Interview Prep Flashcards
What do I want from a medical school?
PBL/CBL - application of the science into real life scenarios
Full body dissection - practical way of anatomy which can’t be learnt from a textbook
Clinical placements throughout the course and lots of patient contact
Manchester unique points
Support team for medical students
Technology enhanced learning - free iPads
PEP programme - research projects and analysing literature
Focus on independent learning and small group sizes for PBL
Peak District and audacious
Cardiff unique points
Varied placements - more than just city medicine
Altruistic approach
Medic sports teams
Medic support systems
Spiral learning - revisiting topics but each time having more patient contact and more responsibility
Harmonised 5th year - not exam focused and elective for Africa
Simulator
World leading in clinical neurosciences
Teamwork examples
Youth - task distribution and involving seniors
Hospice - coordinating with the chef, nurses and other volunteers to ensure efficiency
Painting the church - me on the scaffolding, those older lower down
Welsh NHS
No NHS prescription charge
7 health boards - each is responsible for delivering all healthcare services
3 trusts
GMC roles
Keeping a register of all qualified doctors
Fostering good medical practice
Promoting high standards of medical education and training
Dealing with doctors who may not be fit to practice
Informed consent
Means that the patient has consented to a procedure or treatment having been given and having considered all the facts that were necessary for a decision to be reached
Four principles of medical ethics plus another key point
Autonomy - patient has the right to make their own decisions
Beneficence - do good and act in the best interests of the patient
Non-maleficence - doctors shouldn’t act in a way that will harm
Justice - fairness in medical practice, only discriminate based on clinical needs
Confidentiality
Why GP?
Holistic approach to patient care - lifestyle intervention
Ongoing patient relationship
More flexibility to accommodate work life balance
Variety
Work in the community
Opportunity to run lifestyle intervention clinics
Recent medical interests
China study
Dr Esselstyn and heart disease
Cognitive behavioural therapy for insomnia reverses grey matter atrophy in those with fibro
Preliminary ideas of using medication to combat insulin resistance to help reduce pain from fibro
Welsh trusts
Welsh ambulance services
Velindre NHS trust - specialist cancer care and support
Public Health Wales - organisation as opposed to delivery of healthcare
What does Crowland GP practice provide that hospitals often can’t?
Additional support for carers
Smoking cessation service
20th century medical advances
Boost in pharmacology - vaccines e.g. Smallpox and polio
Antibiotics - penicillin Alexander Fleming
Imaging - PET, MRI, ultrasound imaging
Artificial organs - for kidney failure
Prosthetics
Politics in healthcare
Working hours - European time directive
Funding
Regulation - e.g. Of pharmaceutical companies
Rationing - making cuts and restrictions
Holistic medicine
Treating the patient as a whole
Not only physical but also social and psychological issues
E.g. Rash - give them ointment but also determine whether it could’ve been caused by a stressful lifestyle
Chronic illness - not just the physical aspects but the psychological and social impact
IT in medicine
Sending referrals
Storing patient data
Pathology results e.g. Blood tests
Imaging results
Organs could be built using 3D printer
Teaching and research
Patients can make GP appointments and request repeat prescriptions
A doctors team
Other doctors
Nurses and healthcare assistants
Secretaries and receptionists
GPs and other specialists
Dietitians
Porters
Cleaners
Physiotherapists
Patients
Social workers
Extended roles of nurses
Due to the decrease in doctors working hours nurses have been able to take extended roles in medicine:
Advanced nurse practitioners
Speciality nurse practitioners
Managerial nurses
Research nurses
Does the bulk of medical treatment occur in the community or the hospital?
In the community:
Self-medication
GPs are the first port of call
Some GPs can provide basic specialist care
Chronic diseases
Community speciality doctors
Outreach clinics
Multiculturalism in medicine
Can impact treatment - Jehovahs witnesses and blood transfusions
Widening participation schemes for medical schools
Results in medical practitioners requiring education about cultures and beliefs
Language barriers
Euthanasia
Active euthanasia - act of ending someone’s life through a practical action
Passive euthanasia - lack of action results in the death
Voluntary euthanasia - euthanasia with consent
Non-voluntary euthanasia - where the person whose life has ended was unable to give consent
Involuntary euthanasia - where the person whose life was ended was able to give consent but said no to euthanasia or wasn’t asked
Arguments in favour of euthanasia
Patients should be allowed to choose what is best for them
Patients can avoid lengthy and unnecessary suffering
Patients can die with dignity at a time of their choices
It would free up beds and other NHS resources
Arguments against euthanasia
Goes against religious principles - doctors or relatives playing God
People may have changed their mind at a later time when they may have already passed away
Cases where lost causes have recovered
Difficult to set specific criteria
Relatives could face murder charges or abuse the situation
Patient may be pressured into it
Causes of anger, stress, aggression etc in patients
Influence of drugs
They are in pain
Waiting times and delays
They don’t feel they are being listened to
Fear
Advantages of PBL
Provides a practical view of medicine
Small group teaching - greater contributions from each student
Promotes teamwork
Early exposure to clinical scenarios and patient contact
Facilitator makes sure the learning is guided in the right direction
Disadvantages of PBL
Some topics may be best taught formally
May leave gaps which would need to be filled by lectures or reading
Learning experience is dependent on the rest of your team
Advantages of lecture-based learning
Ensures all students receive the same information
Students drive their own learning experience
Strong background in scientific principles
Disadvantages of lecture-based learning
No real life application for the first few years
Patient contact is delayed
Lectures can be boring
Difficult to participate and ask questions
Same pace of learning for all students
Qualities that make a good doctor
Empathy
Teamwork
Communication
Remaining calm under pressure
Integrity
Skills learnt from my hospice work experience
Communication - particularly listening to patients and relatives
Empathy
Building trust
Teamwork
Patience
Skills learnt from youth work and peer mentoring
Communication
Being a role model/leader
Teamwork
Key situations in the hospice
Puzzles and time with Bruce - he had no visitors
The angry lady when I brought her food
The relative who I spoke to about her situation she just needed someone to talk to
Ivy - made her day by going out of my way to bring royals news
Tibial head
The top of the bone below the knee on the inside of the leg
AKA the shinbone
Why do you want to be a doctor?
Unique combination of science and caring for others
Discovered that I wanted to involve the care of others in my career through voluntary work in a youth group and a hospice
Discovered how much I enjoyed medical science from my EPQ project and also the PBL taster sessions at open days
Summary of the China Study
Most comprehensive study of its kind:
65 counties
367 variables used for thousands of comparisons e.g. Blood cholesterol to coronary heart disease
Concluded that a WFPB diet was optimal for human health
Summary of How Not to Die
Unpacks the science of using nutrition in the prevention and treatment of diseases
Then gives more applied practical advice
Points that stood out to me:
Dr Neal Barnard study diabetes
Dr Esselstyn and heart disease
Diseases such as Alzheimers and dementia are linked with plaque build ups in the arteries of brain blood vessels
Dr Dean Ornish and prostate cancer
Integrated course
A course where basic medical sciences are taught concurrently with clinical studies - not in separate years
Advantages of integrated course
Students learn in context
Students are encouraged to take a more holistic approach
Promotion of communication, teamwork, application of knowledge and problem solving skills
Students are able to see a direct application of what they learn early on
Disadvantages of an integrated course
Non-integrated course may provide a stronger underpinning of scientific theories of Medicine
Some topics may be omitted
May require teachers to teach outside their discipline
How have I developed my communication skills
Presentations at school
Hospice work experience
Youth work
Teaching others complex science
STARR framework
Situation/task
Action
Result
Reflection
Attributes of a good team player
Understands his role in the team and how it fits within the whole picture
Respectful of others and supportive
Willing to help
Flexible and adaptable
Communicates constructively and listens actively - encouraging
Reliable, takes responsibility and ownership of his role
Attributes of a good team leader
Has clear objectives and communicates effectively to the team
Leads by example
Understands and motivates the team
Communicates and interacts well with the team
Recognises the need for change and implements it - a decision maker
Flexible
Advantages of being in a team
Able to spread the workload
Easier to gather ideas to deal with issues as everyone can contribute
Can learn from others
Able to rely on the support of others if you require assistance
Can achieve more through using everyone’s strengths
More social environment
Disadvantages of being in a team
Too much input can be confusing - hinders decision making
There could be disputes and ‘group politics’
Requires a strong leader
Can be distracting having to many people around
Shipman case
Harold Shipman was a practicing GP in the Manchester area who was convicted of murdering 15 patients mostly via opiates
MMR vaccination Wakefield case
Results couldn’t be independently validated
His motives were wrong he wanted to scare people into buying a single-jab measles vaccine
Wakefield ignored data that conflicted with his hypothesis
Revalidation
A system used to impose regular checks on doctors to ensure they are fit to practice
Licensed doctors must maintain a portfolio demonstrating good medical practice
Required to link to a responsible officer
Normally the responsible officer will make a recommendation to the GMC regarding fitness to practice every 5 years
Clinical governance
Doctors should ensure their practice is compliant with latest evidence
Provide safe care to patients
Should own up to mistakes and learn from them
Constantly develop skills and should train others
Attentive to patient needs and take on board feedback
Recognise limitations and ask for help
Organisational skills
Time management
Multitasking
Identifying the right resources
Plan effectively
Prioritise
Delegate tasks
Stay focused on the task at hand
What is your main weakness?
Sometimes I can be over-empathetic which could lead to attachment to patients - I am learning from the hospice the balance between empathy and not becoming emotionally involved
Taking criticism too personally - but learning that criticism is a way to improve
What makes a good teacher?
Knowledge
Communication skills
Generating interests
Respect
Approachable and supportive
Reasons for cosmetic surgery
Embarrassment about a particular features
Physically inconvenienced by a feature e.g. Breast reduction to reduce backache
Low self-esteem due to the media
Pressure from others
Advantages of private healthcare
Private healthcare reduces NHS waiting lists
People using private in effect pay twice so the NI contributions can be redirected to other patients
Some doctors use private work to supplement their income and may be driven out of medicine is this is unavailable
Takes some of the strain off the NHS in terms of budgets
Disadvantages of private healthcare
Benefits the wealthier population leading to inequality
Some private institutions subcontract back to the NHS which diverts NHS time and resources away
Financially driven - could be issues with doctor motivation, may not be altruistic
Inequalities in healthcare
Socio-economic inequalities - some areas are less educated regarding health
Geographical distribution of healthcare resources - postcode lottery
Private vs public healthcare
Arguments for paying for your own healthcare
Currently you pay NI regardless of whether you use healthcare services or not - new system would mean you only pay for what you need
Prevents time wasting visits
Introduce competition at doctors’ level leaving to improved standards of care
May encourage healthier lifestyles
Arguments against paying for your own healthcare
Would place the poor at a disadvantage
People may put off seeing a doctor when they need to - could cause problems when urgent medical attention is needed
Patients may choose cheapest treatments rather than the best option
Would disadvantage those with chronic illnesses
Alternative medicine
Complementary medicine
Therapy taken instead of conventional treatment
Therapy taken alongside conventional treatment
Arguments for alternative/complementary therapies
Some therapies take a very holistic approach fulfilling patients spiritual needs
Can offer future hope when conventional medicine has nothing left to offer
May have a role in treating side effects of conventional treatments and medical conditions
Arguments against complementary medicine/alternative medicine
Not a very substantial evidence base
Mechanism of action of alternative therapies is poorly understood
Some complementary therapies involving taken substances that could be toxic
Poorly regulated
Alternative therapists aren’t doctors so won’t be able to advise the patient with the full picture in mind
Self inflicted illnesses examples
Heart and hypertension due to an unhealthy lifestyle
Skin cancer following prolonged exposure to sun rays
Lung cancer due to smoking
Liver cirrhosis due to excessive drinking
It’s important to remember most disease are self inflicted to some extent
Arguments for funding non essential surgery
Some of these surgeries arise from underlying psychological issues
Could lead to debts of patients if not funded
Not funding could push people to choose to have surgery in less regulated environments
Arguments against funding non essential surgery
Some non essential surgeries may be better treated through psychological intervention
People may exploit and abuse this type of surgery being funded
Difficult to implement boundaries - it opens the floodgates and could require additional funding
Why are 60% of medical school applicants female?
Statistics - more girls alive than boys at age 17
Academic success - girls tend to perform better than boys at exams
Government campaigns - Medicine was a male-dominated profession and the government encouraged girls to take up the profession
Work-life balance - European working time directive has reduced working hours making it easier for female doctors to start families
Advantages of extending the role of nurses
May free up doctors’ time and helps reduce waiting lists
Better continuity of care for patients - doctors change posts frequently throughout their training
Nurses may be able to spend more time with patients
Acts as a motivator for nurses
Disadvantages of the extended role of nurses
Nurses are taken away from frontline nursing care
Reduces opportunities for junior doctors which will adversely impact their training
Issue of patients’ confidence - they may not want to be treated by nurses and may prefer a doctor
Example of being a leader
When organising the dodgeball and tug of war
Leading the presentations
Solving the problem of transplant organ shortages
More research into alternatives to living organs
Introduce financial incentives
NHS communicating to help people get over the psychological barrier of donating organs to others
Why do doctors no longer wear a white coats?
Infection control
An effort to get closer to patients and appear more professional
The white coat can be perceived to create an artificial barrier to the doctor-patient relationship
Book that taught be about another side of medicine
Atul Gawande - Being Mortal
This book really emphasised to me the importance of quality of life over prolonging it
This concept I saw put into practice in the hospice
