By Usman Nasir
No matter which medical school you apply to, it is extremely likely that you will encounter an ethical scenario during the interview stage. This could be in the form of a full dedicated ethics station or questions integrated into different stations. So, practising your ability to discuss different ethical scenarios is important when preparing for an interview. Hopefully, this article will give you some helpful tips for tackling them.
Tip 1: Remember the 4 ethical pillars
When tackling an ethical scenario always remember the 4 ethical pillars:
Autonomy – patient’s right to make their own decision
Non-maleficence – DO NO HARM to your patient
Justice – How would the wider community be impacted by your decision?
Beneficence – Is it good for the patient?
These should be the foundation for your answer, and you should always try to refer to them throughout your answer. By specifically highlighting them, it tells the interviewer that you have a good understanding of medical ethics.
Tip 2: Keep in the know
Always stay up to date with current affairs by reading/watching the news and researching the latest articles. Many ethical scenarios in interviews come from the latest news updates so make things easier for yourself by staying ‘in the know’. The more you read, the more knowledge you can draw upon in your answers. This will help you feel more comfortable and prepared for any scenario they throw at you.
Useful resources:
Ethical guidance for medical student’s toolkit – BMA. This is one of the best resources available as it gives interesting patient scenarios that will help you get to grips with a wide range of ethical scenarios.
News articles and apps. Always stay up to date with the latest developments in the news. There may be an important piece of breaking news on the morning of the interview that you will be glad that you read.
Medical Ethics: A Very Short Introduction by Tony Hope. Very useful introduction to how to approach the complexities of ethical scenarios. An interesting read that is easy to understand.
BMJ review articles. They have several articles surrounding the most common ethical scenarios. Review articles are very easy to understand and summarise all the research in that field.
GMC guidance – Tomorrow’s doctors. Will give you up to date information detailing the current state of ethical topics (e.g. guidelines, laws, medical practice).
Tip 3: Structure your answer
When talking about ethics, students commonly get caught out by having a disorganised and muddled answer. This can make you lose your train of thought or repeat yourself multiple times throughout the answer. To avoid this, follow a structure and stick with it so that it is clear, concise and easy to follow. Everyone has their own structure that they like to use but using the following method could be very helpful when building your answer. I am going to use a common question as an example: “Should euthanasia be legalised in the UK?”
Set the scene – Give a brief description about the scenario to introduce the topic. For example, if it is about euthanasia, then briefly describe it by giving a definition and the current state of its laws in the UK. This is a great way to make sure that you and the interviewer are on the same page and it also gives you more time to think about the rest of your answer.
Arguments for – Give 2 clear and different reasons supporting euthanasia, using examples that you have read about in the news or from articles. For example:
1. Strongly advocates for a patient’s autonomy – they should have the right to make a decision about their own lives?
2. Beneficence - allows the patient to die with dignity and respect.
Arguments against – Again, give 2 clear and different reasons against the use of euthanasia, using examples.
1. Maleficence – you are doing harm for your patient (against the oath of becoming a doctor).
2. Justice – implications on wider community? Could this lead to a slippery slope where elderly individuals would be coerced to accepting euthanasia? Where would you draw the line for what is eligible for euthanasia or not?
Conclusion – Reconcile the arguments you have laid out and ALWAYS relate back to the question. Directly address the question at this point. You can give your own opinion, but your answer should always be balanced. Also, show an appreciation for the complexity of the scenario by highlighting the many contradictory factors. It is also useful to mention at this point that you would not make an ethical decision by yourself, you would use the expertise of the whole multi-disciplinary team.
Top tip:
Always keep your arguments balanced by using phrases such as “Some might say…” or “It could be argued”.
Tip 4: Taking your answer to the next level
Including relevant statistics and real-life cases in your answer demonstrates to an interviewer that you have an excellent understanding of the topic. They will be impressed if you can incorporate them appropriately into your answer. Using examples from your work experience or volunteering can also provide a reflective aspect to your answer, as it shows you have gained a real insight into medicine from your personal experiences.
Example of key cases and facts you could use:
Suicide Act of 1961 – what is the current UK law on euthanasia. Outline the legal case.
In which countries is euthanasia legal? Netherlands, Switzerland, Belgium and Colombia
Latest court cases of euthanasia in the news
Statistics surrounding the use of euthanasia (Don’t worry if you can’t remember them though)
Tip 5: Staying calm in that 1 minute
Keep the structure you have practised in your head before the station and use the 1-minute reading time to formulate your answer and compose yourself. Use this time as a break so you can focus to the best of your ability during the station. Get a drink of water and think about the arguments for the scenario in your head so you are ready to discuss them with the interviewer. Most importantly, forget about the other stations and put all your concentration into the next one.
Also, ALWAYS remember that you were chosen for an interview for a reason. You are a fantastic student and the university have seen something special in you. You have already proven you are capable with your excellent grades and application so just do your best and show them why you belong there.
Good luck with your medicine applications and I hope this has given you more confidence when tackling ethical scenarios. Stay tuned for the next article on common ethical scenarios.