Medicine interviews

Question 1

Challenges of being a doctor

Answer 1

Long/anti-social hours: Carer, street assist
Breaking bad news/witnessing passing of patients: Carer (witnessing death of clients)

Learn through experiences and always talk to friends/family if you are struggling. Prevent burnout.

Question 2

Why become a doctor?

Answer 2

Depth of medical knowledge
Patient-centred care
Leadership and decision-making
Research and innovation

Question 3

How to balance my degree?

Answer 3

Always had to have a job to keep financially independent.
Realised what is important to me and how to prioritise - “rly want to got out but have an important test in 2 weeks time, then i would go to library”
Surround myself with like-minded people who understand the demands of their degree.

Question 4

Postcode lottery

Answer 4

The quality and availability of healthcare services can vary depending on geographical location. Access to treatments and specialists can be more readily available in some regions than others. This inequality leads to disparities in health outcomes based on where an individual lives.

• Lung cancer and COPD are more common in poorer communities, due to their association with smoking. This in large part reflects higher rates of smoking among deprived groups. A total of 23% of those earning under £10,000 are smokers, compared with 11% of those earning £40,000.
• Poor housing is another challenge. Mold spores and dust mites, which can lead to asthma and general respiratory irritation, are most common in damp, less well-constructed houses. This affects mainly people who are on the lowest incomes and unable to afford a better home.
• In Wales, fee exemption rules on prescriptions, leading to the phenomenon of “drug runs” whereby people on the English side of the border drive across to stock up on cheaper medicines
• In England, people living in the poorest areas will die, on average, seven years earlier than those in the richest areas.
• Well-off Kingston and Richmond, Surrey, has 50% more GPs than deprived Barnsley, for example.
• the poorer you are, and the more socially deprived your area, the worse your care and access to it is likely to be “inverse care law”

How to fix this:
- National service frameworks set in place, setting a standard of care for key conditions and diseases.
- the Commission for Health Improvement which will monitor the quality of NHS services and have powers to send in “hit squads” to take over failing hospitals
- Nice - the National Institute for Clinical Effectiveness (in Scotland, the Scottish Health Technology Assessment Centre), which will make NHS-wide decisions on the availability of expensive new drugs and treatments.
- In the 2001 election manifesto, Labour pledges to “further tackle the lottery of care” and says it will force health authorities and trusts to pay for drugs and treatments that are approved by Nice.

Question 5

UK, canada and US healthcare system comparisons

Answer 5

Universal Access: Canada and the UK have universal access, while the U.S. does not. Both universal systems typically have lower administrative costs compared to the U.S. system.
Cost: The U.S. spends significantly more on healthcare per capita compared to Canada and the UK, yet it does not achieve universal coverage. Canada and the UK spend less per capita but provide universal coverage.
Choice of Providers: The U.S. offers greater choice in healthcare providers and facilities. In Canada and the UK, patients often have less choice but are guaranteed access to care.
Wait Times: Canada and the UK have experienced challenges with wait times for some medical services. In contrast, the U.S. generally has shorter wait times for many services but faces issues related to affordability and access for many individuals.

Question 6

Why do you think healthcare professionals leave the NHS?

Answer 6

1. Workload and Stress: The NHS often faces high patient demand and staff shortages, leading to heavy workloads and stress for healthcare professionals. The pressure to meet patient needs while managing administrative tasks can be overwhelming.
2. Burnout: Prolonged exposure to high levels of stress and overwork can lead to burnout, which may prompt healthcare professionals to seek a change in their career or work environment.
3. Better Work-Life Balance: Some healthcare professionals leave the NHS in pursuit of a better work-life balance. Long working hours and unpredictable schedules can strain personal lives and relationships.
4. Career Advancement: Healthcare professionals may leave to explore new career opportunities, gain further specialization, or pursue research and academia, which may not be readily available within the NHS.
5. Financial Considerations: Salary disparities, limited earning potential, or the desire for more competitive compensation packages can motivate professionals to seek employment in other healthcare systems or sectors.
6. Private Practice: Some doctors opt to transition to private practice, attracted by the potential for higher incomes, greater autonomy, and shorter waiting times for patients.
7. Lack of Resources: Inadequate resources, including outdated equipment and facilities, can hinder the ability to provide high-quality care and may lead professionals to seek better-equipped healthcare settings.
8. Administrative Burden: Administrative tasks, such as paperwork and bureaucratic processes, can be time-consuming and frustrating for healthcare professionals, detracting from patient care.
9. Quality of Care: Concerns about the ability to provide safe and effective patient care due to resource constraints, including staff shortages and insufficient funding, may lead professionals to seek opportunities where they feel they can deliver better care.
10. Moral and Ethical Concerns: Professionals may leave if they perceive that the healthcare system’s values or policies conflict with their ethics or if they believe they can have a greater impact elsewhere.

Question 7

Science v. art

Answer 7

Science: Relies on evidence, research, and an understanding of biology, physiology, pharmacology, and medical technologies. Evidence-based medicine (EBM) emphasises the use of scientific research to guide clinical decisions.

Art: Application of scientific knowledge in a personalised and compassionate manner. Skill of diagnosis and preferences in treatment decisions.
Ability to listen to the patient and their needs. Bedside manner, empathy, and effective doctor-patient relationships are integral to the art of medicine.

Question 8

Doctors leading by example

Answer 8

Trust and Credibility: Patients may find it easier to trust and take advice from doctors who demonstrate healthy lifestyles and adherence to medical recommendations.

Motivation: Leading by example can motivate patients to make positive health choices, such as adopting healthier diets, exercising, and quitting smoking.

Professionalism: Doctors serve as role models for medical students and healthcare professionals, reinforcing the importance of ethical and healthy behavior.

Question 9

Doctors bad press

Answer 9

Resource Constraints: Reports of waiting times, staff shortages, and resource limitations can lead to criticism.

Exceptional Cases: High-profile cases of medical errors or patient dissatisfaction may receive significant media attention.

Political Debates: Healthcare is often a subject of political debates, and media coverage can be influenced by partisan interests.

Patient Experiences: Patients’ personal experiences, whether positive or negative, can shape media stories.

Question 10

Non-essential surgery

Answer 10

For Non-Essential Surgery:
1. Improved Quality of Life: Non-essential surgeries, such as cosmetic procedures or joint replacements, can significantly improve patients’ quality of life by reducing pain, enhancing mobility, or boosting self-esteem.
2. Preventative Impact: Some non-essential surgeries can prevent the progression of underlying conditions, reducing the need for more extensive interventions in the future.
3. Patient Choice: Allowing non-essential surgeries on the NHS respects patient autonomy and choice, as individuals may prioritize certain procedures for personal or psychological reasons.
4. Economic Impact: Revenue generated by non-essential surgeries can help fund essential healthcare services, reducing the burden on the healthcare system.

Against Non-Essential Surgery:
1. Resource Allocation: Limited healthcare resources, including operating rooms and staff, should be prioritized for essential and life-saving procedures.
2. Cost-Effectiveness: Non-essential surgeries may not provide the same cost-effectiveness in terms of health outcomes compared to investing resources in preventive care or treating more critical conditions.
3. Inequality: Prioritizing non-essential surgeries may exacerbate healthcare inequalities, as those who can afford private healthcare may receive quicker access.
4. Ethical Dilemmas: Determining what qualifies as “non-essential” can raise ethical dilemmas and challenges in decision-making.