Advice & Insight From Interview Specialists
We have compiled a list of 100 ethical scenarios and questions from MMI interviews at Medical Schools in the UK, US, Canada and Australia.
For additional MMI Interview Scenarios and model answers, review our Medical School Interviewer Approved MMI Question Bank.
Birth Control
A 14-year-old patient requests birth control pills from you and asks that you not tell her parents. What would you do?
Alternative Medicine
A member of your family decides to depend solely on alternative medicine for the treatment of his or her significant illness. What action would you take, if any?
You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of bruises on the boy’s torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as “Cao Gio,” which is also known as “coining.” The procedure involves rubbing warm oils or gels on a person’s skin with a coin or other flat metal object. The mother explains that Cao Gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy’s back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. When should a physician step in to stop a cultural practice? Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine?
Dr Blair recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr Blair doesn’t believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches because he believes that it will do no harm, but will give them reassurance. Consider the ethical problems that Dr Blair’s behaviour might pose.
Justice & Public Health
A Vancouver biotech company was hired by the US Military to develop a cure for Ebola. They successfully developed a vaccine to treat the symptoms of the virus and lowered the mortality rate for infected patients. Discuss the implications of this on a global scale.
Discuss the ethics of treatment resources being used on patients who knowingly ignore public health advice on smoking and exercise.
Genetic Counselling
You are a genetic counsellor. 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 carries 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 neither Linda nor her husband is 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?
Transplants
If you have the choice of giving a liver transplant to a successful elderly member of the community and a 20-year-old drug addict, who would you allocate the organ to? And what factors would influence your decision?
You have a patient who was a chronic alcoholic and wants a liver transplant. Would you add this patient to the transplant waiting list?
Would you give a liver transplant to an alcoholic?
Autonomy & Consent
An eighteen-year-old female arrives in the emergency room with a profound nosebleed. You are the physician, and you have stopped the bleeding. She is now in a coma from blood loss and will die without a transfusion. A nurse finds a recently signed card from Jehovah’s Witnesses Church in the patient’s purse refusing blood transfusions under any circumstance. What would you do?
Is it ever okay to lie to a patient?
Your mother calls you and asks you to help with a major family decision. Your maternal grandfather is 70 years old and has been diagnosed with a condition that will kill him sometime in the next five years. He can have a procedure that will correct the disease and not leave him with any long-term problems, but the procedure has a 10% mortality rate. He wants to have the procedure, but your mother does not want him to. How would you help mediate this issue?
How would you handle a situation as a medical student if an attending physician demanded (at the risk of you not getting your first choice residency program) that you take pictures of a patient for a research paper without getting approval from the patient?
The Canadian Paediatric Association has recommended that circumcisions ‘not be routinely performed’. They base this recommendation on their determination that ‘the benefits have not been shown to clearly outweigh the risks and costs’. Doctors have no obligation to refer for, or provide, a circumcision, but many do, even when they are clearly not medically necessary. BC Medicare no longer pays for unnecessary circumcisions. Consider the ethical problems that exist in this case. Discuss these issues with the interviewer.
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 anaesthetize 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?
You have a patient who just lost his wife and found that he has prostate cancer but refuses treatment. His family is begging you to force him to have the treatment done. What are the main ethical issues in this scenario?
Would you tell someone they have a debilitating disease (e.g. cancer) even if their spouse begs you not to because it would crush them because a relative died of the same disease previously?
You recommend chemotherapy for your teenage cancer patient, but his mother refuses treatment because she’s afraid chemotherapy will make him sick. What action would you take, if any?
A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who understood the procedure. Can the patient give consent?
A 17-year old boy lives independently. He is married and has one child. He wants to participate in a medical research study. Does he need his parents’ permission?
A 12-year old boy is diagnosed with a terminal illness (e.g., malignancy). He asked the doctor about his prognosis. His parents requested the doctor not to tell him the bad news. What should the doctor do in this situation?
A patient with Down’s syndrome became pregnant. The patient does not want an abortion. Her mother and husband want the patient to have an abortion. What should a physician do in this situation?
Would you tell a terminally ill patient the stark reality of their condition or be optimistic?
Learn the best interview strategies and practice with past interview questions & model answers.
Sex Selection
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?
Conflict of Interest and Bias
A physician became sexually involved with a current patient who initiated or consented to the contact. Is it ethical for a physician to become sexually involved?
What kind of relationship should exist between pharmaceutical companies and physicians?
What is your opinion on a patient giving their doctor gifts for work performed?
Responsibility for / to Patients
You’re a family practitioner who is seeing a 75-year-old woman in your practice. She reveals to you that she’s being physically abused by her husband. What do you do?
A physician went on vacation for two weeks. He did not find another physician to cover him. One of his patients with hypertension developed a severe headache. The patient has an appointment with the doctor as soon as he comes back from vacation. The patient did not look for another physician and decided to wait. The patient suddenly collapses and was diagnosed to have an intracranial haemorrhage. Is the physician responsible for this patient?
A physician picked up a car accident victim from the street and brought him to the ER in his car. He did not want to wait for an ambulance because the patient’s condition was critical. Physical examination in the ER reveals quadriplegia. Is the physician liable for this consequence?
There is an outbreak of an incredibly contagious life-threatening disease. The disease is spreading across the country at a rapid rate and the survival rate is less than 50%. You are a senior health care administrator, and when the vaccine is developed, you have priority to receive the drug. Do you take the vaccine yourself or give it to another person? Why or why not?
A mother brings in her 12-year-old son and says he is very ill and needs a note to excuse him from school for the next few days, but when you examine him you elicit no abnormalities. Explain your actions in this scenario.
A patient is suing another doctor for medical malpractice and comes to see you; would you treat that patient and how would you deal with them?
In 2007, The American Family Physician Journal published an article exploring the issue of physicians as role models, using a scenario in which an obese physician is offering nutrition and exercise counselling to his obese patients. According to the authors’ research, patients have more confidence in the health-counselling advice of non-obese versus obese physicians, and physicians with poor personal lifestyle habits are less likely to counsel patients about a healthy lifestyle. Based on these research findings, do physicians have a responsibility to act as healthy role models to their patients? Please elaborate.
Follow Up Probing Questions:
Is a physician who does not follow a healthy lifestyle employing a double standard when they are providing lifestyle-counselling? Explain.
Do you think that there is a difference between unhealthy lifestyle habits which manifest themselves more visibly than others (e.g. smoking or alcohol consumption)? Explain.
What determines whether or not another person is a role model? Who decides and why?
What are the limits of this responsibility?
Do you have any additional comments before we end this discussion?
Do you think that asking people to donate their tissue to a lab is coercive?
An 80-year-old terminally ill man calls you up to tell you that he is going to take a lethal dose of painkillers. He has called you to tell you that you have been a great doctor and many thanks. How do you handle the situation?
You’re a practising paediatrician and a mother brings in her little boy who’s about six and is very sick. Just after you get them situated in an exam room, an administrator comes to you and says that they are illegal immigrants, have no insurance, your clinic has met its quota of Medicaid and Medicare patients for the month and you can’t afford to treat the boy. What do you do?
Safety of Others
As a physician at a local hospital, you notice that there is a man with an alcohol dependency who keeps on consuming the hand sanitizer offered at the hand sanitizer stands throughout the hospital. He is not a patient at the hospital at present but has been many times in the past. Consequently, there is often no hand sanitizer for public use. What do you do? Do you remove/change the location of hand sanitizer stands? Do you approach him?
Have you ever had to report something to an authority about someone who was acting in an unethical or unlawful manner?
You are a health researcher at an academic institution. You have been asked to work on a top-secret vaccine that would treat biomedical weapons or other communicable diseases. Before your breakthrough, you are instructed by the government to stop all research and turn over all materials and copies of your work to be destroyed. You know you are very close to finding a cure. What do you do?
Transmissible Disease
An 18-year old man is diagnosed to have suspected bacterial meningitis. He refuses therapy and returns to the college dormitory. What should a physician do in this situation?
Healthcare Workers & Strikes
Is it ethical for doctors to strike? If so, under what conditions?
Substance Abuse Issues
A patient requests needles and syringes at his/her local pharmacy. They do not present with a prescription and based on the records you can access, they are not receiving treatment for diabetes. Do you sell the syringes or not?
Plagiarism & Cheating
Every week, your classmates gather at the local coffee house to review the lessons from that week. In the last month, everyone has been working on a major paper on Roman history which accounts for 40% of the course grade. One of your classmates has copies of two of the papers that last years’ students wrote for the same course. Your classmate has emailed copies of the papers to you and the other people in the group.
What would you do in this situation and explain why?
Follow Up Probing Questions:
Discuss what values and choices are relevant in this situation?
What are the implications if you decide to read the papers from last year?
What are the implications if you decline the offer to read the papers from last year?
What would you do if one of the classmates decided to draw upon the material from the two papers in developing their submission?
Do you have any additional comments before we end this discussion?
You’re a pre-med student and have been studying for your biochem exam until midnight. You come back to your dorm room and your roommate tells you that she has decided to cheat. What do you do?
How would you react if you discovered a classmate cheating?
Euthanasia
Would you ever perform euthanasia?
Would you prescribe a lethal dose of morphine to a patient who was terminal if requested?
What is your opinion on euthanasia?
What is your opinion on physician-assisted suicide?
Your patient is on a ventilator and wants to have it removed even though he won’t live without it. How would you manage this scenario?
A woman has expressed the past that she never wants to be on a breathing machine. Three months later, she must go on a breathing machine or die. You get her to try it for a week. After six days on the machine, she is progressing positively and she wants the breathing machine removed. You are not certain that she is ready, but she wants it done now. What do you do?
How would you go about making the decision on whether or not to discontinue life support for a brain-dead patient?
You are caring for a terminally-ill patient and he repeatedly asks you for medication in surplus to his actual weekly requirement. You suspect that that he has been storing them up and is going to take them to end his life. How would you address your concerns?
Abortion & Birth Control
Suppose you are against abortion. I am a 15-year-old girl and I come to your office asking for an abortion. What do you say to me?
Given your faith, you are opposed to abortion. A 14-year-old girl comes to you requesting the procedure. What action would you take?
Suppose you have two teenage daughters and one of their 15-year-old friends comes to you as a physician asking for birth control without parental consent. What would you do? What would you do if her mother finds the pill pack with your name on it and angrily confronts you about it in the supermarket?
What would you do if a woman with two children came to you and asked for a tubal ligation (fertility management); she requests that you do not inform her husband.
Animal Testing
What is your response to people who say that all use of animals in experiments is wrong and unethical?
What is your opinion on animal research and testing in the medical field?
Stem Cell Research
Stem cell research has generated heated debate. What are the pros and cons of this issue?
In the current age of Medicine, should stem cell research be supported?
Miscellaneous
What do you think is a big ethical issue facing people today?
How do you express your opinions on controversial topics such as abortion, euthanasia, physician-assisted suicide and cloning?
It’s the end of the world and you can save two people (from a given list of 10) who would you choose and why? What sort of information about these people might change your mind?
A serial killer is moving in next door after being released from his sentence. What are his rights and what are your rights in the community?
Is cloning acceptable under any circumstances?
If it’s survival of the fittest, why even bother to work to save people who are impoverished or who are sick abroad?
Discuss an ethical dilemma that you have experienced.
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