Medical SJT - The inside scoop

Maintaining professionalism whilst working as a doctor is one of the most fundamental pillars of the profession. Modern medical professionalism includes the ability to communicate specialist knowledge, diagnosis and treatment options in an easy-to-understand way, rather than seeking to use specialist knowledge as a means to create distance from, and a dependency of, the public.

Professionalism also involves confidentiality, continuity, trust, honesty and compassion. As a junior doctor your professionalism will be tested, and it is important particularly in the early stages of your career you seek guidance, mentorship and CPD to continually develop this skill.

Maintaining excellent medical professionalism will allow you to practice medicine in a safe and effective manner, ensuring you are always putting the patient’s best interest first and maintaining the doctor-patient relationship.

Below are some SJT questions which touch on the themes of professionalism and the close link it has with good communication and effective teamwork.

 

Question 1:

Mr West, a 74-year-old patient is being prepared for discharge today and is going home. He was brought into hospital following an episode of wheezing suffering an acute asthma exacerbation. He is much better now and is otherwise deemed fit and well. His son feels it is best for his dad to go into a full-time nursing home as living alone is becoming more challenging.

Rank in order the following actions in response to this situation (A = most appropriate; E = least appropriate).

A: Rearrange the discharge for Mr West to a local nursing home

B: Discuss with Mr West how he is coping with living alone at home

C: Ask the son what his concerns are regarding Mr West living at home alone

D: Tell Mr West his son’s concerns

E: Ignore the son’s concern and complete the discharge as normal

 

Question 2:

You see a 45-year-old woman with Type 2 Diabetes. Her diabetes is uncontrolled, her adherence to medication is not great and she is living a non-active lifestyle and still eating a high sugar diet.

Rank in order the following actions in response to this situation (A = most appropriate; E = least appropriate).

A: Discuss the patient’s medication and optimise her treatment

B: Ask her thoughts on her diet and lifestyle

C: Refer her to the diabetes dietetics service

D: Tell her she needs to eat less sugar as she is increasing the burden on NHS resources

E: Provide her brief information on the recommended physical exercise she should be doing

 

Question 3:

A patient comes up to you asking you to prescribe a natural drug they have taken when they lived in China to manage their hypertension. You are not familiar with the drug and have not seen it mentioned in any guidelines.

Rank in order the following actions in response to this situation (A = most appropriate; E = least appropriate).

A: Advise the patient you will read up about the supplement and come back to them, in the mean time they should not buy the drug

B: Tell the patient it is not going to work, you are the expert not them

C: Advise the patient to go and buy the drug online

D: Refuse to prescribe the medicine

E: Provide information, evidence and advice on current NHS available treatments used to manage hypertension

 

Question 4:

You are on a social night out with friends, it’s late into the night when you bump into an FY1 colleague. Your colleague is heavily intoxicated and informs you they are going to need a lot of coffee in the morning as they start their shift in 4 hours.

Rank in order the following actions in response to this situation (A = most appropriate; E = least appropriate).

A: Continue enjoying your social night out as normal, you’re not working tomorrow so it’s not your problem

B: Advise your colleague to go home now so they can at least get a little extra sleep before they have to start work

C: Inform a senior colleague as you are worried about compromising patient safety

D: Firmly advise your colleague to go home, call in sick and not come into work the next day as they will not be fit to practice.

E: Take your colleague home and make the necessary arrangements for him not to attend work the next day, reminding him the importance of professionalism and ensuring his social life is planned so it doesn’t impact patient care

 

Question 5:

The consultant on your ward, Dr Shah, is a good friend of yours. He has just sent you a WhatsApp message saying his train has been delayed, he is running 45 minutes late for work and asks you to cover for him. One of the patients on the ward informs you that Dr Shah was supposed to be discharging him first thing that morning and it is now 9am. He explains that it is urgent he is discharged first thing as he has a job interview he needs to attend at 10:30am.

Rank in order the following actions in response to this situation (A = most appropriate; E = least appropriate).

A: Offer the patient the option of signing a self-discharge form.

B: Contact Dr Shah finding out whether he can verbally approve the discharge

C: Explain to the patient that Mr Shah is running late so he should make the people interviewing him aware that he may be delayed for his job interview

D: Find another senior colleague in your team to review and discharge the patient

E: Sign the discharge papers yourself

 

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