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Summary High yield interview notes for medical school interviews
Medical school interview preperation notes used to tutor significant number of students with a 96% success rate
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Medical school interviewAt some medical school they don’t take a Hippocratic oath
General advice:
- In an MMI roleplay ensure you take a holistic approach. They may have a broken arm
but explore what else may be going on that isn’t obvious i.e mental health issues or
abuse
- Walk into each station with a straight back and head held high
- Look alert and sit up straight and avoid crossing your arms
- Don’t slouch – lean slightly forward to show your engaged with the interviewer
- Sit a few inches away from the table
- Look at the interviewer when they are speaking and when you are speaking
- Keep hands still unless illustrating a point
- Smile and speak slowly
- Have a question prepared for them
Info to learn:
- Patient centred care
o decisions made in conjunction with a patient as opposed to doctor centred
care which medicine originated as
- Bed locking
o Medically fit patients who are ready to be discharged form a medical point of
view cannot be discharged due to social issues such as no one to look after
them at home. One possible solution could be involving the family early on so
the family have a plan for discharge
- NHS:
o Established 1948
o Ideology of treatment available to all regardless of socioeconomic status
o Primary care is community service and GP, secondary care is hospital
medicine, tertiary care is teaching hospitals and higher level of specialised
care
- GMC
o Regulating body for doctors in the UK
, o Must be registered to practice medicine
o Licence may be revoked if conditions breached
- NICE
o Provides national guidance and advice on how to improve healthcare
o National institute of health and care excellence
o Analyse how effective and affordable services are
- CCG
o Clinical commissioning groups
o Choose which services should be offered to people in a local area
o Choose to commission NHS services of sometimes private ones
o They buy services from hospitals, hospices and other services
- EWTD
o European law doctors should work a maximum of 48 hrs a week on average
o At least 11 hours rest a day
o Entitled to break if they work more than 6 consecutive hours
o Minimum of 5.6 paid annual leave
o Negative is reduced patient continuity as doctors get rest to compensate on
call
- Clinical governance
o System through which hospitals and CCG’s are responsible for maintaining
good standards of care, learning from mistakes and improving the quality of
care
- Junior doctors Contract:
o September 2015 Hunt proposed it saying NHS needed 7 day service
(apparently patients admitted on weekend had greater mortality than those
admitted on a weekday but this was disputed)
o Removed overtime rates for work between 7-22 on all days but Sunday
o Small increase of basic pay of 10%
o Reduction of the maximum hours per week from 91 to 72
o Strikes but imposed on doctors from October 2016 onwards
- Clinical trials:
o Phase one tested on healthy volunteers to assess suitable dose (tens of
volunteers)
o Phase two – tested on patients to assess safety (hundreds)
o Phase three – tested on patients to assess safety and effectiveness
(thousands)
- Medical Training:
o 5-6 years medical school
o 2 years foundation training
o Either:
o 2 core medical years specialist medical training (5-9 years) consultant
o 2 core surgical years specialist surgical training (5-9 years) consultant
surgeon
, o 3 years GP training GP
o 3 years other specialty training Speciality consultant
- Revalidation:
o Process to prove doctors have kept up to date with advances in medicine
o Introduce to restore public confidence following Harold Shipman scandal
o Every 5 years
o Prove they’ve attended conferences, reading research
- Audit cycle:
o Systematic investigation into a system to see how its performing compared to
national guidelines so as to identify potential problems preventing good
medical practice
o When problems are identified, changes are made to try resolve them
o The audit is repeated after time to see if an improvement has occurred
o Audits occur nationally, hospital based, and ward based
o Examples are ensuring all patients are reviewed by a consultant daily,
ensuring thermometers are all calibrated correctly
o
NHS scandals:
- Harold shipman
o Death rate amongst elderly patients (GP) was unusually high
o Police found eh falsified medical records, overprescribed morphine like drugs
to those that didn’t need, collected medicine from home of recently
deceased ‘to collect unused medication for disposal’, made false 999 calls in
presence of family but then cancelled the call, forge wills of patients to
benefit himself
o Led to changed to regulation of profession such as revalidation process
- Bristol hearts investigation
o New consultant anaesthetist noticed cardiac surgery was taking longer and
mortality rate of babies higher
o He did an audit leading to formal investigation
, o 29 children died and more left with disability due to poor standards
o Two cardiothoracic surgeons permanently banned
o Poor performance due to poor management and lack of leadership, poor
quality checks, lack of monitoring, managers not approachable so raising
concerns difficult
o Changes:
Hospitals monitored by regulating bodies more closely
Change to a ‘no blame culture’
Nati0anl league tables for hospitals introduced
Framework for national standards of care established
- Alder Hay
o Removal and retention of children’s organs without family consent from
1988-1995
o Enquiry after baby died undergoing open heart surgery
o Hospitals paid millions in compensation
o Resulted in human tissue act the ensured removal and storage, use and
disposal of bodies, organs and tissues was regulated
- Mid-staffs investigation
o 2008 Stafford hospital had abnormally high mortality rates and poor care so
external enquiry
o 1000 avoidable patient deaths and many not cleaned for long periods of time
caused by short starring, poor training, poor management, falsification of
date
o Resulted in:
Introduction of duty of candour (being honest with patients when
mistakes occur)
Financial compensation
Resignation of several senior managers
Publication of mortality rates for each hospital online
- MMR vaccine
o Started in 1988 after Andrew Wakefield published a paper showing an
apparent link between MMR vaccine and autism
o Sunday times found he had undeclared interests, manipulated date and
broke several ethical code
o GMC removed his medical registration
o Lancet retracted his paper
o Multiple large studies found no link
o Vaccination rates in UK dropped dramatically and so increased rates of
measles and mumps
o Effort to re-immunise kids that didn’t have the MMR vaccine
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