How to Ace Multiple Mini Interview Ethical Dilemma Questions | BeMo Academic Consulting



what do you do when you are in an interview and you are presented with a life-or-death scenario today I want to walk you through one of the most difficult kinds of scenarios that you can face in the MMI in an interview traditional or panel or any other variety or even in Casper so before I get started hi my name is dr. Sarah Klebe and I'm an academic and admissions expert at BMO academic consulting so I'm going to provide you with a really tough prompt that will give you an idea of the situation we have to deal with first I'll give you a sort of overview of some of our strategies for addressing this kind of scenario and the station in general is if this were at MMI then I'll give you will run down through how you might put together an answer that takes into consideration a variety of things some provided in the prompt some not an answer that pushes back against the prompt a little bit it demonstrates our ability to isolate what is the most central concern and put together a mature responsible professional answer to in a situation where you need to you know sort of act quickly so first that little overview of our general strategy again assuming this is an MMI although this would work in any kind of interview scenario you're going to enter the room you're going to make your first best impression by offering a warm and assertive greeting providing your name getting the name of the interviewer if possible so that you can extend that professional courtesy to them and at that point begin your answer now the first thing that we want to do is offer a recap of the prompt to ensure that we're on the same page as the interviewer after that we're going to identify what type of question we're dealing with the central issue that needs to be considered check our assumption or any assumptions that might be present in the prompt itself no any involved parties and how they might be affected by our decision and then outline some options for moving forward so here's the difficult prompt that we're dealing with and I'm just going to read this so forgive me for that you are the only ER doctor on duty and you're responsible for all decision-making during this shift this night you have two patients rushed into the ER who both desperately require a kidney transplant one of these patients is 80 years old he's a university professor suffering from acute kidney failure related to his age the other patient is a 20 year old university student who has been brought in to the ER several times previously and here he is again with another episode of kidney problems related to excessive drinking of alcohol at school parties there's only one kidney available that matches both patients who do you give the kidney to so this is really difficult alright this is a scenario in which there is a lot at stake there are some serious ethical questions to take into consideration and a lot of us without preparation would look at a question like this and probably be in shock and don't really know how to move forward from there especially if you haven't read up on professional ethics in the area so that's a quick aside to make sure that whatever a professional area you are intending to go in to ensure that you're familiar with the professional ethics in that field obviously this particular scenario is most immediately relevant to med students pre-med students residency students things like that however this kind of scenario can absolutely come up in other disciplines simply to see what your decision-making process looks like but in general as long as you have a good general idea of those professional ethics you'll have some foundation to build on in putting together a response so again after I've read the prompt on the door to the room if this was an MMI I'm going to enter with and the buzzer goes off I'm going to give my warm and assertive greeting exchanged names provide a recap to ensure that we're on the same page and a recap that also sort of acts as almost the introduction to your answer as if this were a short essay that you were verbalizing you always want to give a short intro and then setting up the answer so for my recap I would start off by simply saying you know in the prompt that I have been given I am dealing with a pretty significant ethical dilemma as the only physician on duty in the emergency room I'm in charge of making decisions and two patients with severe kidney complications have come in one elderly man with acute renal failure and one young university student both of these individuals require transplants but there is only one kidney available that matches both so note here I have identified my role right knowing and clearly stating what your role is in each scenario will allow you to think of what kinds of options are available to you different roles will have different options available to them I've focused on objective facts I haven't offered any speculation about particularly the young student you know we know that his kidney issues are likely to do with alcohol consumption there are other explanations sure he's been here several times according to the prompt for that drinking related kidney complication there could be something else going on here and we also don't really want that to shade our answer and I'll get to that in a minute I've identified the central issue which is the fact that there are two people and only one hit me and that introduction was concise it was well-organized and it was to the point this is something that usually only takes about 15-20 seconds to do you are under a time crunch when you're dealing with MMI but it really helps set things up helps the interviewer see where you're coming from and make sure that you've isolated that critical central point so after giving that I would begin going on with my answer so I would want to acknowledge that this is an incredibly difficult position that I am in I want to have a sympathetic approach to both patients and appreciate that both of them are in pain and suffering a lot so that's simply how I would start don't give you sort of my ideal answer here so in this scenario according to the rehab that I've just given I'm in a very difficult position the central issue here is the fact that we need to ensure that this kidney goes to whomever has the best chance of accepting it successfully I am sympathetic to both patients and what they're going through a renal failure or kidney complications are extremely painful and I really appreciate the suffering that both of them are going through however I need to make sure that whatever decision I make is based on my own expertise my clinical experiences and the scientific literature and evidence to be completely honest the personal backgrounds of each of these candidates is irrelevant what matters most and what my decision needs to be based on is who is going to most benefit from this transplant and who has a better chance of surviving the surgery surviving the post surgical complications that might arise and who is least likely to reject the transplant so the first that I need to do is try to get these patients stabilized and buy myself some time so I'm going to put them both on dialysis and have them put under constant monitoring so that I can gather some resources some information brush up on the most recent literature if necessary maybe even consult with some of my colleagues and if it hasn't been done already I'm going to ensure that someone contacts the families of both individuals again with only one kidney between the two this is a really tough decision so I'm going to want to review the medical records of each of these patients I'm going to need to take a detailed history find out what if any medications they're currently on what other conditions they may have anything else that would contribute to my larger process of decision making I'm going to send for some tests and some labs to make sure that I have verified all of their health information and don't see anything that really stands out as potential for rejection and again I'm going to review that current literature on the effects and the outcomes of transplants on an 80 year old male with acute renal failure and a 20 year old male I'm going to make sure that I do this as objectively as possible analyzing the risks and benefits in each patient and then based on what I've learned on the information that I've gathered I'm going to perform the transplant on whomever will have a better chance from a scientific and a clinical point of view whoever receives the kidney is going to ultimately be educated on any potential complications that might arise and any lifestyle changes that may be necessary to maximize the benefits and that applies in both cases again regardless of their background there are always potential complications there are very often lifestyle changes that need to be made and so whatever is contextually appropriate to each individual that's the information that they will get and importantly whoever does not receive the kidney at this time will remain on dialysis under monitoring until another he becomes available so that is a strong mature and appropriate response was organized in a clear way we walked through the logic that was necessary to follow to come to our decision it was coherent it was concise and most importantly it was delivered in a very systematic matters men are step by step here are the steps here are the chronological steps that I'm going to take here's why I'm taking those steps here's what I'm taking into consideration and here's what needs to be set aside in terms of the prompt right not all of the information that they gave us was actually directly relevant to the decision that needed to be made again if the kidney goes to the young man who attends to drink he's going to have to be educated about how to better take care of himself to ensure that he's able to you know maintain his health with this kidney transplant so my answer was objective and non-judgmental this is absolutely critical in these kinds of scenarios and I didn't allow those personal attributes of either patient to interfere with my decision-making there I acknowledge that further investigation was required again that's really important it may seem obvious that you would do things like get a full medical history look over their charts or send for labs and things like that but if you don't articulate those things then the interviewer has no idea that they have actually crossed your mind do you need to be really careful to give the interviewer access to all the things that are going on in here you can't take anything for granted or assume that they will assume that you know these things if you don't tell them they have no way of knowing then so after I identified the fact that there was information missing I demonstrated some of the outlets that I would utilize for gathering that information and then came up with a practical solution and I chose the most rational objective and scientifically sound option which was in the best interest of the patients and which caused the least amount of harm to those involved this is not an ideal situation you're not going to get an ideal answer all right somebody's going to get a kidney and somebody isn't in this case but what we can do is ensure that we demonstrate how we would make the best choice given what is available to us and then importantly at the end we followed up to say you know whoever doesn't get it they're not just going to be you know abandoned we're going to keep them on dialysis we're going to keep them on monitoring we're going to help keep them alive and as healthy as possible until another transplant opportunity arises so we've planned for the future both in the case of the next medical intervention necessary for whoever doesn't get the kidney and we plan for the future for whomever does receive that kidney by ensuring that we discussed how we're going to educate that person on any potential complications and lifestyle changes that they might need to incorporate so overall this is one way that you can approach these kinds of really difficult scenarios a lot of ethical scenarios or ethical dilemmas aren't going to be life-or-death situations but even for the ones that are you can still often work through them in a very logical systematic manner plodding step by step buying yourself a little bit of time and really demonstrating that you can approach a genuine crisis with a cool objective and clear and concise answer so I hope that you enjoyed this and that you found it helpful if you did please do go ahead and like it share it with a friend who might find it useful or benefit from it and feel free to comment with any questions you might have if you'd like us to help you out with your own preparations please do click the link that should appear either above or below this video just gives you a free initial consultation with us we'll set you up with one of our admissions experts to answer any questions you might have and get you started on your preparations we have all sorts of different programs to suit your needs and we are happy to work with you to determine which plan is going to support you most effectively thank you so very much your time take care and I'll see you next time

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