MMI Medical Ethics
Medical ethics are a key component of any medical school interview. While these scenarios are very similar to traditional interview questions, in an MMI the ethical scenarios may involve role play, so you’ll be tested on your communication skills and empathy as well as ethical knowledge. Read on to find out how to approach these stations in your interview.
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Remember the four pillars of Ethics
This is key to all ethical scenarios, but in MMIs you may need to apply Autonomy, Beneficence, Non-Maleficence and Justice to a role play situation. For example, before the station you may be told that you are going to be speaking to a 15-year-old girl who has come to the GP asking for the oral contraceptive pill.
Ethical scenarios in MMIs may not always be obvious: for example, the above scenario may not immediately appear to be an ethical scenario, but it touches on issues of autonomy, beneficence, non-maleficence as well as justice, so it’s important to be aware of these and take a moment before speaking to consider the implications of each one, showing you’re aware of these issues when talking to the patient.
Let’s consider autonomy in the above scenario. You must respect the decision made by the patient, but remember that this isn’t absolute. As her GP, you have a duty to assess her competency (you can read more on Gillick competency on the NSPCC website) – this involves assessing maturity and whether or not sexual abuse is taking place to ensure her safety.
Tailor your responses to the patient
In this station, you’re speaking to a 15-year-old girl – and the way you interact with her will be different to interacting with an elderly patient, so make sure you tailor your responses accordingly. Avoid using medical jargon and speak clearly, checking that the patient understands what you are saying.
Equally, it’s important to measure your patient’s responses. As with all role play scenarios, actors may become irritated or upset – so it’s important to react to their responses to show you’re listening to them. Try calming them down if they’re angry, or reassuring them if they’re distressed. As the MMI is all about communication, it’s crucial that you respond to their concerns and behaviour – this demonstrates empathy as well as your communication skills.
Know the legal basics of Medicine
This is very important in medical ethics. In the scenario provided above, it’s crucial you have an understanding of doctor-patient confidentiality. For example, if the patient is worried about her parents finding out about the contraception, you can use this knowledge to reassure her that the consultation will be confidential (and check that she understands this).
Outside of doctor-patient confidentiality, it’s also a good idea to read the GMC’s Good Medical Practice for guidelines on interacting with patients, safety and good practice. Remember to ensure you’re familiar with the legality of medical issues (such as abortion, age of consent, euthanasia) before your MMI, as this will inform how you interact with patients at the role play stations. You can’t correctly advise a patient if you’re not sure of the law!
MMI Medical Ethics: Example Scenarios
- Before you enter the station, you’ve been told that you’re going to be speaking to a 15 year old girl who has asked for the oral contraceptive pill as her GP.
- A man who has just had surgery and is bleeding heavily is refusing a blood transfusion. Enter the station and discuss with him.
- Organ donation should be an opt-out system rather than an opt-in system in this country. Do you agree or disagree? Discuss.