Queens Belfast

Question 1

Give info about interview

Answer 1

. 7 MMI interviews.
Two are role play

Question 2

What are the 4 key themes they want to look at

Answer 2

Empathy

Problem solving

Moral reasoning

Communication

Question 3

What have you learnt from volunteering at the nursing home

Answer 3

• I volunteer at Bridgeside nursing home. I have the opportunity to meet with patients weekly, where usually I try to help the staff by taking them outside for fresh air, or simply conversing with them.
  Many of the patients have dementia, and I’ve learned how to change my way of speaking for them to understand me and feel comfortable. For example I’ve recently been going through old photos with an elderly woman with dementia, and although i can see the frustration she has about not being able to remember names, something I’ve learned is to change the subject and distract her from it which I have found has prevented her from getting frustrated.
  Overall, I’ve learnt the importance of communication, whether it has been actively listening to their stories.

I also attended a board meeting with all the staff in the home, where they discussed any problems they encountered that month and how to stop these happening. This taught me the importance of communicating between staff also, as the struggles were layed out on the table and everyone came to a consensus on how to stop these problems happening again.
The staff explained to me how the residents can feel quite forgotten in the home, so if they ever have a spare minute they spend it talking and asking about the patient.

. I also did some gardening with them in the summer where we harvested tomatoes which was a really fun activity to get them involved.

Question 4

What have you done to be a suitable doctor in the future

Answer 4

. Nursing home has taught me communication with elderly patients and those with dementia

. Work experience in intensive care unit has helped me understand empathy, for example story of blood clot man.

. Duke of Edinburgh Gold has helped me improve both my leadership and teamwork skills.

Question 5

Explain a time where you showed leadership skills

Answer 5

Talk about DofE Bailey situation

Question 6

Explain a time where you showed teamwork skills

Answer 6

On my Duke of Edinburgh Gold exhibition in the Brecon Beacons my friend had been complaining about a leg cramp on the morning of the last day, and as we were walking this pain heightened and she was unable to walk.

I suggested we sat down so she could rest her leg, and decided that it would be a good idea for us to split her belongings equally between the four of us.
This meant she had less weight to carry so hopefully the pain would be alleviated.

Luckily this suggestion worked as we were able to make it to the meeting point where we were going back to London, so she was able to treat her leg properly and recover.

Question 7

Why do you want to study here in Belfast

Answer 7

. My parents are both from waterford so I’ve spent every christmas, easter and summer here in Ireland.
I’ve grown to love the slower pace of life here as I’m used to living in a more stressed city environment I always enjoy coming to Irish towns such as belfast where there is a much stronger sense of community.

. My dad did a masters here in Belfast, but in Ulster university and stayed in the Holylands, which we actually went to see this morning and I’ve had a lovely walk around the town and I really like it here

. I have an Auntie in Donegal and another in Roscommon neither of which are too far away so I feel that if i came here I’d have a really strong support network around me even if my parents are in london.

Also the campus is absolutely beautiful and it would be amazing to study in such a historical university

Question 8

Why is Queens University belfast a good medical school

Answer 8

• They teach in case based learning which is effective because you can apply your knowledge about a certain disease, to a real life scenario.
  It also will help me work on teamwork and communication skills as working in groups allows lots of opportunities to ask questions.
• The simulation suite is a great way to develop my clinical skills, where there may be actors for me to practice them with. It will simulate a real clinical environment, with patient rooms, and also mannequins. I think this will be really helpful for me because I won’t be afraid to make mistakes as no patients will actually be harmed.
• Open Cadaver dissection is a great way to get hands on and really be able to connect the dots on how organs function together to make a system. I am a visual learner so I know I’d really enjoy these classes.

. Welcome Wolfson research . Intercalated year is something I definitely want to take part in. In particular I did work experience with PHD students who were looking into ventilation and how it can damage lungs. Eg VILI and single/double ventilation so I’ve heard there is research being done here about respiratory medicine which I would love to be a part of.

• Early patient contact from the first year
• Reflective practice tutors: I am a very curious person who asks lots of questions so it will be a great supportive environment to learn. After attending a lecture I may be confused…

Question 9

What research is Queens belfast currently conducting

Answer 9

Welcome-wolfson makes scientific breakthroughs for disease.
It is second in the UK for research power.

Some research that I have found interesting is respiratory medicine. So looking into asthma, cystic fibrosis.

I did some work experience looking into how ventilators can damage lungs. Called VILI ventilator induced lung injury.
So single lung ventilation can put lots of stress on one lung and weaken it in the long term, whilst double lung ventilation is also thought to damage lungs. It can overstretch the alveoli air sacs when a patient is on ventilation eg if they’re in a coma.
The PHD students I was with in Imperial were telling me all about it.

I would love to go to the Welcome Wolfson labs and do some research myself on it.

Question 10

Structure of medical course

Answer 10

• Year 1 and 2 you explore each body system and do subjects such as pathology, genetics. Mainly pre-clinical.
  . Clinical skills training is also acquired using the simulation suite where you act out scenarios with actors as patients
  . Dissections occur throughout the course, on a cadaver so you can visualise where each organ is to know your anatomy well
• Year 3 is mainly clinical exposure so you will have classes in each medical and surgical specialties

Intercalated year

• Year 4 learn more about child health, women’s health etc
• Year 5 is exams

Question 11

What type of learning is it

Answer 11

. There is some cased based learning so i can work as a team with others to work out a cure and discuss key cases.
There is lots of group work which I love since working on cooperation in duke of Edinburgh Gold

Question 12

Clubs and societies at Queens

Answer 12

I love the culture here in Belfast, and the idea of a cosy evening in the pub, whilst seeing all the art and museums is very attractive

. I’d join the Belfast Medical Students Association (BMSA)
and scrubs
. Join book club
. Cooking society
. Wine and cheese society
. Taylor swift society

Question 13

Tell me about a time where you showed empathy

Answer 13

One time I showed empathy was when I was volunteering in the nursing home which mostly specialised in dementia patients however one woman was staying there because of a stroke she had so was unable to take care of herself for a couple months so was staying there.

She explained to me how isolated she feels staying in the home, as there is no one she can talk to and she felt the staff were very busy and she didn’t want to bother them to have a conversation. She explained how she felt she had no freedom and like she has no control over where she can go and was visibly quite frustrated.

After I heard she felt like this i suggested we go outside to sit down by the canal, so that she felt a bit more free as I suppose it can get quite stuffy in the nursing home rooms. I listened to her complaints and tried to show her I understood her by asking her ways she thinks the situation could improve. I decided to make a deal with her that every time I saw her, which was twice a week, we could go outside together for a chat so she feels less cooped up. This seemed to make her feel better, and now she’s been able to go back home as she has recovered.

Question 14

Tell me about the Billy Caldwell case

Answer 14

Billy Caldwell was a young boy from Northern Ireland diagnosed with severe epilepsy.
He has experienced frequent seizures that were resistant to normal treatments.
He was prescribed Cannabis oil from abroad which improved his condition.

His mother campaigned for legalisation of medicinal cannabis in the UK for medicinal purposes
This led to laws being changed so now it is legal but is very difficult to get your hands on.
It is only for epilepsy and a few other conditions.

Question 15

What is Max and Keiras bill

Answer 15

This is an organ donation law that came into place in 2020. It introduced an opt out system for organ donation, so all adults over the age of 18 are organ donors.
Keira died and gave her heart to Max who now campaigns for organ donation.

It has been estimated that 700 more lives a year will be saved by this bill.

Question 16

Should the NHS provide services for IVF and other non essential treatments?

Answer 16

Pros:
- Fertility issues can cause a lot of mental stress as well as physical stress. NHS founding principles is to give help according to patient needs rather than the money they can afford.
- Preventing inequality: It could be going against the pillar of justice to only allow wealthy people to undergo IVF whilst poorer people can’t afford it.
- Although they’re labelled as non essential, the trauma that can come with infertility can lead to other mental health issues down the line

Cons:
- NHS resources are limited as it is underfunded so they should only be allocated to those who require them such as cancer or life threatening diseases
- Low success rates of IVF so critics could say this funding could be better spend on other healthcare issues.

Question 17

Do you think doctors should set a good example to their patients in their own lives?

How or why might this be difficult?

Answer 17

This is quite a difficult question, and there are some ethical considerations here. A doctors role is to provide their professional opinion to a patient, taking into account all information available to give the patient the autonomy to make the final decision.

In particular, Doctors are seen as role models in society and people turn to them for advice about keeping a healthy lifestyle. If a doctor is constantly encouraging a patient to give up smoking, but is seen smoking themselves the patient may feel that that trust barrier is broken.This means patients may stop listening to them so patient care may be compromised as a result. They will continue doing these actions that will potentially worsen their conditions. This could be going against the pillar of non-maleficence as if the patient refuses to quit smoking, the doctor could be indirectly causing harm to them.

Also, the profession of medicine as a whole could be impacted by the decisions doctors make. Like it or not doctors are held to high ethical and social standards. Breaking these could cause society to have less trust in the profession and there can be a negative image of them drawn.

At the same time however, doctors have the right to their personal life so have autonomy over their own bodies. If they want to smoke they can, especially if it is in their personal time.

Not only this but being a doctor is an incredibly stressful and demanding career so smoking could be a way that many doctors use to calm down.

There are some benefits for when doctors don’t adhere to some of their expectations out of the career. In particular if a patient is struggling to give up smoking, doctors can empathise with them better which could improve the trust in the relationship.

Question 18

A patient refuses treatment for a
life-threatening condition. Discuss the ethical issues involved

Answer 18

One ethical issue involved here is informed consent. It is very important to make sure the patient has been given all available information, and also that they have the capacity to consent.
There is a possibility that they have been misinformed about the treatment which could be why they’re refusing it. For example rumours on social media with vaccinations.
Addressing these issues could allow the patient to change their minds and ultimately consent for the treatment.

If their mental health is good enough to comprehend what the doctors are explaining to them, or if they are old enough to understand they should have capacity.
Medical capacity act 2005 means if a patient lacks capacity a decision should be made in their best interest.

The age of the patient is something to consider, however Gillicks Competence could come into play as children under 16 can consent or deny treatment and make the decision themselves as long as they have capacity to understand.
Autonomy is one of the pillars of medicine and is where patients have the right to decide what happens to their body and what treatment they want. Ultimately the decision is the patients if they have capacity.

It could be worth involving family members to explain the situation (if patient consents) to explain importance of the treatment so they convince patient to take it.

Pillars of Beneficence means we should act in the best interest of the patient by providing treatments that will improve their quality of life. Maybe this also means we should discuss alternative treatments that they could be more likely to take.

Consider religious or cultural perspectives eg Jehovahs witnesses can refuse blood transfusions.

Question 19

A 13-year old patient goes to the GP by
herself and asks for the oral contraceptive pill.

What are the ethical issues involved?

Answer 19

If a young patient is asking for a contraceptive pill there are many implications that should be considered.

It is a good idea to look into the reasons behind it so if the girl wants it to avoid pregnancy because she is sexually active, or if she has very bad menstrual cramps.
If she explains that she is sexually active this can raise many issues. One of them being who her partner is and if they’re the same age as her. Being 13 is under the age of consent so it is important to make sure there are no safeguarding problems.

It is a good idea to look into Gillicks competence and the Fraser guidelines. These explain that someone under the age of 16 has the right to consent for treatment as long as they show that they have capacity.
To test for capacity have a conversation with her about the implications that come with taking the contraception and see if she fully understands what is happening. For example reasons for taking the pill, side effects of the pill.

Consider the autonomy of the patient, where they have the right to decide treatment and it is your job as doctor to provide all the information needed and to give your professional opinion.

Also as she is very young maybe try to talk to her parents about it and find out their opinions on it. However if the patient specifically tells you not to and if you are confident there are no safeguarding problems, don’t inform the parents due to confidentiality stated by Good Medical Practice.

Being sexually active can also mean there are sexually transmitted diseases so maybe HIV. It could be a good idea to test for these if she is having unprotected sex to make sure patient safety isn’t at risk.

Look into pillars of beneficence, as giving her the birth control can stop her becoming pregnant, so you could be doing good for the patient by prescribing her this.

Question 20

• Why do you think the law allows Gillick competent children (under 16) to have contraception, despite the law stating the age of consent is 16?

Answer 20

• Primary reason is to avoid unwanted pregnancies as if they are too young to consent to the treatment they are definitely too young to have a baby
• Gillicks competence allows for patients under 16 to refuse or consent to medical treatments if deemed able to. So if they have the mental capacity to and if they demonstrate understanding of implications.
• Non-maleficence means we want to reduce harm done to the patient. Providing contraception can reduce harm done to patient by preventing pregnancy
• Confidentiality: Adolescents may feel afraid to ask for help from medical professionals if they fear the information will be disclosed to parents. It is important to maintain the trust between doctor and patient.

Question 21

How has the pandemic affected your motivation to study this course

Answer 21

Positive impacts:
- I am inspired by all the healthcare professionals who continued to work throughout all the lockdowns. They showed resilience and bravery which are incredibly important traits for medical professionals to have.

• Focus on innovations and research such as vaccinations, these were manufactured so quickly so the pandemic shows the power that medical research can have on society by almost eliminating all deaths of covid.

Negatives:
- Burnout and mental health struggle: Doctors had to work longer hours in a more stressful environment as many patients were dying from COVID. This must have been very hard for healthcare professionals to witness, especially as family members couldn’t visit their loved ones.

• Pandemic exposed problems within the healthcare system such as underfunding as they didn’t have enough resources such as beds to provide care for all patients. This could have led to amenable mortality.

Question 22

You are a GP and suspected a patient of yours has lung cancer after looking at his/her X-ray film. What would you do?

Answer 22

• It is important to gather all the information possible about the patient. So run more tests with their permission, to make sure you’re certain about the diagnosis.
• Find a quiet area with no interruptions, turn of pager etc so you aren’t distracted. Also make sure you have enough time to spend with patient.
• Then ask to have a conversation with patient.
  ‘ What is your understanding of your condition’ or ‘What do you think is the problem’
  With this information you have a better idea about where the patient is so you can get on the same page.
• Is now a good time to talk about your diagnosis? Is there anyone you want here with you? Say this to ease them into conversation.
• Explain their diagnosis with all the information the patient needs. Offer to go into more detail if needed.
  Answer any questions they have.
• Offer empathy to them so ‘ I know this must be really difficult for you’ and sit with them.
• Then ask if when they’re ready lets make a plan to treat the cancer.

Question 23

SPIKES stands for

Answer 23

Setting
Perception
Invitation
Knowledge
Empathy
Strategise