EXAMPLE OF MBBS INTERVIEW QUESTIONS

ETHICAL QUESTIONS:
1. WOULD YOU GET OUT OF YOUR CAR TO HELP A VICTIM AFTER OBSERVING AN ACCIDENT?

My answer (personal opinion): Yes. I would get out of my car after observing an accident to treat any
wounded passengers or victims around the occurrence of accident scene.

2. WHAT DO YOU THINK OF AFFIRMATIVE ACTION?

Affirmative action: an action or policy favouring those who tend to suffer from discriminate,
especially in relation to employment or education; positive

3. WHAT ARE YOUR THOUGHTS ON EUTHANASIA?

Euthanasia: the painless killing of a patient suffering from an incurable and painful disease or in an
irreversible coma. The practice is illegal in most countries.

If agree with euthanasia:

- It frees up hospital beds and resources
- It ends the patient life because he/she is already terminally ill
- It relieves suffering
- The relatives spared the agony of watching their loved ones deteriorate beyond
recognition
- It reduces the spread of diseases
- How to save a life
If disagree with euthanasia:

- It is not moral to end the patients life because he has the right to live longer
- It is a murder
- Sanctity of life
- Voluntary euthanasia gives doctors too much power
- A lack of responsibility for the doctors
- The worst evil
Source: debatewise.org/debates/861-do-you-agree-or-disagree-with-euthanasia-or-mercy-
killing/

4. A PREGNANT 15-YEAR-OLD UNMARRIED TEENAGER COMES INTO YOUR OFFICE ASKING

FOR AN ABORTION.WHAT WOULD YOU DO? WOULD YOU INFORM HER PARENTS?
My answer(personal opinion): I would advise her to see a psychiatrist or a psychologist for further
help on her and I will not tell her parents that she is pregnant due to respecting her rights.

Additional info: patients have their own rights.

 5. YOU OBSERVE A FELLOW MEDICAL STUDENT CHEATING ON AN EXAMINATION. WHAT
WOULD YOU DO?

My answer(personal opinion): tell the exam invigilator to take action upon the one who is cheating

6. HOW WOULD YOU TELL A PATIENT JUST DIAGNOSED WITH CANCER THAT HE HAS ONLY A
FEW WEEKS TO LIVE?
My answer (personal opinion): I will tell the patient that I will try my best to find a cure and treat the
cancer. Also, I will tell do not lose hope and keep on living.

7. A 14-YEAR-OLD GAY AND PROMISCUOUS MALE COMES TO YOU TO BE TREATED FOR A

STD. DURING THE CONVERSATION HE MENTIONS THAT HE HAS BEEN TESTED FOR HIV
SEVERAL TIMES AND WOULD LIKE TO BE TESTED AGAIN TO SEE IF HE IS STILL UNINFECTED.
HOW WOULD YOU HANDLE THIS SITUATION?

STD: Sexually Transmitted Disease

My answer (personal opinion): I would treat the 14-year old gay due to STD. Also, I will run
the test to see whether he has HIV or not. I will not share his personal information with
other people including his parents due to his rights.

Additional info: if a patient request for a procedure then it is okay to proceed with it.

8. WHAT IS THE DIFFERENCE BETWEEN AN HMO AND A PPO? WHICH SYSTEM DO YOU
PREFER AND WHY?

HMO: Health Maintenance Organization

- Health insurance organization to which subscribers pay a predetermined fee in return
for a range of medical services from physicians and healthcare workers registered with
organization
PPO: Preferred Provider Organization

- Health plan that contracts with medical providers, such as hospitals and doctors, to
create a network of participating providers. You pay less if you use providers that belong
to the plans network.

HMO plans PPO plans

- Pick one primary care physician. - Flexibility
- All health care services go through - Dont need a primary care
that doctor. physician
- Need a referral before go see any - Go to any health care
other health care professional except professional you want without a
emergency. referral; inside/outside of your
- Visits to health care professional network
outside of your network arent - Staying inside of network ->
covered by insurance smaller co-pays & full coverage
- Exception: women dont need a - Outside network -> higher out of
 referral to see an pocket costs & not all services
obstetrician/gynaecologist may be covered.
- (less paperwork & lower health care
costs for everyone)

My answer (personal opinion): I prefer PPO

Reasons:

- Can avoid referrals lies

- Can go to any health care professional inside/outside network
- Can get full medical attention -> get complete medical advices
Source: http://www.bcbsm.com/index/health-insurance-help/faqs/topics/how-health-insurance-
works/difference-hmo-ppo-epo.html

9. HOW WOULD YOU EXPRESS YOUR CONCERN FOR A CHILD WHO NEEDS AN AMPUTATION?

Amputation: action of surgically cutting off a limb

My answer (personal opinion): I would tell the child that he/she is going to survive after
going through the surgery. Also, I will tell the child to pursue your dream even if you have
abnormalities within you.

10. DURING A ROUTINE PHYSICAL EXAMINATION OF A 10-YEAR-OLD GIRL YOU DISCOVER

UNMISTAKEABLE EVIDENCE THAT SHE HAS BEEN PHYSICALLY AND SEXUALLY ABUSED
OVER A PERIOD OF TIME. BOTH HER PARENTS ARE IN THE WAITING ROOM. HOW WOULD
YOU RESPOND TO THIS SITUATION?
My answer (personal opinion): I will not tell her parents if she does not let me to tell them. Also, I
would advise for her safety so that things like this will not occur again.

11. YOU HAVE 2 PATIENTS WHO HAVE BEEN ADMITTED AFTER A SERIOUS ACCIDENT. BOTH
REQUIRE IMMEDIATE ATTENTION IN ORDER TO SURVIVE. ONE PATIENT IS 20 YEARS OLD,
THE OTHER IS 60 YEARS OLD. WHICH LIFE WOULD YOU SAVE?
My answer (personal opinion): I will save the life of the 20 year old person than the 60 year old. It is
because the 20 year old person has a higher chance of survival due to his/her age in which at this
stage the rate of recovery is high in the persons body than an old persons body.
SOCIAL QUESTIONS:

DO YOU THINK THAT DOCTORS ARE BEING PAID TOO MUCH OR TOO LITTLE? WHY?

My answer (personal opinion): I think doctors are paid too little. It is because a person in medical
field has been trained harder than any other professions. Even though, people complained about the
medical charges are high but it takes a long time for the doctors to become a pro so that they can
complete their tasks on treating patients with ease. This quality of a doctor must be consider when
talking about payments for the doctor.

Source: www.kevinmd.com/blog/2016/08/think-doctors-make-much-money-think.html

HOW DO YOU FEEL ABOUT THE NEW HIPAA REGULATIONS?

HIPAA: Health Insurance Portability and Accountability Act

Purpose of HIPAA:
- Protects the security and privacy of all medical records and other health information
used or shared in any form.
- Protects patients rights by giving access to health information and control over how it is
used
HIPAA concerns with PHI

PHI: Protected Health Information

PHI relates to:

- The health of an individual

- Health care provided to that individual
- Payment for health care provided
Any physician tries to violate HIPAA Law will be suspended or terminated by the hospital.

My answer (personal opinion): I think the new HIPAA regulation is a good law because it protects
patients privacy.
HOW WOULD YOU GO ABOUT IMPROVING ACCESS TO HEALTH CARE IN THIS COUNTRY?

Ways to improve access to healthcare:

- Changing scope of practice laws
-> Nurses can perform their practices efficiently.
- Utilizing coordinated care models
team based care models work collaboratively
Enables primary care physician to focus on the complicated patients
- Outside-the-box solutions to optimize care
Appointment between a physician with more than one patient at a time -> 15-20
patients -> people exchange ideas
- Telehealth
Patients can communicate with a doctor through face video in a laptop at health
institute
- Extending physician hours
More patients can get treatment from their primary care physician
- Investing in the workforce
More physicians can work to treat more patients
- Reducing administrative burden
Reduce amount of time physicians spend doing non-clinical tasks such as paperwork

Source: managedhealthcareexecutive.modernmedicine.com/managed-healthcare-
executive/content/tags/access-care/7-ways-improve-access
WHAT ARE YOUR VIEWS ON THE LATEST CHANGES TO THE MEDICARE PROGRAM?

Medicare- federal health insurance program (for people age of 65+, people with disabilities, and
people with permanent kidney failure)

Medicare is divided into;- Part A (hospital insurance), Part B (medical insurance), Part C (medicare
advantage plans), Part D (prescription drugs coverage)

Changes for Medicare enrollees in 2017:

*Medicare Part B premium costs increases

*Part B deductible also increases

*Part A premium, deductible and coinsurance also increases slightly

*Part D, average premium are expected to increase by 9%

*Part C premiums decreasing in 2017

*Medicare Therapy Cap is increasing. (Medicare therapy cap is the benefit limit that applies to
outpatient therapy)

How these changes affect people? ((benefit))

*It strengthened medicares finances

-Spending rate rises because of the increasing health care costs and increasing number of
beneficiaries

-Medicare would be in worse if the spending rate is not rise due to many cost-cutting provisions

-subsidized insurance to millions of people

Sources:

https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-
medicare/what-is-medicare.html

http://www.huffingtonpost.com/laura-adams/what-changes-in-medicare-_b_12049482.html

https://www.medicareresources.org/faqs/what-kind-of-medicare-benefit-changes-can-i-expect-this-
year/

http://time.com/money/4662792/obamacare-repeal-medicare-why-you-should-care/
DO PHYSICIANS HAVE THE RIGHT TO DENY CARE TO PATIENTS ON MEDICAID?

Medicaid- program created by the federal government, but administered by the state, to provide
payment for medical services for low-income citizens. It covered the aged, the blind, the disabled,
and single-parent families.

Reasons why the physicians are reluctant to treat Medicaid patients:

*they did not want good deeds to bankrupt their clinical practices (low payment)

*they will get less money after a longer wait, lowest payer (not money maker)

*they lose money on every Medicaid recipient that they see.

*these patients often required much more time and attention than the average patient

*many physicians felt that the social and behavioral needs of Medicaid patients required a
disproportionate share of their time, and of their support staff.

*insurance programs continue to devalue physician time and education

*Medicaid is going bankrupt and it isn't because they are paying physicians too much

Medical Ethics:

*physician must give the patient reasonable notice and assist him in finding another doctor who will
treat Medicaid patients.

*the physician in private practice can choose his patients unless this violates a contractual
arrangement

*doctors can place a limit on the number of Medicaid patients they will accept in their practice

[[AMA ETHICS POLICIES

One of The AMA's principles of medical ethics (No. VI) states that a physician shall, in providing
appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to
associate, and the environment in which to provide medical care.

Code Policy E-10.01, Fundamental Elements of the Patient-Physician Relationship, states a physician
may not discontinue a patient's treatment as long as further treatment is medically indicated without
giving the patient reasonable assistance and sufficient opportunity to make alternative
arrangements for care. It also says physicians should continue their traditional assumption of a part
of the responsibility for the medical care of those who cannot afford essential health care.

Policy E-8.115, Termination of the Physician-Patient Relationship, states that physicians have an
obligation to support continuity of care for their patients. While physicians have the option of
withdrawing from a case, they cannot do so without giving notice to the patient, the relatives, or
responsible friends sufficiently long in advance of withdrawal to permit another medical attendant to
be secured.
Policy E-8.11, Neglect of Patient, states that physicians are free to choose whom they will serve. The
physician should, however, respond to the best of his or her ability in cases of emergency where first
aid treatment is essential. Once having undertaken a case, the physician should not neglect the
patient.

Policy E-9.12, Physician-Patient Relationship: Respect for Law and Human Rights, states the creation
of the patient-physician relationship is contractual in nature. Generally, both the physician and the
patient are free to enter into or decline the relationship. For example, a physician may decline to
undertake the care of a patient whose medical condition is not within his current competence.
However, physicians who offer their services to the public may not decline to accept patients because
of race, color, religion, national origin, sexual orientation, or any other basis that would constitute
invidious discrimination. Physicians who are obligated under pre-existing contractual arrangements
may not decline to accept patients as provided by those arrangements]]

[[Patients Bill of Rights In Medicare and Medicaid

https://archive.hhs.gov/news/press/1999pres/990412.html]]

Sources:

http://dhss.alaska.gov/dhcs/Pages/medicaid_medicare/default.aspx

http://health.usnews.com/health-news/health-insurance/articles/2015/05/26/youve-got-medicaid-
why-cant-you-see-the-doctor

https://www.cga.ct.gov/2001/rpt/2001-R-0679.htm

http://thehappyhospitalist.blogspot.my/2010/05/medicaid-contagion-has-spread-medicaid.html

http://www.cbsnews.com/news/medicaid-expansion-may-fail-because-of-doctors-refusal-to-see-
patients/
WHAT ARE YOUR VIEWS ON ALTERNATIVE MEDICINE?

Alternative medicine- any of a range of medical therapies (not regarded as orthodox by the medical
profession, such as herbalism, homeopathy, and acupuncture).

Alternative medicine : Pros

*Whole-person treatments;

-alternative medicine emphasize whole-body care (including physical, emotional and spiritual health)

-more holistic approach to health

-encourage people to lead a healthy life and concentrate on what has actually caused the disease
and led to imbalance

*Personal attention;

-alternative medicine practitioners often offer patients a great deal of personal attention.

-place greater emphasis on one-on-one attention.

*Focus on prevention;

-treatments are focused on preventing diseases, and in addition to being cared for when sick.

*Reduce stress;

-reducing stress and emotional tension, in order to combat illnesses.

*Medicines;

-alternative medicine remedies do not have harmful effects (harmful microorganisms such as in
antibiotics)

-alternative medicine treats patients without overloading them with chemical medications

Alternative medicine: Cons

*Limited scientific research;

-there are several studies under way

-not yet been scientifically proved

*Confusing marketing;

-natural or safe? (natural doesnt mean it is safe)

-not risk free, can do more harm than good if taken without having the details of their effects over
the body.
-not approved by any governing body and there arent any health insurance companies that provide
coverage

*Potentially dangerous interactions;

-supplements and herbs can still potentially interact with prescription and over-the-counter
medication

-have side effects

*Long-term treatments;

- require a longer time to heal a problem.

-cannot have immediate results

*Effectiveness;

-each person has different reactions toward alternative medicine (can be very harmful to health
also)

[[Consult a physician upon the proper medication and dosage. When considering alternative
medicine, think balance taking the best health care from both the traditional and alternative sides
of medicine could be the best option.]]

Sources:

http://www.everydayhealth.com/alternative-health/the-basics/are-you-conisdering-
complementary-and-alternative-medicine.aspx

http://www.everydayhealth.com/alternative-health/the-basics.aspx

http://www.healthguidance.org/entry/12421/1/Benefits-of-Alternative-Medicine.html

http://youqueen.com/life/health/pros-and-cons-of-alternative-medicine/

http://ezinearticles.com/?Advantages-and-Disadvantages-of-Alternative-Medicine&id=4599395
WHAT HAVE YOU RECENTLY READ IN THE PRESS ABOUT HEALTH CARE?

((general knowledge- better if you read by yourself in the Internet etc))

*CMS proposes 2018 payment and policy updates for Medicare hospital admissions, and releases a
Request for Information

>The proposed rule aims to relieve regulatory burdens for providers; supports the patient-doctor
relationship in health care; and promotes transparency, flexibility, and innovation in the delivery of
care.

*CMS releases quality data showing racial, ethnic and gender differences in Medicare Advantage
health care during National Minority Health Month

>The data helps CMS to understand the intersection between a persons race, ethnicity, and gender
and their health care

>Plans to improve healthcare quality and accountability for different racial and ethnic groups by
gender at the national level

[[p/s: CMS= Centers for Medicare & Medicaid Services]]

*Health Care Legislation Must Guarantee Coverage for Emergency Patients

>The current version of the legislation- allow states to apply for waivers to opt out of providing
insurance coverage for essential benefits, including emergency care.

*HCA and March of Dimes Collaborate to Improve Health of Babies

>HCA- one of the nation's leading providers of healthcare services

>March of Dimes- the leading nonprofit organization for pregnancy and baby health

>To the financial support, fundraising and educational events and clinical research, HCA hospitals
will offer the March of Dimes NICU Family Support program (This program provides comfort and
educational materials to families who have a newborn in intensive care as well as evidence-based
training to caregivers to help improve communication and teamwork with NICU families.)

Sources:

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases.html

http://www.prnewswire.com/news-releases/english-releases/health-care-legislation-must-
guarantee-coverage-for-emergency-patients-300448161.html

http://www.news1130.com/2017/04/27/the-canadian-press-explains-the-ontario-budgets-health-
care-funding/

http://investor.hcahealthcare.com/press-release/amazing-together-hca-and-march-dimes-
collaborate-improve-health-babies
LIST THREE ISSUES THAT CONFRONT MEDICINE TODAY. OF THE THREE, WHICH IS THE MOST
IMPORTANT AND WHY?

1) Staying motivated to practice medicine

*causes of unhappiness of physicians;

-> they include ever-increasing amounts of time spent on administrative tasks and documentation,
frustration with the demands imposed by electronic health records and the feeling they are having
to cede control of their practices to government regulators and third-party payers.

->physicians feel theyre spending their days doing the wrong work, and that leads to burnout.

*steps that doctors can take on the practice and individual levels to combat burnout and maintain
their enthusiasm for practicing medicine;

->Many of the tutorials focus on ways doctors and practices can save time (renewing all of a
patients medications once a year, or spreading documentation and data entry among members of a
care team)

->employ stress reduction techniques, such as mindfulness (meditation)

->doctors become more resourceful for their patients and their staffs, and can be a little kinder and
gentler to themselves by developing the habit of focusing on the here and now

2) Patient frustration with rising costs

*patients are skipping care as a result of these increasing healthcare costs.

*how to solve?;

->do research when shopping for health care

->physicians should make sure they know about copay assistance programs available from
pharmaceutical companies and nonprofits, and to coach patients to speak up if price is an issue

->Encouraging the patient to discuss financial barriers gives doctors the opportunity to work with the
patient either to find other treatment options or identify a less-costly service provider and also
prevents a lot of wasted physician time.

3) Changing patient attitudes

*Todays patients are educating themselves more (coz of google etc, so they already self-diagnosed)

*Solution;

->physicians can use to better communicate and connect with patients.

->physicians should consider the patients perspective when they respond.

->everything from medication decisions to referrals for testing or procedures can be a collaboration
with patients

4) The remote medicine disruption (telemedicine)

*telemedicine detracts from continuity of care and increases the fragmentation of care delivery

*telemedicine firms are providing some of the acute-care services that primary care doctors rely on

*Physicians have to decide whether they want to do virtual visits, expand their work schedules; have
a designated doctor do them on a rotating basis; and/or have nurse practitioners or physician
assistants do some of them

Sources:

http://medicaleconomics.modernmedicine.com/medical-economics/news/top-10-challenges-
2017?page=0,4

http://medicaleconomics.modernmedicine.com/medical-economics/news/top-10-challenges-
2017?page=0,7

http://medicaleconomics.modernmedicine.com/medical-economics/news/top-10-challenges-
2017?page=0,9

http://medicaleconomics.modernmedicine.com/medical-economics/news/top-10-challenges-facing-
physicians-2016?page=0,12

https://www.forbes.com/sites/leahbinder/2013/02/21/the-five-biggest-problems-in-health-care-
today/#3a1990364587
WHAT DO YOU THINK SHOULD BE DONE TO CONTROL HEALTH CARE COSTS IN THIS COUNTRY?

*to manage pharmaceutical spending- better research on effectiveness and costs of different
treatments, and to keep the prices of lifesaving drugs affordable

*consumers and providers should easily understand the informations regarding prices, costs and
quality

*reference pricing - patients will choose the less expensive providers, while the high price providers
will bring the prices down

*encourage competition among payers and providers - consolidation of local healthcare markets do
not lead to higher premiums and prices for consumer

*more scholarships or subsidy for med school and expanded slots, so that we have more doctors in
general, more GPs in particular, less need to jack up charges to pay off med school loans.

*Decreasing overhead for insurance companies (including the government)

*Making the cost of the same service the same throughout the country, making the payment
amounts and rules the same for all insurance companies and requiring insurance companies to pay
all bills submitted by health care providers

*Payment by capitation and outcome, not fee for service - each hospital group propose its own mix
of capitation and bundled payments and compete on the best price and outcome.

*Transition from hospital to home and community care - The costs of treating the rapidly growing
number of elderly patients in high-tech, multi-specialty hospitals will bust their budget, so this is a
plan to deliver quality care at home and in community health centers through expanded training and
increased use of technology

Sources:

http://www.commonwealthfund.org/interactives-and-data/infographics/2014/us-health-care-costs

https://www.managedcaremag.com/archives/2002/2/health-care-cost-control-getting-right-track

http://www.merckmanuals.com/home/fundamentals/financial-issues-in-health-care/controlling-
health-care-costs

http://www.thefiscaltimes.com/Columns/2013/06/17/How-to-Control-Americas-Health-Care-Costs
WHAT ARE YOUR THOUGHTS ON CAPITATION?

Capitation - the payment of a fee or grant to a doctor, school, or other person or body providing
services to a number of people, such that the amount paid is determined by the number of patients,
students, or customers.

Capitation (health care) -method of compensation in the healthcare industry in which physicians are
paid a fixed and pre arranged amount for each patient seen in a health plan regardless of any
treatments or services being offered.

Advantages:

To patients;

*build a stronger relationship between physicians and their patients

*lowers the risk of patients being overtreated (physicians committed to the aim of reducing costs-
prescribe necessary treatments only)

*cost of treatment is lower per patient (costs are shared with other members in the system)

To physicians;

*provide physicians with financial security since their income for a given year is predictable and
guaranteed

*entitled to incentives for delivering quality and well-managed services to their patients.

Disadvantages:

To patients;

*complicated medical issues patients are likely to be left out of the enrollment system for a
capitated plan (due to the high cost involved in treating them, so physicians would make little profit)

*a patient's choice of primary health care providers is limited to a particular physician or group of
physicians

*optimal treatment may not always be delivered to the patient (physicians are required to keep
costs down in order to earn yet better incentives)

To physicians;

*they are paid a fixed rate per patient and when many patients requiring expensive procedures or
diagnoses, so the doctor can end up essentially providing more services than he has been paid for.

*they tend to ignore complex cases in favor of choosing patients who are easier to care for
http://www.ehow.com/info_12185015_advantages-disadvantages-capitation-payments.html

https://forums.studentdoctor.net/threads/capitation-pros-and-cons.149134/