MMI Practice Questions
You are the director of an organisation that aims to improve healthcare within Indigenous communities. An initiative has been proposed which involves a holiday program designed to help indigenous students enter medicine. It requires $10,000 funding, which is beyond the capacity of your organisation to fund. A tobacco company offers to pay in exchange for advertising for them during the holiday program.
- What are the issues you need to consider?
- Would you accept funding from the tobacco company?
- What if there were no other alternatives for funding?
- Why do you think Indigenous health is so poor in Australia?
- What can be done to improve the health outcomes of indigenous population?
You are a general practitioner, working in a practice near a naturopath. The naturopath treats patients with symptoms such as pain, fatigue and headaches. Many of your own patients who have become frustrated with the lack of response to mainstream treatments consult the naturopath. The naturopath recommends various treatments which they know do not have a physiological effect on the body. There is no scientific evidence or accepted theory that the treatments work, and in fact the naturopath is aware of research papers that show that the treatments do not work. The naturopath’s justification is that the treatments do no harm, and help reassure patients who often have no other option.
- What are some of the ethical problems that the naturopath’s behaviour poses?
- What would be some of the reasons behind his/her behaviour?
- Can you see any circumstances under which recommending such a treatment might be the appropriate action?
- What action might you take regarding the naturopath?
- Why might some patients seek out naturopathic medicine?
You are a five year old boy who lives in a suburban area. Your neighbour is on a disability pension. When your parents and other adults are present, your neighbour walks with a limp and is not very active. However, when you are by yourself, you sometimes observe your neighbour digging in the garden, and he does not appear to have a disability.
- What may be some reasons for the neighbour’s behaviour?
- lf the neighbour tells you not to tell anyone, how would you react?
- If you were made aware of this as a parent, how would you deal with the situation?
- What are the implications of the neighbour’s behaviour on society?
- Do you think all people with disabilities should be entitled to benefits?
Healthcare costs the government billions of dollars a year, and health funding for various initiatives is limited. A working party reviewing the Australian healthcare system proposed a deterrent fee (a small charge, for example $10, which everyone who initiates a visit to a health professional would have to pay on the first consult) as a way to control health care costs. The reasoning behind this is that it will deter people from visiting their doctor for unnecessary reasons.
- What are the broad implications of this policy on health and healthcare costs?
- Do you think the approach will help in the efficient utilisation of healthcare resources?
- Would you support this proposal? If so, why?
- What are the ethical issues involved in this proposal?
- What are some other ways in which healthcare costs can be reduced?
lmagine you are the principal of a full fee paying school. There has been an allegation by members of the public of an incident in a park in which at least two senior school students were seen verbally abusing a young person with intellectual impairment for the amusement of a group of other students. Two final year students are to attend a hearing with the principal to explain their actions in the incident. What are the issues the principal is likely to consider at the hearing?
- In what ways might the Principal establish the facts of the case?
- What possible impact might this incident have for the disabled young person?
- How might the attitudes of the parents of the disabled young person differ from those of the senior students in responding to the Principal about the incident?
- What underlying reasons might the Principal give for recommending the two final year students are suspended from school?
- How might the Principle use the incident to raise awareness around disability discrimination in the school?
A friend confides in you that ever since her boyfriend broke up with her, she has been feeling down. You offer to have coffee with her to chat about it. When you meet, you see that she does not look well, and seems to have lost weight. During the course of the conversation, she tells you that she is not coping, and sometimes feels that life isn’t worth living anymore. She has even thought about how she might end her life. She then tells you that she does not want to you tell anyone that she is feeling this way. She knows that you will not, because you are her close friend.
- What would you say to your friend?
- What are the issues that you need to consider?
- In what circumstances would you tell someone about a friend who has suicidal thoughts?
- What resources or other sources of help might you suggest for your friend?
- If you were feeling that you were not coping with a particular situation, how would you deal with the situation
You are an oncologist. One of your patients is a five year old girl who has cancer. An experimental treatment is available that is very expensive. The efficacy of the treatment is uncertain, and there are significant side effects including severe nausea and headaches.
- The parents ask you a question about the treatment, and you do not know the answer. What would you do?
- As the treating oncologist, would you give the treatment?
- Just say the patient’s parents want you to make the decision. What would you decide?
- You [give/don’t give] the treatment, and your patient dies. How do you feel? Do you feel that you made the right decision?
- What will you tell the patient’s family?
You are an Infectious Diseases doctor who has a special interest in HIV/AIDS, and you are currently conducting research into the field. The leader of your research team tells you about a conference that is being held overseas on HIV/AIDs and suggests that you should attend, as it will significantly aid the research. She tells you that the conference will not cost you anything. You do some research and find out that the conference is being funded by a company who manufactures medication for HIV/AIDs, and pays for all expenses of the attendees. You know that this company sells its medications to predominantly first world, Western countries, since the cost of the medication is very high. The company does not subsidise medication for poorer countries such as sub-Saharan Africa. Such countries have the highest number of people affected by HIV/AIDs.
- What issues will you consider when deciding whether or not to go to the conference?
- What will you do if one of your colleagues says he/she is going?
- Do you think it is reasonable for the drug company to fund events such as conferences?
- Should governments fund doctors to attend conferences?
- Asa doctor, what broad strategies might you use to help redress inequities in a healthcare system?
You and one of your close friends are both completing a PhD. Throughout your PhD, you have conferred with your friend and have exchanged advice and support. You are now both writing your thesis, and you are finding it particularly challenging. You call your friend and confide in him that you are having some difficulty with the thesis. He tells you that it doesn’t all have to be original, and that you should try using the internet for inspiration. He says that he has been copying material from the internet for his thesis.
- What are the issues in this scenario?
- With regard to your assignment, what would you do?
- With regard to your friend, what would you do?
- If you were having difficulty with an assignment at university, what steps might you take to resolve it?
- Do you think copying is ever justified?
You are sitting in a cafe having a cappuccino. Across the road there is a lady in her late 20s standing with four children, waiting at the bus station. There is a little baby in a pram, a three year old girl holding the lady’s hand, and two other boys running amok on the footpath. The woman is shouting and asking her children to keep still. She catches one of the boys and slaps him hard several times. The boy starts crying. The little girl is upset and also starts crying. The mother asks the other boy to come closer but he moves away from her.
- What factors may have contributed to the woman’s behaviour?
- If deciding to intervene in some way, what would you do or say?
- What potential safety issues does the situation present?
- What factors might inhibit members of the public intervening in some way?
- If the woman was not the children’s mother, would this influence your response?
Since the death of your grandfather, your grandmother (who is your mother’s mother) is living with you in your house, along with your younger sister, your mother and your father. You have known for some time that your father does not get along well with your grandmother. It seems to be a longstanding issue, but you do not know the details. Your grandmother moving in has made the situation worse. One day, your grandmother is in the bathroom and she has a fall. She is taken to hospital, and the doctors advise you and your family that she has a fractured hip. They say that given her age, it will take some time for her to recover, and she will need significant care. They recommend placing her in a nursing home. Your grandmother is adamant that she will not go. Your father makes it quite clear that he thinks the nursing home is a good idea. Your mother is surprisingly quiet.
- How would you manage the situation?
- What do you think your mother might be feeling?
- How would you approach your grandmother in this situation?
- How would you approach your father in this situation?
- How would you come to a personal decision about the issue?
You and one of your close friends from high school are both in first year medical school. You are both from the country, and your parents are supporting you to stay in one of the halls of residence on campus. Your friend’s parents are not well off, and he has had to work part time to support himself to live in Melbourne. He has been unable to make it to some compulsory tutorials because of his part time work, and has received a letter of warning from the university stating that he must attend the tutorials in order to pass. Your friend asks you to mark his name present on the roll.
- What would you do in this situation?
- What factors may have led to your friend asking you to do this?
- Is it ever justified to lie on behalf of a friend?
- What sources of support would you suggest for your friend?
- How might universities better support students who are struggling financially?
Due to the shortage of General Practitioners in rural communities, the Australian Government has increased the rewards and incentives for doctors to move to these areas. City doctors who move to regional or remote areas will receive up to $120 000 in relocation payments, and up to $47 000 a year to retain doctors in these communities. The government’s approach has been described as ‘the more remote you go, the greater the reward’. Under the new scheme, medical students with a HECS debt can now repay the cost of their studies up to three years earlier by working in rural areas. It has also been suggested that medical programs preferentially admit students who are willing to commit to 2- or 3-year terms in rural areas upon graduation.
- What are the broad implications of this policy for health and healthcare costs?
- Do you think the approach will be effective in attracting doctors to rural areas?
- Do you think the government should be spending this much money on these initiatives?
- What do you think about the government paying for private schooling for the children of rural doctors?
- What are the implications for medical students committing to terms in rural areas?
Doctor Jones is a physician and known to be an excellent diagnostician. He has a successful private practice. He also works in a public hospital one night per week to contribute to the public health system, even though it does not pay as much. His work is often stressful, particularly given many of the referrals he receives are complex and unwell patients. His work commitments mean that he often has limited time to spend with his family.
- What are the rewards of Dr Jones’ career?
- What are the disadvantages of Dr Jones’ career?
- How could Dr Jones cope with or address the stress involved in his career?
- What experiences have you had that have informed your choice to become a doctor?
- What are some of the disadvantages that you would face in the study and practice of medicine
There has been recent debate regarding the benefits of feeding infants with baby formula as opposed to breast milk as well as the accessibility of baby formula in rural towns. In response, the concept of a breast milk bank has been put forth as a solution – such a bank would receive breast milk donations from women and distributes it to mothers who encounter difficulties with lactation.
- What are the benefits of breast milk over baby formula, particularly for those in rural towns?
- Are there any ethical issues that may arise following the introduction of breast milk banks?
- What else can be done to assist mothers who have difficulty lactating?
- What are issues that may be encountered by new mothers living rurally?
- What can be done to combat the lack of accessibility to healthcare in rural areas?
You are currently a student completing your final VCE exams. You’re not quite sure whether you want to go to university as you aspire to be a concert pianist – your parents however have different plans for your future. In spite of your career aspirations, your parents want you to study medicine.
- How would you go about telling your parents that you don’t want to do medicine?
- Do you think it is right to do medicine because your parents want you to?
- What do you think are the right reasons for wanting to do medicine?
- What are the potential repercussions of pursuing a career that you do not want to do?
- What will you choose to do – pursue your career or please your parents? Why?
A shortage of kidney donors is currently a particularly prevalent problem throughout the Australian healthcare system. A plan has been proposed by which potential donors would be financially subsidised by the government for their kidneys. Discuss the potential issues posed by this proposal.
- Do you believe it is ethical to pay potential donors for their organs?
- What potential issues may arise by placing monetary value on organs?
- What are the advantages of introducing such a system?
- What else do you believe can be done to remedy the shortage of kidney donors in Australia?
- How would you increase awareness surrounding the shortage of organ donors in Australia?
You are the music captain at your school and are in charge of running auditions for the school musical. Your best friend is auditioning and you know that although they are a great actor, their singing skills are not sufficient to be in the musical. You don’t want to ruin your relationship with your friend but you’re not sure whether that is reason enough to give them a spot in the musical.
- What would you do given that your friends audition is not to the standard expected to earn a spot in the musical?
- How would you respond if your friend confronts you about not being selected for the musical?
- Would it be ethical to give your friend a spot simply because you are friends?
- Would it be ethical to lie to your friend prior to the audition and tell them that they have selected the cast?
- Is it ever ethical to lie?
You are a medical student on placement in a rural hospital. You are filling out paperwork when a patient is rushed in in a critical condition. You rush to your consultant’s office to find him smelling of alcohol. Although he is intoxicated, he is the only doctor in the hospital that is able to treat the patient.
- A nurse asks you to treat the patient – what do you do?
- Is it ethical for the doctor to treat the patient?
- After the patient is treated and is in a stable condition, what do you do about your consultant?
- Why might there be a shortage of doctors in rural hospitals?
- How might the shortage of doctors in rural hospitals be addressed?
You are a GP working in a private practice in suburban Melbourne. Your next patient comes in and tells you that she is suffering from joint pain and general tiredness. She complains that every doctor she has seen blames her obesity and that she is sick of them targeting her weight. You know that the patient’s weight is the most likely cause of her problems but she demands that you give her a prescription for the pain and let her go.
- How would you deal with this particular patient?
- How might you address a patient that demands a certain prescription without heeding your advice?
- Is it ethical to lie to the patient and tell her that her obesity is not the issue?
- Do you think that exercise should be compulsory for high school students? Are there any ethical issues in making an activity compulsory?
- Should GPs focus more on targeting the lifestyle choices (e.g. exercise, diet) of patients?
Despite recent advances in rural health care the quality of life in rural areas is still considered to be significantly lower than that of metropolitan areas. It has been proposed that the lack of medical professionals in rural areas is the primary contributing factor for this. Discuss.
- What else may contribute to the issue of poor quality of life in rural areas?
- What are some strategies that may be used to improve the access to health care in rural areas?
- Why might medical professionals be hesitant to work in rural areas?
- What might be done to attract medical professionals to work in rural areas?
- Do you believe that bonded medical places – conditional course offers that require medical professionals to work in rural areas after they complete their studies – would help address this issue?
You are a medical student doing a summer internship in a pathology laboratory. You have just obtained the results of a biopsy when you realise that the biopsy was conducted on your close friend. The test results are abnormal and their situation looks dire.
- Do you tell your friend? Why or why not?
- You notice they haven’t have the usual follow up with their doctor – would you contact them?
- How would you approach this if you didn’t know the patient?
- What ethical issues need to be considered when treating friends or family?
- Do you think that medical students should be able to treat friends and family using the knowledge they have learnt?
You are a high school student working on a group project that is to be submitted to a national competition. You have been nominated as the leader of the group but in spite of your substantial leadership experience, you feel nervous about the magnitude of the competition and your role in leading the group.
- What would you do first as leader of the group?
- Each member of the group has specialist knowledge in a particular area – do you assign them the tasks they’re more familiar with?
- One person isn’t contributing as much as the others – how do you address this?
- One person is contribution enough but is not producing work to an adequate standard – how do you address this?
- One of your team members is unwell and continuing on the project would only cause them to deteriorate. Do you encourage them to continue to participate given that the competition is only a few days away?
You are a PhD student who is conducting ground-breaking research in an exciting new field. You are about to attend a conference and present the findings of your research when you receive the results of your last experiment. You discover that these results contradict all of your prior work.
- Your friend suggests that you omit the new data. What do you do?
- You are told that your work is potentially Nobel Prize worthy – does this change your decision?
- You run some further tests and find that your originals findings still have some practical application – does this change your decision? What do you do now?
- How important do you think integrity is in academia and research?
- The omission of negative findings is a prevalent issue in academia. What do you think can be done to combat this?
You are a GP in a clinic in a rural town. The 14 year old daughter of one of your long time patients sees you without her parents and asks for the pill. You give it to her. A week later her mother finds the pills and comes to your practice, angrily demanding to speak to you.
- What do you do?
- What other options could you have offered the girl?
- Did the mother have the right to know what you gave her daughter?
- Should doctor-patient confidentiality still be valid when immediate family are involved?
- Do you think that there should be a minimum age limit for the pill?
You are the principal of a highly regarded school. You discover a video that has been circulating around social media of two year 12 students bullying a younger, disabled student. You call all three students into your office.
- How do you address the students?
- The parents of the disabled child call you and angrily demand that the year 12 students are suspended – how do you respond to this?
- You discover that the video was staged and was made to raise awareness about bullying. How do you respond to this?
- How would you respond if you were being bullied?
- Do you think that the ‘friendly bullying’ of new students or employees, or hazing, has a place in schools or in the workplace?
You are a medical student who is sharing a room with a fellow medical student during the semester. Your roommate likes to go out and party and often fails to submit assignments on time. One weekend, your roommate calls you and says that he is too hungover to finish the assignment. He asks you to finish it, claiming that you’ll only have to write a few paragraphs.
- What do you do?
- Your friend says that he will pay you and that no one will ever know – does this change your decision?
- How important is integrity in the medical profession?
- Your roommate admits he has a drinking problem – how do you respond?
- Your roommate insists that he doesn’t want to see a counsellor – do you try and help him yourself? Why or why not?
You are a first year medical student on the second floor of your parents’ house. One day you see your neighbour, who had recently received money from WorkCover due to a back injury at work, lifting heavy bags of concrete around his backyard. He sees you and gives you a wink before raising a finger to his lips as if to say ‘shh’.
- What do you do?
- Would it change your opinion if your parents knew?
- Would you respond differently if your parents knew and told you specifically not to say anything?
- You confront your neighbour and he agrees to stop receiving WorkCover payments. You discover however that he continues to do so. What do you do?
- Is it ethical in any situation to remain silent as a witness of wrongdoing?
Your grandmother lives alone and is fiercely independent. Recently however, she has become quite ill and your mother is worried that she is unable to look after herself anymore. Your grandmother however flatly refuses to live in a nursing home. Your mother then decides that it would be best for her if she came and lived with the family instead. Your father however, is resolutely against this idea.
- What should your mother do?
- How might you discuss this with your father?
- How might you persuade your father that your grandmother should come and live with you?
- After living with you for a few weeks, you come to learn that you grandmother is very conservative. How might you react to this?
- Your father is growing increasingly frustrated with your grandmother’s presence and threatens to move out if she does not leave. What do you do?
You are a first year medical student whose little brother has been selected to represent Australia in an U16 basketball competition in the USA. Your mother is worried as a swine flu situation is forming in the USA and your brother’s diabetes makes him a high risk person. Your brother insists that he will be fine but your mother is intent on not letting him go.
- Who do you think is right, your mother or your brother?
- As the mediator between your mother and brother, what do you do?
- Naturally, your brother is frustrated with your mother’s decision. What might you do to console him?
- Many countries started stockpiling Tamiflu (a swine flu medication) following the outbreak. What are the problems with this?
- What can be done to prevent outbreaks such as that of the swine flu?
Your little sister wants to become a doctor. She did exceptionally well in her university entrance exams and as a result, was offered a full scholarship for a biomedical degree with guaranteed entry into postgraduate medicine. There is also the option of undergraduate medicine – this pathway however is not guaranteed, nor will your sister receive a scholarship.
- What do you think your little sister should choose?
- What are the advantages of undergraduate medicine over graduate medicine?
- What are the qualities needed for a person to succeed in graduate medicine?
- What are the qualities needed for a person to succeed in any sort of medical course?
- What is your motivation to pursue a career in medicine?
You are a medical student on placement at a metropolitan hospital. A patient comes in with severe pain in her abdomen caused by a tube left over from a previous surgery in your hospital. There had been a misunderstanding and she did not realise that she needed to come back again to remove the tube a week after her first surgery. The hospital said that it was not their responsibility as they had informed the patient already.
- The patient comes and speaks to you about her situation. As a medical student, how do you respond?
- Who is at fault in this situation? Is this a case of neglect?
- What might have caused the misunderstanding?
- What would you suggest should be done to improve the situation?
- What further action should be taken to prevent this from happening again?
The 2016 United Kingdom budget saw the announcement of a sugar tax that would tax sugary beverage manufacturers according to the volume of sugary beverages they produce. The announcement was met by vehement opposition from such manufacturers who claimed that such a tax is unfounded and unnecessary.
- What do you think the introduction of such a tax would achieve?
- Do you think that a sugar tax is ethical? Why or why not?
- How much control do you think governments should have on what its citizens consume?
- What alternatives are there to imposing a sugar tax on beverage manufacturers?
- Proponents of the sugar tax claim that it will have substantial long-term effects in the prevention of diseases such as diabetes. How important is preventative medicine in the sustainability of a health care system?
You are a teacher in a rural primary school that is largely composed of indigenous children. There is a state funded program that provides $5000 per month to provide breakfast for the children as many are from disadvantaged backgrounds and cannot not afford to be fed in the morning. There has been a visible improvement in children’s performance now that they are guaranteed to have breakfast. The president however wants to scrap this program and use the money to buy more books for the school library that has not been updated for two years. He states that, “with a new library it will benefit all children, not just the black ones.”.
- What do you say to the president?
- What would happen if the program was scrapped?
- What would you do if the program were scrapped?
- Are there any alternatives to stopping the program?
- A mother complained that her sons reading was not up to standard and stated that she would rather see the money go toward more books. How do you respond?
You are a house captain and your school is running a house choir competition. You are trying to organise a time during which your house can practice but you find that no one is willing to put in the effort to do so.
- Your vice house captain is being difficult and contradicts you in front of everyone. What do you do?
- Have you ever been in a situation where someone in a team wasn’t pulling their weight? What did you do?
- You notice that two particular people are incredibly enthusiastic but can’t really sing. What do you do?
- Your vice-captain is becoming increasingly difficult and doesn’t show up to the final practice. What do you do?
- On the day of the performance your pianist falls ill but insists that she can still play. What do you do?
Due to media reports of ‘bad doctors’ it is proposed that doctors sit an exam every five years to ensure their skills and knowledge is up to date. The proposal was poorly received by most medical professionals who believe that the years of training they receive is sufficient.
- What do you think of this proposal?
- What are the alternatives to this proposal?
- Do you think the media should influence health policy?
- Do you think doctors should be rated or reviewed by their patients?
- How important is negative feedback compared to positive feedback in encouraging self- improvement?