key issues and topics you need to know about

Question 1

Harold Shipman case

Answer 1

HS was a practicing GP and was convicted of the murder of 15 patients and forging a will

Question 2

what was the consequences of Harold Shipman case

Answer 2

• A move away from single-handed GP practices

As Shipman was working on his own, there were few opportunities for colleagues to check on what he was doing. As a result, he was able to murder many without questions being asked

• Tighter regulations on the use of controlled drug
• Tighter regulation of death certification
• Review of the revalidation

Question 3

MMR vaccination and the 2013 measles epidemic

Answer 3

surgeon Andrew Wakefield published a researcher paper showing that there was a link between the administration of the Measles

called for th suspension of MMR until further research could be done

suggested parents opt for single jabs agains measles mumps e.t.c separated by gaps of one year

Question 4

what happened as a result of Wakefield’s statement

Answer 4

manyh parents around the world became worried about their child developing autism as a result of the MMR vaccination and decided against giving the vaccine to their child

0 resulted in more cases of measles being reported in 2008 than any year since 1997

more than 90% of those infected had not been vaccinated

Question 5

the structure of medical training

Answer 5

step 1: foundation year
-after leaving medical school

2 years designed to help young doctors get used to working as “proper” doctors

step 2 core training
-give trainees a good basis in their area of interest

step 3: specialist training
-ranges form 4-9 years

Question 6

clinical govermance

Answer 6

it is a concept familiar to all doctors

essentially set of principles and behaviours that all doctors should adhere to in order to ensure that they offer their patients the best quality clinical care

Question 7

what are the fundamental principles of clinical principles

Answer 7

• doctors should ensure that their practice is compliant with the latest evidence
• Doctors should provide safe care to their patients and ensure they do not place their patients at risk
• doctors should ensure they recognise when they have reached their limitations and should be willing to ask for help if necessary

Question 8

audit process

Answer 8

systematic examination of current practice to assess how an institution/ practitioner is performing against set standards

Question 9

why are audits important

Answer 9

main purpose of an audit is to identify weaknesses in your practice and increases the quality of service provided to users

provide opportunities for training and education

Question 10

how does the audit process occur

Answer 10

referred to as the “audit cycle”

1. chosse a topic for the audit
2. define standard that you would like to be achieved
3. collect relevant data
4. compare results of analysis against standard
5. identify changes that need to b*complete loop) several months later to measure the impacts of the change

Question 11

the four ethical principles

Answer 11

1. autonomy
   - patients are entitled to their opinion and to make decisions for themselves, In particular, patients have the tight to choose the treatment that they feel is best for them and also have the right to refuse treatment
2. beneficence
   doctors have to have the best interest of their patients
3. justice
   patients who are in the same position should be considered in the same way

4.right to confidentiality

Question 12

informed consent

Answer 12

they have the right to procedure with treatment

after been given all the relevant information

Question 13

competence of a patient

Answer 13

consent can only be taken form patients who are deemed competent

in other words, they understand the information given to them and are able to make rational decisions themselves

competencey is assessed by Doctors and nurses

Question 14

when are adults deemed competent

Answer 14

adults and children aged 16-17 are deemed competent unless proven otherwide

If an adult is not comprtent e.g. because they have a serious mental disorder, no other party can give consent on their behalf their are two options

Question 15

what are the two options

Answer 15

1. if a parent issued a living will at an earlier date stating how the wich to be treated if they are at some point unable to make decisions themselves
2. if patients have not indicated any particular wishes, it is up to the doctors to act in the best interest of the patient

Question 16

children below the ages of 16

Answer 16

deemed competent if they are shown to be mature enough to understand information given to them about the procedure and its consequence

however doctors have the responsibility to discuss with the child the possible involvement of the parents/ legal discussion

if the child does not wish to involve their parents then they should respect this as it would be a breach of confidentiality (unless child is deemed not competent or id the child is in danger)

Question 17

what happens if both of the parents disagree for a life or death procedure

Answer 17

if both parents refused to give consent on behalf of their child for a life-saving procedure, doctors would need to act in the best interest of the child

If possible, they should get a court order to impose treatment

If time is of the essence they should do the treatment first and justify that decision later if needed

Question 18

when can you breach confidentiality

Answer 18

when it is in the public interest to protect the patients and others

-where the interest to society or others of disclosing the information without the patient’s consent outweighs the benefit to the patient of keeping the information confidential

suspected case of child abuse or neglect

Question 19

what are is the best way to answer a question

Answer 19

S- What is the context of the story

T - What was the aim

A - What did you do

R - what was the end result

R - what did you feel you did well, what would you have done differently, what skills did you demonstrate

Question 20

how do you answer questions relating to doctors

Answer 20

Clinical - patient care

Academic - teaching and research

management - managing others, running
and developing services

Personal - personal attributes and hobbies

Question 21

example of using CAMP

Answer 21

Clinical - they have meetings to discuss complex cases and they invest time in keeping up yo date e.g. reading journals

Academic - they teach medial students, trainees and professionals. They also undertake research

Management they manage and support other collegues

Personal they try and have their own life