.

 

One smaller step would be to video yourself talking, then work up to practicing with people. Ideally find people you aren't super comfortable practicing with (i.e., not your roommate or partner)

 

The bright side is you can make a mediocre answer sound fantastic if you are a good public speaker/interviewer

[ArdentMed]

I second this! 

 

Writing is totally different than speaking, and may be either much easier or (commonly) more difficult to do effectively in a high-pressure situation. I wouldn't suggest practicing any more writing because it's largely irrelevant to the actual interview.

 

One smaller step would be to video yourself talking, then work up to practicing with people. Ideally find people you aren't super comfortable practicing with (i.e., not your roommate or partner)

 

The bright side is you can make a mediocre answer sound fantastic if you are a good public speaker/interviewer

Do you have any public speaking tips for the MMI?

 

Thanks for the feedback, guys.

[jfdes]

Could also speak and record, then transcribe a summary here if you want feedback from the forum

[ArdentMed]

Hey guys. Thanks for the feedback. Any more feedback for this new prompt? I will consider recording them and posting them from now on.

 

Prompt:

A couple has decided to have a child through artificial insemination. They asked the physician for sex selection of the child. What should a physician advise in this situation? 

Immediate decision: The physician, being a health professional, should remove himself from imposing judgment on the couple and perform his duties while informing the couple of any negative repercussions of sex selection.

 

Pros:

-The physician must be compassionate and view the situation from the couple’s standpoint. Perhaps they have a vision of an ideal family that suits their lifestyle. Whether that entails a boy or girl in their lives is a personal matter and as a professional, the physician must seek to improve the psychosocial health of his patients. If the patients are enraptured by the prospect of a child with their preferred gender, then that will improve the quality of life for the patients from a psychosocial standpoint.

-As a health advocate, a physician must be culturally aware as opposed to ethnocentric. Perhaps certain cultures have a preference for a certain gender for the child. To criticize the couple would mean to marginalize a culture which, in the long term, has stark health implications. I have read somewhere that Aboriginals suffer from a chronic disease rate (ie: diabetes) that is double the national average in Canada. If sex selection is based on cultural reasons, we would be overlooking an important social determinant of health by refusing to perform sex selection.

-A professional physician must fulfill his role as a compassionate health professional and avoid imposing judgment on the couple. Sex selection may understandably conjure controversy due to destroying cells in the process. But the professional must fulfill his patients’ wishes without holding judgment against them. Any personal objections should be repressed and only objective information or information that is to the patient’s benefit should be conveyed.

 

Cons:

-Other arguments may state that the definition of life if controversial and a fetus would have potential formed a full human. If the physician, however, has qualms with the controversy over sex selection, he may consider referring the couple to another professional.

 

Decision:

-The physician should respect the wishes of the patient or refer them to another professional accordingly. Information provided to the patient should be objective or inform them without involving the physician’s own sentimentality about a situation.

[InstantRamen]

Hey friend .

 

-As a health advocate, a physician must be culturally aware as opposed to ethnocentric. Perhaps certain cultures have a preference for a certain gender for the child. To criticize the couple would mean to marginalize a culture which, in the long term, has stark health implications. I have read somewhere that Aboriginals suffer from a chronic disease rate (ie: diabetes) that is double the national average in Canada. If sex selection is based on cultural reasons, we would be overlooking an important social determinant of health by refusing to perform sex selection.

 

Decision:

-The physician should respect the wishes of the patient or refer them to another professional accordingly. Information provided to the patient should be objective or inform them without involving the physician’s own sentimentality about a situation.

 

First off, I love how you wanted to see the scenario from the parents perspective. Informing them about the risks of their choice is awesome! Keep it up! I think cultural sensitivity is a very important aspect of the question, but I don't understand the relevance to the Indigenous population. Perhaps talk about how China and how there is preference for male children there. Are we denouncing their cultural norms? (Also, side note: perhaps gene selection can reduce cases of child abandonment, which actually happens in places that prefer a specific sex.)

 

Another point to add would be that some genes are sex specific. Perhaps the parents had the intention of ensuring that their child would not have a specific gene that could greatly impact the child's life. Though many living with disability/disease have very happy and fulfilled lives, it is a tough life to live. So if we can select the gene out to improve quality of life, why not? 

 

That being said, gene selection is a contentious issue... Before advising the patients, these thoughts would run through my head.

 

Indirect discrimination against specific gender? Are we perpetuating an unintentional message that a culture should favour one gender over another? (Can you tell I'm a feminist?)

 

Slippery slope of creating designer babies. Are we going to be selecting only for sex? Or are we going to select for other genes in the future? (specific traits  which can potentially have undertones of discriminating against groups of people. Like I mentioned earlier, we could be getting rid of a disease or disability, but are we discriminating against a minority population? What are we saying about the people who are living as a specific gender or with disease/disability? are they less worthy of living?)

 

Does this have potential for large social injury? What will our society look like in the future if we are selecting sex/genes?

 

A lot of geneticists don't believe the world is ready for gene selection quite yet. 

 

IMHO, I think your decision is a bit hasty. I would probably do something similar. Listen to what they have to say and why they want a specific sex. Understand their perspective. Give them all necessary information and mention why gene selection is controversial. I would probably collaborate with an ethics board to see if this is a case where we can grant gene selection. Advocate for the patients if necessary!

 

That being said, its only my opinion. Can someone please chime in?

[ArdentMed]

Hello everybody, 

 

Thank you for the immensely insightful constructive criticism. I have been recording myself for the past few weeks as opposed to writing out responses for an increased sense of realism as recommended by a member. 

 

I have recently started preparing for the Casper test and was wondering how the criteria for these responses differ from the MMI's. 

 

Here is a prompt I recently answered. I incorporated the "if I do this, then the best/worst case scenarios would be" approach. I would appreciate your feedback. 

 

Summary of the prompt: Fellow group members refuse to continue working on a project because one of the group members purportedly has a bad "B.O." (scent). 

 

Response: 

1. If I were to tell them that I think their words would be insulting to the group member, the best case scenario is that they will realize the connotation of their words and approach a more subtle and collaborative approach. The worst case scenario is that I too may be insulted and they will refuse to work with me as well, which further threatens the progress made on the project.

-If I were to tell them that I will confront the group member, the best case scenario is that they may see me as an excellent collaborator, while the worst case scenario is they will become further polarized in their opinion and have justified their reason further to avoid working on the project.

-I would go with the first decision as the former does not insult a partner nor the progress of the project as much as the latter choice.

 

2. If I communicate my peers’ thoughts to Jenny with suggestions and questions that do not personally involve her (by avoiding “you are” statements), I may be able to convey the message to her without offending her. The best case scenario is she will understand the message without taking offence. If she attempts to read between the lines, she may become offended and become upset. I would opt for this decision regardless because even if she becomes upset temporarily, I can follow up with positive comments and strengthen the relationship.

 

3. For uncooperative group members, it is best to resolve conflicts while also viewing the situation from their point of view. The best case scenario is that they will feel more rapport with you and thus trust you more and will consider alternative approaches. The worst case scenario is group polarization and more uncooperatively. The latter should not occur so long as you are firm in your stance while also allowing for some flexibility to accommodate the opinions of others. 

[ArdentMed]

-Edited.