southampton questions

Question 1

what are the 6 values of the NHS?

Answer 1

1 - working together for patients
2- respect and dignity
3 - commitments to quality of care
4 - compassion
5 - improving lives
6 - everyone counts

Question 2

what are the 7 principles of the NHS?

Answer 2

1 - provides a comprehensive service available to all
2 - Access to NHS is based on clinical need, not an individuals ability to pay.
3 - NHS aspires to the highest standards of excellence and professionalism.
4 - NHS aspires to put patients at the heart of everything it does, including their families (SLT)
5 - NHS works across organisational boundaries in order to also support local communities and wider population - school vaccination programmes
6 - NHS is committed to providing the best value for taxpayers money
7 - NHS is accountable to public, communities and patients that it serves.

Question 3

What is the evidence that further devolution may be a good thing?

Answer 3

• trial in 2016 in manchester where they were given control of their healthcare spending
• investment and therefore access to mental health services improved.
• physical inactivity is being tackled 3x faster than national average.
• 6000 unemployed due to ill health were helped back into workforce.
• 37% reduction in number of people sleeping rough.
• care homes saw increase in good and outstanding ratings.

Question 4

details about course structure?

Answer 4

• early patient exposure
• week of nursing placement.
• integrated spiral
• case based learning.
• opportunity to shadow junior doctor just after graduating.

Question 5

time you dealt with a conflict?

Answer 5

• STAR
• S - friends were having dispute about cleaning and cooking rota.
• T - They each spoke to me separately about their issues.
• A - I encouraged them to speak to each other. Having listened to their perspectives, it was clear that there wasn’t any malice from either side, just different perspectives.
• R - They spoke to one another and came to a compromise which has left both of them much happier since.
• This is something that is important in medicine. This could be patients refusing treatment and me needing to ensure they have all of the information and that they have considered other perspectives when making their decision.
• It could be a situation like a patient being angry about their waiting time and again i would need to communicate, empathise and have us understand each others perspectives in order to work together.
• Or it could be group work, either a multidisciplinary hospital team, or a project in which there is a disagreement. Again, empathising with each other and working together to find a solution rather than standing at arms length espousing our particular view is the way to address things in my opinion.

Question 6

Are you a leader or a follower?

Answer 6

• Depending on the situation i can be either of these things.
• I often gravitate towards leadership roles because of my demeanour and people skills, however i think the knowledge you have of a situation is also important.
• S - i was a leader when housekeeping in canada.
• T - Lots of employees struggled with a lack of appreciation from management and a lack of rotation of tasks in properties.
• A - Me and another employee took it upon ourselves to speak to the teams to see if this was felt by the majority. afterwards I requested a meeting with the owner of the company to explain the different perspectives. By communicating well he was able to understand where we were coming from, and i understood his needs.
• R - we came to a compromise where we had montly staff events like dinner and drinks and cinema trips and they assigned supervisor roles so that we saw better rotation of tasks at properties - although people still worked to their strengths in busier periods.
• this is relevant to medicine in a few ways. Considering things like multidisciplinary teams, it’s important that each member feels valued, and that we understand each others perspectives in order to work efficiently.
• I have been a follower in situation where i don’t have the expert knowledge of the leader. This again is relevant to multidisciplinary teams. There will be points where the aspect of patient care we are considering is best considered by a different consultant. It’s still important to be assertive if you don’t agree with things, or to question them at least, but also to be willing to listen and receive directions.

Question 7

When did you work in a team and it was a success?

Answer 7

• S - working in starbucks in canada
• T - There was good communication and empathy between staff - including supervisors. Training was polite and productive and there was fair rotation of tasks over time, but in busy periods people were assigned to their strengths.
• A - we also had an active whatsapp chat and collaborative spotify playlist which allowed people to develop rapport beyond working shifts together.
• R - We had high customer satisfaction and low staff turnover. People looked forward to coming to work and the store was efficient. There were also very few sick days taken as people had a strong team mentality.
• These are all qualities important in medicine.
• In multidisciplinary teams it’s important that we rotate responsibility and are both empathetic and open to instruction as treating the different morbidities of a patient will require other specialists to take charge. However it’s still important that they be open to assertions from others.
• It’s also important in terms of workplace team mentality. Given healthcare work is stressful, it’s important to have that strong sense of unity. Coworkers may be stressed because of work, or external factors and we need to work hard to support one another, not only for our colleagues health, but also to be able to maintain high standards of care.

Question 8

Time you worked in a team and it failed?

Answer 8

• S - DofE silver - did it by bike. one group member wanted to make it a perfomance exercise and as a result the less fit cyclist was constantly left behind/ grumbled at.
• T - As a group we discussed this and tried to explain the importance of working as a team.
• A - tried to explain each others perspectives in order to get the performance driven member to be more inclusive.
• R - unfortunately he was quite brazen and inflexible. Although he listened to what we were saying, he continued to act in the same way and unfortunately the slower member dropped out after our practice expedition.
• This is something that’s important to medicine. First of all in the context of healthcare teams. This is essentially like a doctor looking down on a nurse or allied healthcare professional. We all shared a passion for cycling but one individual was better at endurance and as a result ruined the experience for another. This is something i’ve heard of happening from a speech and language therapist and is something we really want to avoid in healthcare.
• It’s also important in the context of patient autonomy. There will be times where patients make decisions that aren’t optimal despite having all the information. As was the case in this situation, it’s important to learn how to accept this. Obviously we can’t force treatment on patients of that would be battery, so sometimes all you can do is provide information and learn to be resilient when patients don’t act in the way you would hope.

Question 9

what are the attributes of a good leader?

Answer 9

• this is something i’ve thought about a lot from ski instructing.
• S - working with different types of people and different ages.
• T - provide the best experience possible.
• A - Empathy and communication are vital. It’s hard to lead a group without understanding the aims, peoples strengths and weaknesses. Further to this it’s important to vary your communication to the particular group. This is important in medicine as we want to understand what the patients expectations are from care. We will also see a large variety of backgrounds and ages of a patient and it’s important to be able to adapt communication to each individual.
• Good leaders should also be resilient and able to be assertive. There will be situations in medicine where patients aren’t progressing, or they choose to refuse treatment that is important, in these situations, is the patient is competent and we have to respect their autonomy, it’s vital to be able to handle this.
• in multidisciplinary teams, if you disagree with the group consensus, it’s important to be willing to assert yourself. Although in the end you should still be flexible enough to compromise or accept a different perspective, it’s important to be willing to assert yourself if it’s necessary.
• finally organisation - this is again something that was vital in ski instructing. I would to consider the smaller and bigger picture. I may have a particular area that would be ideal for the drills we were going to work on, but need to consider things like how long it would take to get there, where we needed to be for lunch or the end of the day, the energy levels of the group, how busy the lifts in the area were. again this is important for medicine - it’s important to be able to prioritise tasks - i saw from shadowing just how many things doctors are often juggling at one.

Question 10

what are the attributes of a good team member?

Answer 10

• they should be driven. understand the bigger picture. empathetic and willing to take instructions, but also willing to assert themselves. They should also be positive.
• This is something i did in my university tennis team prior to being a captain. I worked hard to develop rapport between players on our journeys to away matches, i accepted our captains changing of playing order, but i also spoke out against the proposed doubles pairings based on suitability of playing style.
• These qualities are obviously important in medicine, particularly in multidisciplinary teams - there will be times where the aspect of patient care being considered is led by a doctor of the relevant specialty. It’s important to understand why they are making the decisions they are, but also the consider the overall care of the patient in order to speak up if you feel there are changes that can be made that would better serve the patient or be more efficient.

Question 11

According to personal statement what allowed you to work on over-empathising?

Answer 11

check in and chat with responders app.

Question 12

working with autistic children?

Answer 12

• they were often visual learners.
• if giving verbal explanations i found it was best to be clear and direct and to give it in bitesize chunks. this is how i would endeavour to deliver bad news.
• they often had fixations, of interests, by understanding this, you can engage with them better. i had a child who like fantasy and we skied through the trees ‘looking for elves’.

Question 13

can you communicate clearly and appropriately with people from all walks of life?

Answer 13

• yes.
• i’ve been involved in lots of activities. i’ve captained sports teams and have also worked as a ski instructor in canada. this allowed me to develop my ability to lead groups, as well as having to adapt by communication, both verbal and non-verbal to a range of ages and backgrounds of clients to provide the best lesson possible.
• i’ve was also nominated as social secretary for my university tennis team, showing that i can communicate effectively as a leader and instructor, but also as an empathetic and likeable peer.
• through volunteering at a foodbank and working with the responders app, i’ve worked on my empathetic communication too.

Question 14

how would you tell someone something life changing?

Answer 14

• first of all i would make small talk. it’s important to ease into this. dropping this sort of information on someone as the first thing you say will send them into shock.
• i would make small talk and ask how they’re doing, then give a warning shot and tell them that i have some bad news.
• this allows the person to prepare themselves, and by waiting for them to come to me and ask what the news is, i can be sure that they are braced to receive it.
• once they’re ready to hear the news, it’s important to be honest and avoid beating around the bush. although having some tact is still important, an anguish comes from knowing soemthing bad is on the way, and taking a long time revealing the information will only increase the individuals suffering.
• after telling them, they may be in shock. it’s important to give them time to process and wait for them to ask any questions. then provide any support that i can.

Question 15

how good is your written communication?

Answer 15

• i believe it is strong.
• I’m naturally better at verbal communication and often receive high marks for spoken presentations, however, i received a first for a number of essays at university, and try to read broadly and soak up knowledge of structure and syntax.
• I also try to adapt my written communication to that of the reader.

Question 16

how would you cope with the conflicting pressures of being a doctor without compromising patient safety?

Answer 16

• This is something that will come from experience. this is why early patient exposure is so important in my opinion.
• medicine is obviously an applied science, and developing our interpersonal, prioritisation, time management skills as well as our ability to communicate empathetically are all as important as the theoretical knowledge.
• Since undertaking my shadowing, i’ve been working on my ability to schedule effectively while still remaining flexible enough to adapt to changing circumstances.
• i’ve already learned some basic notions for prioritisation in hospital settings, such as treating unwell patients and TTOs being high priority, and bloods being lower. I believe that as i study and work, by being conscientious and proactive about asking questions, i will continue to learn how to best prioritise.
• it’s important to keep this perspective that i’m looking for continual improvement, not immediate perfection.
• beyond learning to prioritise better, there are things i’ve learned from years of playing sports that allow me to deal with pressure situations. i have breathing patterns that allow me to remain focused and perform better.
• i also have a morning routine which helps reduce the build up of stress.
• finally, outside of work, i’m involved in a number of hobbies, whether individual or team based which will again provide catharsis and prevent the buildup of stress.
• it’s also important to speak up about struggles. with patient safety being a top priority, if a young doctor is overwhelmed, speaking to peers or senior colleagues for support is a far better option than gritting your teeth and suffering burnout.

Question 17

what skills do you have that can help you process complex information?

Answer 17

• i believe i have a number.
• i read broadly, having read topics like sociology, psychology, philosophy and economics, i believe i have the ability to draw from a greater pool of knowledge in order to more easily understand complex psycho-socio-economic problems.
• i’m engaged in a variety of activities and hobbies which stimulate different parts of my brain allowing me to develop and maintain abilities to think creatively, rationally, and empathetically. these range from playing team sports, playing chess, playing piano,, reading literature, speaking to my grandparents.
• i’ve developed good communication skills through captaining sports teams, living in various placed with a variety of types of people, and ski instructing clients of all ages and backgrounds. this is a fundamental step to processing complex information. by communicating effectively, you can more quickly understand a situation in order to begin processing the realities of it.
• i have strong logic and reasoning abilities from reading philosophy and although not an active member, i scored highly enough on the iq test to be included invited to join mensa when i was younger.
• finally, through playing sports, i’ve learned good techniques for getting into a flow state. this helps reduce background stress and allows me to focus on the task at hand, which means i can process infomration more effectively.

Question 18

what examples can you give of problem solving situations?

Answer 18

Ski instructing. 
Chess
Tennis 
Playing piano
Solving conflicts amongst friends. 
In medicine I saw many during my shadowing. 
Differentially diagnosing. 
Considering ethical issues. 
Distributing resources fairly. 
Cooperating within multidisciplinary teams to provide the best overall care. 
Prioritising a number of required tasks.

Question 19

how would you react to something going wrong?

Answer 19

• it would depend on the exact nature of the situation.
• the first thing is to determine what caused the mistake. if i made an error performing a task i’ve done hundreds of times, then it was likely a lapse in concentration. if however, i’ve been trying to learn a new skill and have made the same mistake a few times, then i need to take a step back and address what’s causing my lack of progress.
• perspectives are also important. I’m fortunate that from years of playing sport to a high level, i naturally view mistakes as part of the process of learning.
• there are times, especially in medicine however, where a mistake will result in serious consequences. although it’s important to work hard to proactively learn, and avoid making mistakes, a good perspective i learned from a paediatrician i shadowed, it to consider intent. quite often, patients would suffer more, or deteriorate faster if they didn’t seek medical treatment, and although there are situations where the outcome isn’t great, it’s important to remember that any treatment provided is a positive.
• in dealing with a mistake, it’s also important to speak to family members privately at a time when you can talk properly. it’s improtant to provide proper support to them and be honest about the mistake and steps that are being taken to address it.

Question 20

can you learn from your mistakes?

Answer 20

• yes! and i would hope that any prospective medical student can.
• to me, self-awareness is incredibly important. one of the most enjoyable aspects of shadowing for me was that it highlighted some of my weaknesses and has allowed me to work on them.
• this is how i like to view mistakes too. i strive for excellence, but accept that perfection is an unrealistic ideal.
• growing up playing sports has allowed me to foster this mentality of growing and learning from mistakes.
• Given the nature of medical practice, this is an important skill to have. Although we should be striving for excellence and will hopefully be conscientious enough to recognise weaknesses and seek advice or help before being in situations where those weaknesses will pose a risk to patients, mistakes will still happen. And the emotional consequences of these will be particularly high in a lot of cases.
  Having the perspective of whether your intentions were good is a good start in my opinion. And beyond this, using the mistake as a motivating factor in continuing to improve is also good.

Question 21

how will you learn from mistakes?

Answer 21

• it’s important to take a step back in order to view mistakes with fresh eyes. further to this, speaking to others will allow for broader perspectives to be considered.
• this is important, because, without understanding the cause of a mistake, it’s hard to learn anything, and once the cause is understood, hearing varying perspectives will allow us to expand our range of thinking.
• practice is then important. whether it’s actively practicing a technique, or writing down and reminding yourself of a new perspective in order to cement it into your thinking.

Question 22

what has your journey been so far to becoming a doctor?

Answer 22

• After my initial realisation that being a doctor is what i want to do, i spent 2 years ski instructing in Canada. this is already something i had organised to do after university, and it gave me time to read more broadly into the realities of healthcare and be more certain of this decision.
• a year into my time abroad i confirmed that this is what i wanted to do. i declined my opportunity to apply for permanent residency and live a relaxing ski isntructors life in the mountains and began preparing for the gamsat and ucat.
• i also spoke to every hospital and practice in the area to try and secure some shadowing. unfortunately for legal reasons they only allowed this to canadian citizens, but i did manage to volunteer at a food bank for 6 months.
• since returning to the UK, i’ve scored highly in both admissions tests, managed to shadow a GP, worked as a check in and chat volunteer with the responders app, and am on the waiting list to volunteer at milton keynes hospital.
• i’ve read books on medical ethics, psychiatry, and after speaking to medical students and hearing that a number of them struggled with anatomy, i’ve begun teaching it to myself in order to get a headstart for september.
• i’ve also spoken to allied healthcare professionals.
• finally, i found out that the university of texas were live streaming weekly virtual shadowing sessions hosted by consultants of different specialties.
  this has allowed me to shadow a psychiatrist, an endovascular surgeon, radiology, ultrasound, paediatrics, psychiatry, and radiology.

Question 23

if you are unsuccessful, what will make you pick yourself up and carry on?

Answer 23

• the knowledge that this is what i really want to do with my life.
• having worked as a ski instructor, which i enjoyed, but didn’t find fulfilling, and having worked in a graduate job that financially rewarded, but again didn’t fulfil me, and having learned the realities of healthcare as much as i can, i know that the balance of challenge and fulfilment that i will get from medicine will continue to drive me to succeed.
• it’s important to have a range of perspectives on life too. there are ups and downs that everyone experiences, and to a large extent, the way that we deal with the downs is what defines us as people. by having this broader perspective, i’m able to remain resilient in lulls by being cognisant of the fact that by making good choices, and looking at what can be learned from the situation, i will succeed the next time.
• finally, maintaining balance in life is important. i would look to spend some time with friends and enjoy myself for a day or two. Although this is something that’s very important to me, if you make one thing the sole purpose of your existence, you’re in a dangerous position.