You could talk about:

• risk of rejection even if surgery is completed

• patient will be on anti-rejection medication for the rest of their life (this reduces quality of life and also is an additional expense)

• more people would benefit from the hip replacements

• people with hip replacements can then go back to work and will pay taxes (more money back into the NHS)

• empathy towards people who need hip replacements as they are in chronic pain

• staff can be trained when performing the hip replacements

• acknowledge this is a difficult decision and you might need to discuss it with other people

• link to ethical pillars for each side

For this question you must make a balanced argument for each side before coming to a conclusion. Only once you have made the balanced argument may you state your opinion.

You could talk about:

• effect on patients from doctor strikes (non-maleficence)

• doctors have the right to strike

• if doctors didn't strike and continued there could be a risk for their mental health. This can then affect their decision making which could compromise patient safety or cause them to leave the system.

You could talk about:

• the daughter could be assessed for gillick's competence to see if she has capacity and is able to consent for treatment (you could also define what capacity is which is the ability to understand and retain information regarding a treatment plan)

• appreciate how this is a time sensitive situation

• the possibility that the daughter is in A&E because her mother is refusing to give her medication, this could be a further safeguarding issue

• managing mothers ideas, concerns and expectations

• talking with her mother to see if she understands what the implications are

• once situation is over, refer mother to group where she can discuss treatment with other people in similar situations with her

• the daughter has the right to have a say in her treatment (autonomy)

You could talk about:

• building a rapport between the you and the girl so you can build trust, this could cause her to open up more and could help with assessment

• assessing for gillick's competence

• ensuring there is no further safeguarding issue (ensuring the contact was consensual and she is safe)

• link to beneficence - if you prescribe the girl will receive the treatment she needs

• link to non-maleficence - if you don't prescribe the child might not be wanted and might not be looked after properly

• educating the girl on ways in which she can protect herself to avoid future similar situations

You could talk about:

• beneficence - if we treat them, their quality of life will be improved

• non-maleficence - if we don't, patient could become terminal and pass away

• justice - we must treat all patient equally

• drinking is self-inflicted

• there are people with liver failure for reasons which are out of their control

• alcoholics are likely to start drinking after liver transplant and they could require further livers

• money should be focused on prevention than treatment as it is cheaper

You could talk about:

• what AI is and current uses of it within healthcare (remote monitoring, surgical robots, cancer screening, etc)

• link to ethical pillars (beneficence, non-maleficence, etc.)

• how it should be used to complement the role of a doctor, not replace it. If doctors spend less time doing admin work, they can see more patients.

• you could mention an instance when AI was not used properly (Babylon Health is a good example)

You could talk about:

• autism is a spectrum and might not affect individuals to the point they cannot make decisions

• benefit of a diverse staff group (autistic patients could relate to doctor and trust them more which can mean we can find out more information and create a more accurate treatment plan, you can then link this to the ethical pillars)

• appreciate you might not be qualified to make such a call and that you'd need to consult other colleagues

Make sure to come to a conclusion at the end and state your own opinion.

You could talk about:

The argument against treating lifestyle-inflicted illnesses such as obesity (as a result of lifestyle behaviours like sedentary behaviour or smoking) is that the illness is ‘self-inflicted’.

Therefore, it can be argued that treatment of these illnesses should not be prioritised over other illnesses. The reasons behind patients’ lifestyle behaviours are complex and not driven by a simple ‘choice’. Socio-economic inequalities and poor health education can lead to unhealthy lifestyle behaviours, whereby the patient has not ‘chosen’ to inflict the illness on themself.

Furthermore, obesity is not solely caused by lifestyle factors, but also genetic factors. Overall, the overwhelming majority of healthcare professionals agree it is very necessary to treat all lifestyle-related diseases fully and without judgement.

You could talk about:

• It is important to consider the difficulties a doctor will encounter when trying to discuss lifestyle behaviour with obese patients. These difficulties can include:

  • the patient feeling uncomfortable discussing sensitive issues, the stigma surrounding obesity and patients feeling blamed by the doctor.

• Consider what ways the doctor could build a good rapport with the patient and sensitively approach lifestyle discussions without making judgements.

You could talk about:

• How you would define the ‘clinical need’ stated in the GMC’s Good Medical Practice?

• Factors which may determine prioritising a resource for one patient over another may include chance of survival and likelihood of treatment success.

You could talk about: 

• The reasons for giving the organ to each patient in turn – there will always be at least one reason to allocate the organ to each patient. 

• Conclude with the reasons why you would choose one patient over the others and avoid changing your mind. 

You could talk about: 

• Whether you agree with the introduction of the opt-out system! 

• Consider the ethical principles of: beneficence (using an organ to benefit another individual), utilitarianism (making the most out of a resource), consent and patient autonomy (consent may be less well-informed in an optout system compared to an opt-in system).

You could talk about: 

• Mandatory vaccinations would mean herd immunity and protection of the vulnerable. 

• However, we would be taking away people’s autonomy.

You could talk about:

•  The vaccine will be a limited resource for some time so this is a case of resource allocation. 

• You might want to suggest that healthcare and essential workers receive the vaccine first as they are in contact with the most people. The vaccine could then be given to vulnerable groups and the older population. This is similar to how flu jabs are given out. 

• Mention that the aim is to develop herd immunity and the benefits of this. However, note that we need to avoid worsening healthcare inequalities. Healthcare already tends to be less available to those who need it the most.

You could talk about: 

• Personal stories. For example, if you know someone who has had a good or bad experience with mental health services, you can speak about what you felt went well, or what didn’t work. 

• This is an opportunity to show you can reflect and show empathy.

You could talk about:

• Remember that mental and physical health go hand in hand. Problems in one can affect the other significantly. For examples, having a long-term physical illness puts you at higher risk of developing a mental illness. Meanwhile, those with a mental illness have shorter life expectancies.

You could talk about: 

• Try and think about what the additional stresses people might have been under during lockdown and how these relate to mental health. For example, people might have lost loved ones, faced greater financial strain or felt very lonely throughout the lockdown. 

• In addition, people became isolated from support systems which could make mental illnesses even harder to cope with. There is lots to talk about. 

• You might even want to consider if there were any benefits for mental health. Show empathy and appreciate that the lockdown was especially hard for some people.

• Free, fast and easy to use BMI measurements. 

• BMI calculations can help identify overweight or obese patients. 

• Not accurate as people with a high muscle mass may be classified as obese using BMI but do not face the same health risks as someone obese.

When answering this question you should attempt to give a brief overview of childhood obesity and explain whether the prevalence is rising and why this might be.

In order to answer this question fully, you should outline some preventative measures the NHS could use and talk about current measures such as ongoing public education campaigns or regulating school meals’ nutrition. You should also highlight some advantages and disadvantages of these measures and make reference to their effectiveness!

This question is asking you to draw on your A-level & GCSE Biology knowledge to explain the causes of Type 2 Diabetes. You should think critically about the social, physical and environmental influences leading to a rise in Type 2 Diabetes

Explanation: Although this may seem very trivial, this example demonstrates that to follow the principle of beneficence does not always mean that the patient will be happy with your actions. In this scenario you will have to find a way to give Grace the injection as it is in her best interest in terms of medical need, despite her fear of needles and any animosity she shows you for giving it to her. In terms of non-maleficence, you could justify not giving her the injection as by doing so you are causing harm in the form of distress.

Explanation: In this scenario, it is assumed the patient is competent and has capacity to make decisions. Therefore, respecting his autonomy, you cannot stop him from leaving, but you should have tried to explain the importance of having the scan and the risk of him leaving without proper medical assessment and treatment.

Explanation: This is a great medical ethics example where there is no correct answer, but you can use the principle of justice to justify your answer. In terms of clinical need, both Jenna and Mark have liver failure and require a transplant. Mark may die sooner, but Jenna will also eventually die of liver failure or a complication if she doesn’t receive a transplant. What about maximising utility? Jenna is a nurse, and after the transplant and recovery period she will be able to go back to her job looking after patients. 

On the other hand Mark runs a charity, which reaches a large number of people and has a beneficial impact on the area it works in. Supporting homeless people to find a house and a job will create further benefits to society. Both Jenna and Mark have jobs which help others. 25 ‘Fairness’ can mean different things - you may say it is fairer to give the liver to Jenna as she is younger and has two dependents, or fairer to give it to Mark as has a family who may depend on him, a charity which helps many people and may have a better chance of recovery post-transplant, provided he stops drinking. 

Now, ‘just deserts’ - Jenna inherited her condition, whereas Mark developed liver failure due to his alcohol addiction (a self-inflicted cause). Jenna had no role in causing her disease, but you do not know what led Mark to start or continue drinking. Working through the principle you can justify giving the liver to either Jenna or Mark. Most importantly, you need to consider each argument and justify your thought processes during your interview.

1. Should doctors ever allow patients to use alternative medicine?

2. A patient has recently been diagnosed with HIV and refuses to tell his partner. Is it ever okay for doctors to tell the partner if the patient refuses? 

3. A 13 year old girl visits her GP for the oral contraceptive pill as she has recently become sexually active. Should you prescribe it to her? 

4. A 63 year old alcoholic and an 18 year old intravenous drug user are both in need of a liver transplant. Who should get it? 

5. Organ donation should be an opt-out system rather than an opt-in system in this country. Do you agree or disagree? Please discuss your thoughts. 

6. An eighteen year-old female arrives in the emergency department with a profound nosebleed. You are the doctor, and you have stopped the 81 bleeding. She is now in a coma from blood loss and will die without a transfusion. A nurse finds a recent signed card from Jehovah's Witnesses Church in the patient's purse refusing blood transfusions under any circumstance. What would you do in this situation? 

7. You are a medical student. One day at hospital placement, you see one of your fellow students putting medical equipment from the stock room into their bag. When you ask them about it, they say they only want to practise their clinical skills and not to tell anyone. Discuss how you would approach this situation and explain your reasoning