How to Appropriately Respond to the Ethical Station in Medical School Interviews

As medical school interviews are being sent out, many aspiring medical students are rushing to get in as much practice as they can. I remember that during this time, one of the toughest challenges to prepare for was the ethics station. Students may be faced with this type of question in multiple different ways: one or more stations in an MMI format (ex. University of British Columbia, McMaster), a single rotation in the MPI format (ex. University of Toronto), or “Discuss how you would respond to this ethical situation” in a more traditional panel interview (ex. University of Ottawa).

As it is almost impossible to predict which ethical problem you will be faced with on your interview day, a better method of preparing is to have an approach that you follow. Below I outline the approach I used when I was faced with any ethical dilemma in an interview setting as this step-wise approach can be very successful when used effectively.

Framework

1. Introduce topic with empathy

a) “When faced with a dilemma like this, I like to take this approach…”

b) “When faced with a dilemma like this, it’s important to…”

2. Discuss all perspectives / stakeholders involved

a) Put yourself in their shoes

  •  As the patient, I’m thinking…
  •  As a physician, my thought is…

b) Try to think of an “outside the box” stakeholder (i.e. the community where this ethical situation is taking place, the government, etc. c) Attempt to discuss the various perspectives in a non-biased and non-judgmental way.

3. Get to the root cause of the issue OR Discuss the underlying question/theme that the situation encompasses

a) Ex. Patient autonomy, confidentiality, beneficence

b) Attempt to summarize the situation by giving it a “one-word theme”

4. Clearly state the underlying issue!

5. If possible, consult outside sources/experts

a) If the situation takes place in a hospital, consult an ethics board.

6. Make a decision or outline next steps

a) In this case, I would lean towards…

b) These are the next steps I would take to resolve this issue…1,2,3

7. Be malleable.

a) If the situation were to change or new information were to arise, be ready to adjust your decision.

I hope that this approach was helpful to you and you begin to implement aspects of it into all of your answers. I also encourage all students to read “Doing Right” by Philip Hebert (aka. the medical ethics how-to manual) and continue to practice this approach or any other methods you’ve developed on new, challenging ethical problems.