Hypothetical Cases in Medicine as a Student, Its Challenges and How to Resolve Them.
Introduction
Sometimes as students we are bound to come across unpleasant situations. So how do we cope with it or what should we do? Some scenarios can be difficult to deal with and on the moment can make someone’s mind race and go completely blank. Hence, we have to learn how to adapt, act professionally and always be aware that there are people that will always support one another.
Cases and Scenarios
Imagine you are involved on a rural placement. In some scenarios your friends are involved. How should act or response?
cases scenario 1
You are a third-year medical student and you have just scrubbed yourself so that you can participate in theatre for surgery. As you enter the theatre the patient is unconscious and already prepped for the operation. You haven’t yet spoken to the patient or introduced yourself.
Discuss
Hint: Consent to be there and to participate. Think if it was you on the operation table, would you like to have someone you have never met be there and participating?
cases scenario 2
You are in town on a 4-week rural placement on your own and are determined to get the most out of it. However, you are worried about being lonely and bring along “Abducting a General” and notes from lectures for some light evening reading – just in case.
Discuss
Hint: Think about what you should do. If you want the most out of it then why secluding yourself while reading some materials? There is nothing wrong reading mind you, but socialising and learning more about the community of your allocated placement is more ideal.
cases scenario 3
You are staying in the nurse’s quarters and are anxious to make a good first impression. Unfortunately, you get lost on day 1, are late, and get on the wrong side of the Director of Nursing (DON). He often makes snide comments or your punctuality, dress, and attitude.
Discuss
What should you do?
Hint: Professionalism is extremely important in medicine. There is never an excuse for being late (unless there is something remarkable such as an emergency, the wife got pregnant, etc.). Apologise and move on. Maybe the day before make sure you know where it is and know the potential traffic of your area through google maps.
cases scenario 4
On your first day, you are rostered to work with a local doctor, Dr Musk, who also provides services at a clinic in another town. While she’s away at the other clinic a person comes in with chest pain. You are in the hospital with a junior registered nurse who has been left in charge for the afternoon and she is nervous about dealing with this person. You have done the Cardiovascular Medicine Module (which is done in year 2 of medicine) and wonder about what you should do to help out.
Discuss
What should you do?
Hint: Scope of practice.
cases scenario 5
Dr Rudolf is in the next day and they suggest you suture up a drunk man. You wonder what the professional issues are and what you should do.
Discuss
What should you do?
Hint: Scope of practice and consent.
cases scenario 6
While on a visit to a local Indigenous community a physician who does clinics at the community turns up. He invites you to help in a research project that involves taking blood from local people for diabetes. He confesses that he has also added some genetics testing onto the diabetes screening but has not explained this to the community as “…they trust him, and they haven’t really got their heads around genetics anyway”. He said this will “...make a great publication”.
Discuss
What should you do?
Hint: Ethical and moral issues, disclosure of all information, consent, confidentiality.
cases scenario 7
After a long day, you are exhausted by the drive and all the ethical considerations and you are looking for a quiet evening. You and another medical student are staying in health department accommodation – a 6-bedroom house with shared bathroom, kitchen, lounge and laundry. Another older resident who is doing locum work, frequently tells you are making too much noise and mess. He yells at you before you have even finished cooking demanding you move your stuff so they can cook. He also demands to watch what they want to watch on TV and complain that you are ‘using up the internet’. This person calls you ‘spoilt little brats’ and ‘typical med students’. You both feel very uncomfortable and retreat to your rooms. And it is only week 1 of your placement!
Discuss
What should you do?
Hint: These situations do happen, think of how to resolve conflicts. Remember be resolving conflict is being direct, immediate and discreet, and if a mediator is needed then use one. Reporting to superiors or the medical accommodation staff is important too but should be done skillfully.
cases scenario 8
The next week you are in Accident and Emergency when a 2-year-old child is brought in a critical condition after being run over by a tractor. Desperate attempts are made to resuscitate the child, but she dies. You and the other student go back to the accommodation together and talk and talk about this terrible event. You even shed a few tears together. Over several days you feel terrible and can’t stop feeling sad, angry and even a bit guilty about the little girl’s death.
Discuss
Hint: Attachment to patients, professionalism, desensitisation? All very interesting topics! Death is a big part of medicine.
cases scenario 9
A few days later after getting to know your fellow student better, they say to you “I’m dreading going back to year 3”. Students X, Y, and Z are really horrible to me. When we do the GLS (Guided Learning Sessions - basically a three-hour tutorial) they sort of huddle in the corner with their backs to me and laugh at my questions as if I am stupid. On placement, you have found this student to have excellent knowledge and to be pleasant and modest and you wonder if they are actually being bullied.
Discuss
Hint: Confrontation, professionalism, resolve a situation.
cases scenario 10
You’re relaxing on Friday night with a couple of your mates. You befriend a local, who wants an opinion on his moles.
Discuss
Hint: Scope of practice, patient and doctor relation outside the work practice - how to handle that.
cases scenario 11
Late in the evening, another of your new friends comes to you for advice. Randal’s girlfriend is “young and pregnant”, they are terrified of being found out, and even more scared of the consequences.
Discuss
cases scenario 12
Later that night you find out from another source a “big secret” about this young couple. What do you do with this information?
Discuss
Hint: Confidentiality and professionalism. Extremely important in medicine!
cases scenario 13
One of your colleagues is evincing interest in a member of the opposite sex. Mating rituals are taking place. You realise this person was first known to both of you as a patient, who presented for treatment to a minor laceration.
Discuss
Hint: Confidentiality, boundaries and professionalism.
cases scenario 14
Another of your colleagues is also interested in the same person but fortunately has no ethical conflict, never having seen them as a patient.
Discuss
Hint: Confidentiality, boundaries and professionalism.
Case scenario 15
You are an hour out of the nearest town on a single road. You are all alone in your car and you are driving a lonely road. You notice behind you that there is a train truck, so you pull over and the train truck passes you. By going on the shoulder road your car gets bogged down and hence with all the bad luck, the car gets stuck. It is a hot day, and no one seems to be around.
What should you do?
Explain and elaborate
Case scenario 16
You are at a backpacker in Thailand and you do not speak the local language. You came back from a wonderful day which included elephant riding, a water park adventure and some photos taken on the riverboat (it was a fun day). Back at the backpackers, you notice that you have been robbed. Unfortunately, your wallet and your passport got stolen.
What do you do next?
Explain and elaborate
cases scenario 17
You and two of your friends who are second and fourth-years medical students went on camping together for the weekend. The nearest hospital is two hours away. You stopped for a break on the side of the road and the second-year medical student starts to get an allergic reaction that she never had before. The fourth-year medical student say “it is okay she will be fine, I don’t think we need to go to the hospital”.
Do you agree/disagree?
What is the plan of action?
Explain and elaborate
Other ethical concerns in medicine
The rise of obesity and diabetes mellitus type 2 in young people
The mental health of Indigenous people especially suicide is a worrying concern
Scenarios on access to medicine that are affordable and safe
Scenarios on inequalities in communities especially Indigenous where disease, incidents, morbidities and health or disproportionately distributed
Rheumatic Fever in Australia is a big problem especially in Indigenous communities - discuss
Published 31st May 2019. Last reviewed 30th December 2021.
