Sample Questions 2013 2014 Mmi
Sample Questions 2013 2014 Mmi
Sample Questions 2013 2014 Mmi
Ethical Dilemma:
Abortion
Dual Relationships
Conflict of interest
Euthanasia / End-of-life care
Substitute decision-making
1. A 14 year old patient requests birth control pills from you and asks that you not tell her parents. What would you
do?
2. A member of your family decides to depend solely on alternative medicine for treatment of his or her significant
illness. What would you do?
3. If you have the choice of giving a transplant to a successful elderly member of the community and a 20 year old drug
addict how do you choose?
4. An eighteen year-old female arrives in the emergency room with a profound nose bleed. You are the physician, and
you have stopped the bleeding. She is now in a coma from blood loss and will die without a transfusion. A nurse
finds a recent signed card from Jehovah's Witnesses Church in the patient's purse refusing blood transfusions under
any circumstance. What would you do?
5. The Canadian Pediatric Association has recommended that circumcisions 'not be routinely performed'.
They base this recommendation on their determination that 'the benefits have not been shown to clearly outweigh
the risks and costs'. Doctors have no obligation to refer for, or provide, a circumcision, but many do, even when they
are clearly not medically necessary. BC Medicare no longer pays for unnecessary circumcisions.
Consider the ethical problems that exist in this case. Discuss these issues with the interviewer.
6. A Vancouver bio-tech company was hired by the US Military to develop a cure for Ebola. They successfully
developed a vaccine to treat the symptoms of the virus and lowered the mortality rate for infected patients. Discuss
the implications of this on a global scale.
7. Your mother calls you and asks you to help with a major family decision. Your maternal grandfather is 70 years old
and has been diagnosed with a condition that will kill him some time in the next five years. He can have a procedure
that will correct the disease and not leave him with any long-term problems, but the procedure has a 10% mortality
rate. He wants to have the procedure, but your mother does not want him to. How would you help mediate this
issue?
8. You are a genetic counselor. One of your clients, Linda, had a boy with a genetic defect that may have a high
recurrence risk, meaning her subsequent pregnancies has a high chance of being affected by the same defect. You
offered genetic testing of Linda, her husband, and their son to find out more about their disease, to which everyone
agreed. The result showed that neither Linda nor her husband carry the mutation, while the boy inherited the
mutation on a paternal chromosome that did not come from Linda's husband. In other words, the boy's biological
father is someone else, who is unaware that he carries the mutation.
You suspect that Linda nor her husband are aware of this non-paternity. How would you disclose the results of this
genetic analysis to Linda and her family? What principles and who do you have to take into consideration in this
case?
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25. Dr. Blair recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted
theory to suggest that homeopathic medicines work, and Dr. Blair doesn't believe them to. He recommends
homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle
aches, because he believes that it will do no harm, but will give them reassurance. Consider the ethical problems
that Dr. Blairs behaviour might pose. Discuss.
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Physician shortage
Private vs public system
Wait time
Principles of Canadian Health Care: Public administration, comprehensiveness, universality, portability, accessibility
26. The City of Vancouver has taken great measures to increase accessibility to alternative forms of transportation
(Canada Line, Hornby and Dunsmuir Bike Lanes, Proposed Evergreen Line, and Burrard Street Bridge closures).
Discuss the impacts (both positive and negative) of these decisions?
27. If the Prime Minister of Canada were to ask your advice on one change that could be applied to the healthcare
system in Canada that would improve it enormously and have the greatest positive effect, how would you answer?
28. The man who lives next door to you often rides his bicycle in the company of his two young children but without a
helmet. In fact, on several occasions you have seen him riding with his helmet hanging by its straps from the
handlebars. His young children sometimes wear a helmet, sometimes not. If the man fell off his bicycle and hurt his
head in a way that would have been prevented if he had worn a helmet, would it be reasonable to ask him to
contribute towards the treatment costs for his injury?
29. Due to a shortage of physicians in rural and Northern communities in BC, some policy-makers have suggested that
medical programs preferentially admit students who are willing to commit to a 2 or 3 year tenure in rural areas after
graduation. Consider the broad implications of this policy for health care and the costs associated. Will this policy be
effective?
30. Recently, certain hospitals in the Vancouver Area have been charging patients $29/day for their hospital fee on top
of the fees charged to MSP. What are the implications of this policy? Discuss both positive and negative impacts
with the interviewer.
31. Do you think general practitioners have an obligation to report their patients' health status to a public health
agency, if their patients have active infectious diseases?
32. Statistics have shown that effects of advanced age such as changes in vision and response time may adversely affect
elderly drivers' ability to drive safely. As a matter of fact, many doctors discuss the issue of stopping driving with
their older patients as a precaution for the safety of theirs as well as the public's. Do you think older drivers have to
give up driving when they reach a certain age?
33. In recent years, there has been an increase in popularity of full contact sports, such as Ultimate Fighting
Championship (UFC) and boxing. Should doctors have a role in regulating such sports?
34. Do you think medicine should be more about changing behaviour to prevent disease or treating existing disease?
35. Discuss the pros and cons of legalizing marijuana on the Canadian Health Care system. How does this impact a
physicians present ability to write out prescription for medical marijuana? Would legalization cost the health care
system more or less after it was passed?
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48. Liberation Therapy (LT), a vascular operation developed to potentially cure multiple sclerosis (MS) in certain
patients, has recently come under very serious criticism delaying its widespread use. Among other experimental
flaws, critics cite a small sample size in the original evidence used to support LT. As a healthcare policy maker, your
job is to weigh the pros and cons in approving novel drugs and therapies. Please discuss the issues you would
consider during an approval process for LT.
49. In June 2011, the infamous Vancouver riots took place after their hockey team lost in the Stanley Cup Finals. Stores
were ransacked and cars were burned. Hundreds of people were injured and sent to overcrowded hospitals. As the
police chief in Vancouver, what measures or policies would you put in place to make sure this does not happen
again?
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Health Canada Website and Health Canada Act and Publications: http://www.hc-sc.gc.ca
Comparison of Canadian and American Health Systems: http://dsp-psd.pwgsc.gc.ca/Collection-R/LoPBdP/BP/bp300e.htm
Prescription for Excellence Michael Rachils, MD http://www.michaelrachlis.com
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