Key Points
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This question tests both your understanding of ethics and professionalism, as well as your background research into how these factors contribute to Medicine. You should explain the importance of confidentiality thoroughly, before explaining the times when it may be permissible to break confidentiality.
​Example Answer
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‘Doctor-patient confidentiality is enshrined in law, and benefits both individuals and the society that they live in, through providing them with the confidence to seek healthcare, and be truthful in telling their exact symptoms, without fear of the information that they provide being told to others. The flipside of this is that it helps doctors too – they can be more sure that patients are not withholding information, and therefore more certain in their diagnosis and treatment plan. However, there are instances where a doctor may have to breach confidentiality, in the interests of the public good. This may be at the request of a court order, or to prevent another serious crime, like the abuse of a vulnerable person. However, a doctor should first try to persuade the patient to disclose relevant information of their own accord – a typical example being a doctor that sees a patient drive into their car park, despite knowing that they are medically unfit to drive. In this instance, the doctor should try to persuade the patient to contact the DVLA first and foremost. Another common example is a patient refusing to tell their (known and identified) partner that they have a serious sexually communicable disease, like HIV/AIDS. If a doctor must breach confidentiality, they should inform the patient that they are going to do this, to maintain trust as far as possible. Dealing with confidentiality in children and young people is difficult, and revolves around if they are deemed competent in law (called Gillick Competence). Situations that a younger person might be in that might see their confidentiality be broken include suspected child abuse, or a childhood pregnancy under the age of 13 .’
Key Points
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You should understand the GMC and its role, as well as having read their guidance on Good Medical Practice in detail. You should remember that the GMC is designed to protect patients, not doctors – something many people may misunderstand or forget.
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Example Answer
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‘The GMC is the UK’s regulatory body that protects patients and designs the framework within which doctors operate. It does this through the following principle areas. Firstly, it establishes which doctors are qualified to practice within the UK, through managing the Medical Register of more than 300,000 doctors. Secondly, it sets standards for doctors – values, knowledge, skills and behaviours that are required of all UK doctors. To set these standards they will speak to patients, employers, doctors and educators. Thirdly, the GMC oversees UK medical education and training. This involves setting standards for each university, and monitoring that the training at each reaches these standards. Fourthly, the GMC manages a process called revalidation – this is the system through which every licensed doctor must keep their skills and knowledge up to date. Doctors have an annual appraisal, and every five years a senior doctor will inform the GMC if their juniors are keeping up to the standards expected or not. Finally, the GMC will ‘investigate and act on concerns about doctors.’ In the most extreme instances this can mean removing a doctor from the register. I understand that the role of the GMC changes and evolves over time, to reflect what is necessary to keep patients safe and doctors working well and healthily as the world changes too.’Â
Key Points
You should focus on a few reasons, rather than many. Fashion these reasons into one coherent answer that encompasses the process of you realising you wanted to become a doctor. Ensure that you show that your motivation has been developed through research and experience. Make sure you personalise your answer to an extent, but don’t try too hard to deviate from the norm.
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Example Answer
‘My initial interest in Medicine was sparked by my interest in the Sciences, and specifically through an essay competition in which I wrote a piece on the future of healthcare, in conjunction with a charity that I had volunteered for. I realised at that point how diverse the field of Medicine is, how one must combine skills and knowledge from core sciences, epidemiology, public health, sociology, psychology and many other domains to succeed. It’s a profession that will continue to push the frontiers of each of these fields, meaning that I will have to learn throughout my life to keep on top of the range of advances. I was fortunate enough to shadow doctors in a range of specialties, and saw first hand the impact of new technology on patient care in cardiovascular medicine and radiology. Having the chance to learn throughout my life, and through that learning to dedicate myself to improving others’ situations, is the most rewarding path I could choose to follow.’
Key Points
You should show that your choice of medical school is as much down to an understanding of their curriculum and university’s ethos as it is about an understanding of your own learning style and how you will succeed. This means that you should link the facts about the medical school (which are easily discovered online, and therefore will not serve to separate your answer from others) to your own attributes and characteristics.
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Example Answer
‘Through speaking to current students I learnt that the university truly emphasises early patient contact and the importance of learning consultation skills from the outset. With my breadth of experience across different charity roles I’d like to ensure that I continue to speak with and interact with the community from the earliest possible stage of my medical education. The university also clearly places a greater emphasis on PBL than other universities in the UK do, which fits with my learning style – I learn well in groups, and find the teamwork element also suits my personality – I’ve led winning teams in sports and science competitions throughout school.’
Key Points
Whilst universities may offer a greater or lesser degree of PBL, a more ‘traditional’ approach or a more patient-focused approach from the outset, you should still be realistic and understand that there is likely to be a mixture of learning environments from the outset. This question therefore is designed to check if you have experience of learning in each different way, and appear well-informed and eager to take on the challenge that is a medical school curriculum. The below answer assumes a course that is mainly lecture orientated at the outset, with some PBL, a strong self-directed learning component, and early patient contact.
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Example Answer
‘I believe that each of PBL, traditional lectures, and self-directed learning have their place in tuition – and that patient contact is crucial to anchoring each of these. From speaking to current medical students and doctors, I understand that varied learning environments best replicates what one would expect as a doctor in the future, when one must continue to learn and grow. Having lectures as the foundation of a curriculum ensures that all students have the same level of overall guidance – in a more traditional course like this I would see it as the scaffolding on which to build the rest of the curriculum. I relish the opportunity of developing a strong foundation in the sciences and relevant clinical knowledge through lectures taught by world-leading academics here, and from my own experience in school find it easy to digest material learnt in this way. However, it’s important that students are not ‘spoon-fed,’ meaning that PBL and self-directed learning are vital too. This is because a student must have some freedom in their learning, to identify what they need to focus on, or are genuinely interested in learning more about. Throughout school I have shown my ability to learn independently and lead others in learning, both through organising study groups and taking on academic challenges like essay competitions and research projects. Early-patient contact will allow us to understand information that we learn in real-world contexts, helping us to understand its application from the outset. It will also allow the development of crucial communication skills – and other soft skills – that are necessary to work as a doctor. I will succeed in a mixed learning environment because I will embrace the challenge, understand the role of each component, and have proven my ability in each area already.Â
Key Points
You should take this question as a great chance to show the extent to which you have already engaged with the field of Medicine. Avoid simple descriptive terms like ‘fascinating’ that offer little in the way of evidence of your experience or motivation. Try to link your interest in the scientific underpinnings of Medicine to clinical interests or experiences that you’ve already had.
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Example Answer
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‘The aspect of Medicine that I have found most interesting thus far – and there are many to choose from – is the diagnostic process. The way in which an error in the most basic processes within the body can be detected by a physician, through something as simple as a history or examination, to me perfectly encapsulates the beauty of Medicine. The physician is trained to understand the science, to be able to read symptoms and signs, and then of course to treat. This was best illustrated during my work experience when a doctor who worked in orthopaedics that I was shadowing noted jaundice in a patient, and upon examining further noted ascites in addition. Despite working in orthopaedics, he was quickly able to note signs of liver damage likely due to cirrhosis. The fact that he was able to deduce this, and that he understood the pathogenesis of cirrhosis through activation of hepatic stellate cells causing fibrosis – despite this being far from the field in which he now worked – made me immensely interested in the core diagnostic process which all doctors share to an extent.Â
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Whilst this question might seem difficult, you should treat it as an opportunity to show an understanding of the work of doctors, and an understanding of and appreciation for the work of nurses simultaneously. You should use your personal experiences to illustrate your answer. Be careful not to undermine the important work of nurses, and keep in mind that nurses and other MDT members are often present on Medicine Interview panels.
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Example Answer
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‘I am primarily motivated by a desire to have a full understanding of, and responsibility for, the process of treatment. Throughout my work experience I have been lucky enough to encounter both doctors and nurses who were excellent in their fields and hugely helpful to me in helping me to choose my career. However, the longer duration of a medical course, and the extent to which one must study beyond the degree, illustrates that a doctor must learn more of Medicine than a nurse. I relish the chance to learn the science of Medicine for two years before I begin to properly apply that information to clinical environments – and I likewise relish the chance to spend as much as ten years after graduating on honing my craft, becoming truly knowledgeable in one specific area of Medicine. I do not believe that a doctor is always the leader; I think in today’s Multidisciplinary Team there are a range of leaders, and nurses are often leaders too. However, from my own experiences at my local hospital, I have seen MDTs discussing cancer care. In each, there were multiple doctors who had input that clearly was taken into account when deciding on the direction that care should take. These were radiologists, and multiple oncologists including surgeons and medics. I believe therefore that a doctor will have the final responsibility and oversight on the direction that a patient’s care should take. However, I am aware that it is nurses who will take on much of that patient’s care, and who may be largely responsible for their perception of their care, and the system of care we have in place in the UK.
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The academic breadth, along with ultimate responsibility, are my primary drivers. However, I also believe it easier to transition into public health or leadership roles from Medicine than from Nursing, and I understand that there are a greater range of specialties that may be explored in depth in Medicine than in Nursing as well.’Â
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This question is an opportunity for you to show the range of experience you have gained, the discussions you have had with doctors and medical students, and reading that you have done around how healthcare is now delivered. The answer, of course, is ‘very important,’ and everyone will know this – to illustrate your answer and expand on it will spell success with this question.
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Example Answer
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‘It goes without saying that teamwork is completely vital to Medicine. Without teamwork it would be impossible to deliver high quality patient care. I have seen firsthand through my work experience the importance of teamwork in patient care, when doctors from different specialties would meet at MDTs to discuss patients whom they all had input for. This was especially relevant for oncology patients, but I also saw MDTs to discuss certain patients in geriatrics. In both, it was clear that only through combining their expertise could the doctors provide the best care. Of course, today healthcare is provided by a wide range of different team members – doctors, nurses, and allied health professionals. Allied health professionals include occupational therapists, nurse practitioners, and even physician associates, who are able to take on many of the jobs that previously would have been done by doctors. I spoke to one senior doctor who had a leadership role at my local hospital, and she explained that with increasing patient numbers in her trust, budgetary limits and an inability to hire more doctors, allied health professionals could soon become the backbone of her hospital’s ability to provide care. I believe that teamwork is essential to trauma and emergency care as well as care through longer term admissions, with paramedics, nurses, and doctors having to work together at high speed and under great stress. Finally, teamwork is crucial for medics – and other healthcare professionals – as they learn on the job. It is the responsibility of seniors to look out for the juniors on their team, and help them to learn the vital skills needed to care for patients and go on to take senior roles in the future. Â
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This question isn’t designed to trick you; you shouldn’t look to provide a detailed overview of empathy or the psychology behind it – just explain a time that you showed empathy, what that meant, and how it could translate to your future medical practice.
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Example Answer
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‘Whilst volunteering at a care home, I noticed that one of the residents had become very upset after lunch one day. It seemed the staff were too busy at that moment to speak to him, so I asked to be given a break from my duties for 20 minutes so that I might speak to them. It turned out that the lunch that had been served was his wife’s, and his, favourite meal. His wife had passed away a few years previously. He had clearly been trying his hardest not to show grief in public for quite some time, and this small event had pushed him over the edge. Indeed, I had noted that he was always quiet and withdrawn, so I found it surprising at first to see such a show of emotion from him. I spoke to him about his wife, and explored some of his memories with her. I explained that I thought he was brave to continue without her, and to carry her memory with him. I explained that he could always speak to me about her if ever he wanted, and that I was sure the other staff members would be happy to speak to him too. Over the next few weeks we established a bond, and I was happy to see him come out of his shell, and talk to other residents more. Through this experience I learnt the importance of empathy – of how it can help others to speak, and how it can help them feel listened to. A good doctor must show empathy, as patients will only share if they feel understood. I look forward to treating patients holistically, and doing my utmost to understand them and their concerns, in my future practice.’
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