1. The attending surgeon cut a nerve during surgery and repairs it. The attending says “Leave that out of your op note.” What do you do?
ANY incident is REPORTED TO THE PATIENT in post care or PACU; wait until they are awake and oriented. Then include it in the note. Honesty is the best policy. There was a similar situation not too long ago. Now a resident is getting sued, along with the doctor. There is a long process for false or miswritten documentation.
2. In the OR: Attending seems “off.” You have a suspicion that he was drinking and the surgery starts in 15 minutes. What do you do?
My gut feeling tells me that this is wrong, and my ethics training tells me that this should not occur. There is a proper place and time to be drinking, and in this situation, it’s not acceptable. But first I would like to talk to the doctor himself to move the case another day when his mind is not influenced or impaired.
If that fails, go up the hierarchy. I would contact another resident to consult him. I would go up the hierarchy and tell the rotating nurse, the anesthesiologist, etc.
3. You’re in the ED. Patient with a retained foreign body, andthey are septic. You call the attending, they say, “I’m busy. Do I need to come?” How do you respond?
Use your knowledge of medicine, follow your gut feeling, and don’t be afraid to make your attendee come in. If they meet SIRS criteria and have a portal of entry, then they are septic; you want to avoid the next stages of hypotension and/or organ failure. Start IV abx, perform bedside I & D, and consult on-call general medicine. Chances are the attendee will come in for this case.
4. You forgot to order medications, but the patient is still okay. Should you tell the patient you forgot?
A good principle to have is to put the patient first. A healthcare provider should take responsibility for their actions by admitting errors. This can reduce the risk of a lawsuit, and builds trust, good rapport, and great communication between the patient and the doctor.
5. What is your stance on euthanasia? Should a patient have a right to die?
The key is to demonstrate your thought process. There are two sides to this position, and you should not position yourself on one side only. Euthanasia helps relieve pain for a terminally ill individual. On the other hand, it is in the act of killing, which is not supported in the medicine system. Take the middle position; for example, you favor euthanasia if the patient is on life support and has the mental capacity to make a decision.
6. You observe a peer medical student cheating. What would you do?
7. How would you tell a patient who was just diagnosed with cancer and only has a few weeks to live?
8. How would you express your concern for a child who needs an amputation?
9. A 10-year-old child is in for foot examination. You have evidence that the child has been physically and sexually abused, their parent stepped out to take a phone call. How would you respond to this situation?