Test: Appropriateness Questions - UCAT MCQ

By informing the patient’s next of kin about the mistake and offering an apology, you are complying with the duty of candour. This is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects”. Therefore, this action is very appropriate.

By informing the patient’s next of kin about the mistake and offering an apology, you are complying with the duty of candour. This is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects”. Therefore, this action is very appropriate.

The duty of candour is a key principle in medical ethics. The duty of candour requires doctors to inform patients if they have made a mistake. This is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects”. Therefore, by failing to inform the patient’s next of kin about the mistake you are violating Good Medical Practice, so this action is very inappropriate.

If you make any mistakes or notice any clinical incidents you should report them through the appropriate procedures. This is outlined in Good Medical Practice which states “To help keep patients safe you must: contribute to adverse event recognition”. Therefore, by reporting the incident you are complying with Good Medical Practice, so this action is very appropriate. Remember, these options are not done in isolation, so it would still be possible to seek advice and inform the medical school at the same time.

The duty of candour is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects” . The key term is “you”, as Max has made the mistake, he should make every effort to be the doctor explaining this mistake. Furthermore, it is usually inappropriate to delegate these difficult conversations to more junior colleagues without direct supervision. Therefore, this action is very inappropriate.

This action does not address the issue of Alex’s punctuality. This violates GMC guidance which states “It can be difficult to raise concerns about fellow students, who may be people you work with on projects or placements or your friends. But as a student choosing to join a regulated profession, it is your duty to put patients first and this includes patients you see on placements and those treated by your fellow students in the future.”  However, you are not unnecessarily escalating the situation or doing nothing, so this action is not very inappropriate. Although, since it does not address the issue, this action is inappropriate but not awful. 

This action would help address the issue by reminding Alex to turn up to the meetings on time. However, this is not addressing any underlying issues Alex may have which is being disrespectful to him. This violates Good Medical Practice which states “You must treat colleagues fairly and with respect”. Therefore, this action is inappropriate but not awful.

By reporting Alex to their tutor before trying to address the issue, Sarah is unnecessarily escalating the situation. Remember, you should always try and address the issue before escalating it further. Therefore, this action would be very inappropriate.

This is the ideal course of action as it allows Sarah to address the issue of Alex’s punctuality whilst being respectful to him. This is in line with GMC guidelines which states “Persistent inappropriate attitude or behaviour [for medical student includes] poor time management [and] non-attendance]”. Therefore, this action would be very appropriate.

This action is appropriate as it allows you to seek advice from a peer. However, you are disclosing this issue to another member of the group unnecessarily. Therefore, this action would be appropriate but not ideal.

As this is a very rare condition, just removing the patient’s name, age and address is unlikely to sufficiently anonymise the patient’s information. This is outlined in the GMC’s guidelines which states: “The Information Commissioner’s Office anonymisation code of practice (ICO code) considers data to be anonymised if it does not itself identify any individual, and if it is unlikely to allow any individual to be identified through its combination with other data. Simply removing the patient’s name, age, address or other personal identifiers is unlikely to be enough to anonymise information to this standard.”  Therefore, this action would breach patient confidentiality and so would be very inappropriate.

This question is very similar to part A, the platform the case is posted on is irrelevant. As this is a very rare condition, just removing the patient’s name, age and address is unlikely to sufficiently anonymise the patient’s information. This is outlined in the GMC’s guidelines which states: “The Information Commissioner’s Office anonymisation code of practice (ICO code) considers data to be anonymised if it does not itself identify any individual, and if it is unlikely to allow any individual to be identified through its combination with other data. Simply removing the patient’s name, age, address or other personal identifiers is unlikely to be enough to anonymise information to this standard.” Therefore, this action would breach patient confidentiality and so would be very inappropriate.

This action would protect the patient’s right to confidentiality which is outlined in Good Medical Practice which states “You must treat information about patients as confidential. This includes after a patient has died.” However, you are acting out with your competence as you are not a qualified doctor and have not asked a qualified doctor for permission. This principle is contained in the GMC guidance which states “As a medical student, this applies to you in relation to the time you’ll spend with patients on a clinical placement. It also means you should only treat patients or give medical advice when you are under the supervision of a registered healthcare practitioner”. Therefore, this action is inappropriate as you are acting out with your competence. The reason this action is not very inappropriate is because, you are not actively providing advice or treatment. Therefore, this action would be inappropriate but not awful.

This action would protect the patient’s right to confidentiality which is outlined in Good Medical Practice which states “You must treat information about patients as confidential. This includes after a patient has died.” However, this action would also jeopardise a valuable learning opportunity for other students which is a very important part of medical education as individual cases allow others to learn important lessons. Therefore, as this action maintains confidentiality but denies fellow medical students an important learning opportunity, so this action is appropriate but not ideal.

As a medical student, you are not a qualified doctor and therefore it is right to seek advice from a qualified doctor if you are unsure about the course of action. This principle is contained in the GMC guidance which states “As a medical student, this applies to you in relation to the time you’ll spend with patients on a clinical placement. It also means you should only treat patients or give medical advice when you are under the supervision of a registered healthcare practitioner”. Therefore, by seeking advice, you are ensuring you are acting within your competence. Therefore, this action would be very appropriate.