Medicine Interview Hot Topics: Organ Donation

​Key Information

Organ donation is the act of removing an organ from a body in order to transplant it into someone else who has a medical need for it. This is can be from one living patient to another (eg. a kidney from a parent to a child), but, more commonly, the organ is donated from a recently deceased body to a living person. In Northern Ireland and Scotland, this is only allowed if the donor had actively given consent when they were alive (by signing up to the national donor registry). This is called an opt in system. The family can also consent to organ donation on behalf of the deceased after they have died, if they are communicating the deceased’s wishes which they did not have time to put into writing before their death. In Wales however, everyone is automatically signed up to the organ donation scheme at birth, and must actively opt out if they do not want to donate. England followed Wales, and switched from the opt in system to an opt out system, which came into force 20th May 2020.

There is a significant shortage of organs available in the UK, especially because everyone has different tissue types. If the organ given is not a match for the recipient, it will be rapidly rejected, causing organ failure and possibly death. For this reason, it is of the utmost importance to find a match as close as possible to recipient for the transplant to be successful.

Potential questions which could be asked in the Interview

The interviewers can take two approaches to this topic, as it falls into two categories: current issues within the NHS or ethics of organ transplantation. All questions can be asked in both an MMI and traditional interview format.

  • Why is there a shortage of organs for donation in the UK?
  • What is meant by the opt-out system of organ donation, as found in Wales
  • Is the opt-out system of organ donation ethical?
  • Do you think that everyone should donate their organs after death?
  • To what extent does the family of the deceased have a say over their organ donation choices?
  • There are a limited number of organs available. How would you choose who do give organs to?
  • Can you name any country which has a live market for organs? (Hint: Middle East)

The classic example question involving organ donation is where you are presented with two people in different situations who both require the same organ, then asked who you think the organ should be given to.

How to Answer Questions involving Organ Donation

For questions which look at the current affairs surrounding organ donation, it is important to know the general rules about organ donation and systems of consent, as well as keeping an eye out for any news surrounding this topic leading up to your interview.

To answer ethical questions, once again, it is of utmost importance to use the four principles of medical ethics to formulate your answer. As mentioned in other articles, start with the four principles of medical ethics, justice, beneficence, non-maleficence and autonomy. Go through these one by one in your head and decide which ones are applicable to the question. For organ donation related questions, all of the principles can be addressed, and spoken about. Ensure that you lay out all of the arguments for both sides using the four principles to structure your answer. You can use these as the four main points for your answer, and then base your arguments around them.

To answer questions involving deciding between two organ recipients, it is important to speak about each person’s situation in depth in order to show the interviewer that you are methodical in reasoning. Ultimately, the organ should go to the patient who has the greatest tissue match, although often the scenario will involve both parties being an equal match. In these cases, the other factors should be considered, especially if there are young children relying on one of the potential recipients. As long as arguments are laid out clearly and both sides are presented, there is no right answer, and so you are free to choose whichever side you feel deserves the organ most.

How can this be used in a medical school interview?

The issue of organ donation will only come up should an interviewer directly ask you a question about it. However, these are common questions which are often used to test your knowledge of current affairs and decision making. If you are confident with these, they can prove your ability to weigh up different sides of an argument and impress the interviewer with your methodical thought process.

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