Scenario 1 : A fifth year medical student is apologising to a patient due to an admissions error they have made. The patient becomes extremely angry and begins to physically confront the patient.
Response: Remove yourself from the situation and prioritise your own safety.
Answer: A very appropriate thing to do.
Reasoning: Doctors are justified to end consultations in accordance with the NHS non-physical assault policy if they feel that the patient’s behaviour is escalating. If a conversation begins to escalate the doctor should position themselves near the door and leave if necessary.Â
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Scenario 2: A receptionist informs you a doctor completing your specialty training that they smelt alcohol on the breath of their consultant. Yesterday the doctor wrongly administered a patient’s medication, and you are increasingly concerned they may be putting patients at risk.Â
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Response: Report to the consultant to the GMC
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Answer: Appropriate but not ideal
Reasoning: In this scenario the best approach is to consultant advice from the GMC without disclosing the personal information and inform the Primary Care Trust. The GMC will provide confidential advice. This response would prioritise patient safety, however the complaint should be handled locally by the Primary Care Trust where the doctors’ employers can decide on their fitness to practice. This can then be escalated to the GMC by this body if necessary.
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Scenario 3: You are a fourth year Medical Student consulting alone in General Practice. The patient explains how their medication has terrible side effects. When discussing potential treatment plan options, the patient asks you if you would stop taking the lifesaving medication they are on if you were in their position?
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Response: Tell the patient not to stop the treatment as doctors should consider non-maleficence as part of their decision making.
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Answer: A very inappropriate thing to do
Reasoning: For a capacitated patient to make consent refusal decisions they must not be coerced. As a medical student you should explain to the patient that you cannot make the decision for them, but your role is to help and advise them.