MMI PRACTICE!

General / classic Qs they can ask

about you specifically…
◦ Why medicine? Why this uni? (advantages / disadvantages of PBL?)
◦ Why medicine, not nursing?
◦ Describe a time where you worked in a team
◦ Describe a time where you were part of a team and how you solved any particular
problems
◦ E.g. of a time where there was conflict in a team and how you dealt with it?
◦ What are the advantages and disadvantages of working in a team?
◦ Describe a time where you displayed leadership skills. What are attributes of a good
leader?
◦ How have you developed your communication skills?
◦ Medicine is a difficult and stressful subject to study. How do you deal with stress?
◦ What makes you think you have what it takes to study such a hard subject?
◦ What are your strengths / weaknesses?
Ethics Qs
◦ Transplant dilemmas
◦ Patients refusing blood transfusions
◦ Abortion
◦ Anti-vaccination? (might be relevant given COVID vaccine!)
◦ What to do if a patient isn’t compliant with medication that is essential for their health
Qs about medicine / hot topics
◦ Euthanasia / Assisted suicide
◦ What do you understand about the expression “patient confidentiality” and can it ever
be breached?
◦ Tell us about the 4 ethical principles of medicine
◦ Current issues affecting the NHS?
Role play scenarios
◦ Breaking a form of bad news to an actor (won’t necessarily be a medical scenario)
◦ Giving instructions to an actor to carry out a task
◦ Interacting with someone who has had a minor fall / injury (actor)
A quick note…

Here’s a little key I’ve used throughout this powerpoint:

◦ Pt = patient
◦ Dr = doctor
GENERAL QS ABOUT
YOU
Why medicine?
https://www.youtube.com/watch?v=5ttTl3JfxkM&list=PLlSSYB2BgjVj-oyuAeFvYCXcS5NYYe-qr&in
dex=2

◦ Very personal Q!
◦ Don’t just say ‘to help people’
◦ Any particular triggers / turning points that made you think, ‘ah
medicine is definitely for me’? – Explain (always good to talk
about work experience etc.!)
◦ Qualities of a good doctor and link it to YOU – what qualities do
YOU have that could make medicine a good match for you?
NOTE – it’s really important that you always link your
answers back to the profession of a doctor and the
MDT (use phrases like, ”I know that, as a Dr, it’s
important to have skills a, b, c because…”)
Why this uni? (advantages /
disadvantages of PBL?)
Why should we choose you? -
https://www.youtube.com/watch?v=dOdy_lyManE&list=PLlSSYB2BgjVj-
oyuAeFvYCXcS5NYYe-qr&index=7

◦ If your uni is PBL based, did this play a big role in your decision to apply
there? Why?
◦ Do some research on the course and its structure – anything stand out
to you?
◦ Advantages of PBL: developing communication & teamwork skills from
day one, can learn from others, provides a practical view of medicine
◦ Disadvantages of PBL: learning experience depends on the work others
are willing to put in – there may be non-motivated students which can
disrupt the team
Why medicine, not nursing?
https://www.youtube.com/watch?v=XrrsJAd25Mo&list=PLlSSYB2BgjVj-oyuAeFvYCXcS5NY
Ye-qr&index=6

Before you answer, reword this question to: “what is the difference in roles between a
doctor and a nurse?”. From this, you can then delve into what draws you to being a
doctor more so than a nurse.

Remember to always praise nurses because, without them, doctors will have a much
harder job!

Doctors: Nurses:
• More of a problem-solving role • Less problem-solving and more of a
• More of a leadership role practical role in patient care
• They make the ultimate decision • They make decisions but not the ultimate
• They have more clinical expertise decision about treatment for patients
• Depending on what stage they are in their
career, nurses tend to have more specialist
knowledge
Give an e.g. where you played an
effective role as a team member
https://www.youtube.com/watch?v=ydkZgfVgI6Q&
list=PLlSSYB2BgjVj-oyuAeFvYCXcS5NYYe-qr&index=3
Do you have any experiences working in a team? E.g. a job you had / a project you
were part of?

Give a specific situation you were involved in and highlight YOUR role

My example:

◦ I worked as an activity leader at a language school (and I worked with other activity
leaders)
◦ Sometimes we would take the students on big trips
◦ Difficult task at times as there were sometimes disagreements about what the schedule
should be for the day
◦ I thought it would be good to listen to others’ opinions as well as encourage those who,
perhaps, weren’t distributing as many ideas

Elaborate on your answer. The interviewer is likely to ask other prompts (next slides)
Describe a time where you were part of
a team and how you solved any
particular problems
This Q is testing your problem solving skills and communication in a team so make sure
you really emphasise this in your answer (and, as always, remember to link it back to why
these skills are important as a future Dr!)

Note – if you have an e.g. where you tried to solve a problem and it wasn’t successful,
DO NOT WORRY (all you have to do is explain what you would have done upon
reflection)

My example:

◦ We took the students on a trip to London

◦ We lost a student… 😨
◦ I had to communicate with all the activity leaders via phone who were looking for
them
◦ The POLICE got involved 😨😨
◦ We managed to find the student in the end with good communication and teamwork
skills ☺
◦ Then link these skills to medicine and explain why they’re important
E.g. of a time where there was conflict
in a team and how you dealt with it
Think, why are they asking you this? – answer accordingly

Think of a situation where you were in a group and there was some kind of disagreement
– explain what happened and how you managed it e.g.

◦ Active listening skills – gathering all opinions

◦ Listening to both sides and coming up with a sensible solution
◦ Remaining impartial
◦ Voting on solutions

Again, link this to medicine – it’s important to develop these skills as it’s likely for there to
be conflict within the multidisciplinary team regarding what decision is best for the
patient (especially if it’s a complicated case)
Disadvantages and advantages of
working in a team?
Advantages

◦ Able to gain ideas from those who contribute

◦ Maybe achieve more by using everyone’s strength appropriately rather than by
yourself
◦ Learn from others

Disadvantages

◦ Too much input may be confusing and could lead to conflicts

◦ Not everyone is a team player!
◦ Will only function well with a strong leader

Conclusion… e.g. “overall, there are as many advantages as there are disadvantages,
but a good team is really what individuals within it make it. The role of the leader is
important in ensuring everyone fulfils their responsibilities.
Describe a time where you displayed
leadership skills. What are attributes of
https://www.youtube.com/watch?v=ydkZgfVgI6Q&
a good leader? list=PLlSSYB2BgjVj-oyuAeFvYCXcS5NYYe-qr&index=3
Think of an example of a situation

Attributes:
◦ Calm under pressure
◦ Good listening skills (of both sides)
◦ Communicates effectively with the team
◦ Strong-minded
◦ Has clear objectives & communicates them effectively to the team
◦ Leads by example
◦ Understands and motivates the team
◦ Decision maker - recognises the need for change and implements it
◦ Flexible

Did you display these skills in the example you’ve given?

Link to why it’s important for Drs to have good leadership skills
How have you developed your
communication skills?
◦ Experience (medicine-related or other)
◦ Teaching is a good one!
◦ Any activities you’ve taken part in that involve communication?

Again, link to why communication skills are important as a Dr practicing medicine:

◦ Life vs death
◦ Dr-patient rapport – patients could eventually lose trust in the Dr due to poor
communication (this could compromise their future compliance and, ultimately, their
health)
Medicine is a difficult and stressful
subject to study. How do you deal with
stress? https://www.youtube.com/watch?v=3_KCE8j6sAI&list=PLlS
SYB2BgjVj-oyuAeFvYCXcS5NYYe-qr&index=4

Are there any extracurricular activities you do outside of your studies?

What hobbies do you have which keep you sane?!

My example:

◦ I play several instruments which helps me to release any stress that may overwhelm me
◦ I play tennis to wind down etc.

Again, elaborate and explain your experiences and how you think you can deal with
stress
What makes you think you have
what it takes to study such a hard
subject?
Your initial reaction could be: 😱😱😱
But, think about your experience studying throughout your life (particularly at college or
university) – was there a time where you weren’t happy with a particular grade and had to work
really hard to improve? (this was the e.g. I used for my interview 😆)

You’re not going to know what medicine is like until you study it so think about what kind of
qualities they’re trying to get out with this Q:

◦ Perseverance
◦ Resilience
◦ Discipline
◦ Determination
◦ Single-minded
What are your strengths / weaknesses?
https://www.youtube.com/watch?v=RCs_Z-Wm_5E&list=PLlSSYB2B
gjVj-oyuAeFvYCXcS5NYYe-qr&index=5
Be careful with this one! – you don’t want to underestimate / overestimate yourself too much

Give examples for each and back it up with an e.g., then link it to your future career as a Dr

Acknowledge your weaknesses and think of a SOLUTION for improving – they’ll love you if you do
this!

Strengths:
◦ Good communication If you’re feeling clever: you can give an e.g. that is both a
◦ Good team player strength and a weakness! E.g.: ‘having high expectations’
◦ Good leader can be a strength as it means striving for quality but can
◦ Organised
be a weakness as it can make relationships with others
Weaknesses (my e.g.): difficult sometimes
◦ Public speaking - SOLUTION: I did a teacher training course which helped me build my
confidence, as I stand up in front of students to teach.

Avoid turning a ‘strength’ into a ‘weakness’ e.g. “I’m a perfectionist” – they’ll NOT love you if you
do this!
ETHICAL SCENARIOS
Ethical scenarios – transplants
https://www.youtube.com/watch?v=asegO_TmFLE
You are a doctor working in a liver transplant centre. You have one liver available to transplant, but
two patients who have compatible tissue. You must decide which patient should receive the liver.
Note that there is not a correct answer for this dilemma.
◦ Patient A is a 75-year-old retired judge. She requires a transplant due to liver cancer. She has
been a lifelong supporter of the hospital and fundraises for many charities. Apart from her
cancer, she is fit and well and has no long term health conditions. Without the transplant she has
a life expectancy of three months.
◦ Patient B is a 22-year-old shop worker. She requires a transplant as, two days ago, she was
involved in a car crash with a pedestrian that severely damaged her liver. You know that she was
driving the car and the pedestrian involved died. You believe she is fit and well and has no
long-term health conditions. The liver transplant will be lifesaving.
Explain to the interviewer how you would approach deciding who should receive the liver
transplant.

PROMPTS for the interviewer:

◦ Who do you think should receive the liver?
◦ Why have you not chosen the other patient?
◦ Would their ages be relevant?
Ethical scenarios – transplants
https://www.youtube.com/watch?v=asegO_TmFLE
You are a doctor working in a kidney transplant centre. You have one kidney available to
transplant, but two patients who have compatible tissue. You must decide which patient
should receive the kidney.
Note that there is not a correct answer for this dilemma.
◦ Patient A is a 25-year-old medical student. She requires a transplant due to one of her
kidneys being damaged from sepsis. Apart from this, she is fit and well and has no long
term health conditions. Without the transplant she has a life expectancy of one months.
◦ Patient B is a 65-year-old race driver. He requires a transplant as, he was stabbed in the
back, straight into his right kidney. You believe he is fit and well and has no long-term
health conditions. The kidney transplant will be lifesaving.
Explain to the interviewer how you would approach deciding who should receive the
kidney transplant.

PROMPTS for the interviewer:

◦ Who do you think should receive the kidney?
◦ Why have you not chosen the other patient?
◦ Would their ages be relevant?
Answer – intro / summary
◦ NOTE: they will never give you ALL info for each patient so mention throughout that
there are many contraindications that come into this debate/dilemma which can’t be
solved without further info (e.g. past medical history, current medical conditions,
current medications etc.)
◦ Acknowledge that this is a difficult scenario as whatever the outcome of the clinical
decision, one person will not receive the transplant.
◦ When you answer this Q, don’t answer with patient A or B (not straightaway, anyway) –
just show the interviewer that you’re able to see BOTH are in need of it, the question is:
‘who will benefit MOST’?
◦ Explain what to look out for to decide who benefits most
◦ Then, based on this, a clinical decision will be made about who should receive the liver
(might also be good to mention, if you have time, that the decision isn’t made by just
one clinician – it’s the whole MDT)
 Answer – exploring who should get
the transplant
Prejudice and assumptions Never allow prejudice, assumptions, personal beliefs etc. affect your clinical
decision as a Dr – provision of care is always based on CLINICAL NEED
regardless of pt’s reason for transplant (i.e. car crash – could argue it’s pt’s fault
but DON’T do this)
Biological factors - Matching (mention that this scenario has already clarified that both
patients are compatible)
- Age: older person may be less likely to survive surgery / complications so
may be better for younger pt (but older pt may sometimes be fitter overall
than younger pt depending on circumstances so usually consider
BIOLOGICAL age rather than no. of yrs they’ve lived)
- Comorbidities: the higher the co-morbidities, the less likely they’ll survive so
must take a thorough look at PMH, meds etc.
- Risk of recurrence of underlying disease: diseases pt may have which won’t
be cured by transplant (e.g. congenital metabolic disease or alcoholism)
- Who’s most likely to survive treatment: QALYs
Psychosocial factors lifestyle, psych, env factors that can lead to biological reasons for less successful outcome
e.g. chances of relapse in the case of alcoholism (must assess likelihood) – if high chance:
provide necessary care etc.
Impact on society Justice – also consider loss to society if pt doesn’t receive transplant (e.g. effect on fam:
do they have children etc.)
Answer – conclusion
◦ Overall, it’s really important to gather a lot of info about the patients in order to
understand who’s most likely to benefit from treatment
◦ Whoever’s most likely to survive will be given the transplant
◦ Final decision made by MDT
Ethical scenarios – Blood transfusions
https://www.youtube.com/watch?v=dXLw-noxB7U

◦ Mother comes to A&E with a child who is bleeding profusely

◦ She refuses to allow you to administer a blood transfusion to the child
◦ Why do you think this is?
◦ What would you do?
Answer – why is mother refusing?
◦ Likely that she is a Jehovah's Witness (have the belief about interfering with God should
they accept the treatment: ‘not pure’)

◦ BUT don’t assume they are a JW – open your mind to other possibilities e.g. they may
think there are many risks with the transfusion (maybe from their experience)
Answer – what to do next?
◦ In both cases, explain the risks of not having the blood transfusion and compare it with
the benefits of not having it (remember this is allows mother to make an ‘informed’
decision for her child)
◦ If mother continues to refuse despite encouragement, assess competence of child
using Gillick competence
(https://www.nhs.uk/conditions/consent-to-treatment/children/)
◦ If child is deemed competent – can go ahead with the procedure (you are entitled to
disregard mother’s opinion)
◦ This will probs cause tension with the mother so will need to manage the
communication process with her
◦ But what if child is NOT deemed competent…?
Answer – what to do if child isn’t
competent
◦ This case is an emergency (A&E) so will have to make decision ASAP
◦ The decision must always be in the child’s ‘best interests’ – i.e. going ahead with the
blood transfusion
◦ Just need to be sure that you have evidence and you’re confident that this was in the
child’s best interests (in the case where you could be taken to court)
◦ NOTE: if it wasn’t an emergency – further discussion with MDT (+ seniors) and court order
(RARE)
Ethical scenarios – abortion
◦ 14-yr-old girl presents to you asking for an abortion
◦ What are the issues with this?
Answer
◦ Can the girl actually have an abortion? – can only have it before 24weeks gestation
◦ Child’s competence – Fraser guidelines: if competent, she can consent to abortion without parents
◦ Confidentiality – might be likely she doesn’t want fam to know. Explore: rape? Abused? Age of boyf? If
child is at risk – may need to breach confidentiality and notify parents / social services / maybe even
police if extreme (must discuss this with pt)
◦ Holistic approach: physical impact of abortion on the girl, treating any STDs, psych impact – mental
wellbeing before and after abortion
◦ Education: on contraception and prevention of STIs
◦ Trust: don’t be paternalistic, communicate with her at the right level and reassure her that you’ll help
(likely she’s going to be distressed!)
◦ You / others may have anti-abortion views: GMC says Drs can refuse providing procedures , due to
personal beliefs “as long as this does not result in direct or indirect discrimination against, or harassment
of, individual patients” so must ensure there is another Dr who can carry out procedure
◦ Where is abortion illegal? (not many – good website:
https://reproductiverights.org/worldabortionlaws?category[294]=294&category[325]=325&category[29
5]=295&category[296]=296&category[297]=297 )
Ethical scenario – anti-vaccination
◦ This could come up as it’s relevant to today!

Mother is concerned about allowing her child to have the MMR vaccine. What do you
do?
Answer
Why do you think she’s concerned?
◦ May be linked to false info on media
◦ Andy published in lancet a graph about how MMR is ‘linked’ to autism…

What to do…
◦ EDUCATE
◦ Explain the risks of not having the vaccine vs the benefits of having it
◦ If child doesn’t have vaccine, they won’t have immunity and they are likely to die of
M/M/R (deadly diseases!) – maybe mention there was a mini outbreak last year at unis
◦ The risk of having the vaccine are quite minor (e.g. pain etc. very rarely it can cause
allergic reactions but there is the right healthcare provided in this case!)
Ethical scenario – poor compliance
with medication
◦ Elderly lady refuses to take medication for her heart failure following recent heart
attack
◦ Not taking meds = exposure to serious risks (including possible death)
◦ She presents to your surgery with her husband who wants to talk some sense into her
◦ What are the issues?
 NOTE: even if you’ve communicated risks vs
Answer benefits and she still refuses meds – respect their
autonomy (you’ve fulfilled your duty of care)

◦ Competence: may not be competent so need to consider what she would have
wanted if she had been competent – relatives can help with this (note: important to
use good communication skills as you don’t want to force her to take the pills!)
◦ Confidentiality: husband is present – ensure lady is happy for him to sit in on
conversation (don’t want to risk breaching confidentiality when she may not want her
husband to know)
◦ Beneficence vs autonomy: refusing meds = serious risk BUT need to respect her
autonomy (if she’s competent). BUT you also have the duty of care so must act in best
interest – can’t force her to take meds so must at least ensure she has UNDERSTOOD
risks vs benefits so she can make a sensible decision (good communication: educate
her about condition, role of meds, risks vs benefits etc. – do in a neutral manner)
◦ Holistic approach: explore her reason behind her refusal – side effects? She’s
depressed? Maybe she wants to die ☹ (by addressing all the possible issues, you may
actually resolve her problem of non-compliance with treatment!)
MEDICINE QS / HOT
TOPICS
Euthanasia / Assisted suicide
Definitions
◦ Euthanasia – 2nd party terminates someone’s life as an act of mercy (“mercy killing”)
◦ Assisted suicide – individual takes action to commit suicide with the help of 2nd party

Arguments for euthanasia & assisted suicide:

◦ Pts should be able to choose what’s best for them – they can die with dignity at a time of their
choosing
◦ Pts should be able to avoid lengthy and unnecessary suffering period (benefit vs harm)
◦ Free up beds & other NHS resources

Arguments against euthanasia & assisted suicide:

◦ Against some religious principles (“Dr’s playing God”)
◦ Relatives may abuse situation by allowing convenient euthanasia to suit their own needs
◦ Relatives may pressure pt even though it’s against their wishes
https://www.nhs.uk/conditions/euthanasia-and-assisted-suicide/

Legal / illegal
◦ Euthanasia & assisted suicide are currently illegal in UK
◦ Euthanasia is legal in Netherlands, Belgium, Luxembourg, Spain, Canada, Columbia, Switzerland
What do you understand about the
expression “patient confidentiality” and
when can it be breached? https://www.youtube.com/watch
What is ‘pt confidentiality’? ?v=MOoO3vC2jvY

◦ Law whereby a Dr can’t reveal anything said to them by their pts during consultation
/treatment (except for in specific circumstances…)
◦ Important to protect confidentiality as breaching could lead to serious consequences
(lose trust etc.)

When it can be breached:

◦ Implied consent given by pt

◦ Info required by court / judge
◦ In public interest (protect pt / 3rd party)
Tell us about the 4 ethical principles
of medicine
◦ Autonomy: pt’s right to make an informed decision about their healthcare – their wishes (must
be respected if they’re competent – also good to explain it’s their right to accept OR refuse
treatments)

◦ Beneficence: Dr’s duty to do’good’ and act in BEST INTEREST of pt (what will benefit the pt /
society most and is this in line with the pt’s wishes)

◦ Non-maleficence: Dr’s duty to do NO HARM to pt

◦ Justice: fairness – are there sufficient resources available to provide this sepcific care for the
pt? Providing a treatment can be costly and deprives others of care (inverse care law) – could
this money be spent elsewhere in the NHS? Could it be more beneficial to do so?
Can only discriminate on the basis of CLINICAL NEED
Opportunity cost: value of what you ‘give up’ when you make a treatment decision (can be
measured in terms of resources given up/cost or the foregone health for another patient)
Current issues affecting the NHS?
COVID-19!
◦ Current research into how the virus works
◦ Good news: vaccine
◦ Financial problems (funding levels for NHS are a political choice…)
◦ Care for non-covid patients?
◦ Risks to healthcare staff

Long-standing issues
◦ Waiting times
◦ Bed shortages
◦ Postcode lottery
◦ Funding issues https://www.kingsfund.org.uk/projects/positions/nhs-funding?gclid=Cj
◦ Scarce resources wKCAiAxKv_BRBdEiwAyd40N9054GPtO62IzyePUQZgUEXo3F3N0RDoPigr
as7e3Y2cyAlqETqJnhoCG6oQAvD_BwE
◦ Staff : pt ratio
ROLE PLAY
SCENARIOS
Breaking a form of bad news to an
actor (won’t necessarily be a
medical scenario)
This is a communication station (they don’t expect you to be a medical expert so
hopefully the scenario won’t be too difficult!)

Examples of scenarios:

◦ You had to look after your neighbour’s cat while they were away. Unfortunately the cat
somehow got outside and has now gone missing. You need to tell the neighbour what
has happened
◦ You are the leader of a hockey team. One of the members of the team have been
missing several training sessions. An important tournament is coming up. You need to
tell them they’ll have to miss the tournament as they’ve missed too many sessions.
◦ Medical one (just in case): You need to tell an actor they have HIV… (very unlikely
scenario)
Giving instructions to an actor to
carry out a task
E.g. (some unusual ones!) – remember this is all about COMMUNICATION so don’t worry if
you can’t complete the task successfully

◦ Explaining directions (using a map)

◦ Explaining how to tie shoe laces
◦ Explaining a drawing
◦ Shapes
◦ Lego building
Interacting with someone who has
had a minor fall / injury (actor)
Skills to demonstrate:

◦ Communication
◦ Empathy
◦ Support / help
◦ Suggestions to avoid in the future
General tips from moi
◦ Think about WHY they’re asking you this Q (what particular skills do they want you to talk
about?)
◦ ALWAYS ALWAYS ALWAYS link to why these skills are important as a Dr in the future
◦ Treat each station as a SEPARATE station – don’t worry about repeating any info you might
have said in a different station
◦ Try not to panic if you don’t have any specific examples of experiences to what they’re asking
you – you can always admit that you don’t have a particular example for X but I have
experience with Y
◦ Don’t worry about giving a straight out answer – look at both sides
◦ Maintain eye contact
◦ Use a good tone of voice
◦ Sensible hand gestures
◦ In pre-covid times: give a confident handshake!
◦ They have chosen to interview YOU for a reason! They want you ☺
◦ Fake it ‘til you make it!
BEST OF LUCK GUYS!
Hope you found this useful ☺ Interview prep can be pretty overwhelming and stressful so if you have any
questions / worries, feel free to email me (hannahthemedic@gmail.com)