Situational Judgement

In a clinical setting, you witness a senior colleague make an error in drug dosage that has not yet harmed the patient. The colleague doesn't notice. What is the most appropriate immediate action?

• AReport the colleague to the General Medical Council immediately
• BCorrect the error yourself without telling anyone to avoid embarrassing the colleague
• CInform the colleague of the error so it can be corrected promptly✓
• DDocument the error in your personal notes and monitor the patient

Answer: Patient safety is the priority. Informing the colleague immediately allows the error to be corrected without delay. Involving the colleague respects professional relationships while addressing the safety issue.

A patient tells you in confidence that they are planning to stop taking their prescribed medication because of side effects, but asks you not to tell their GP. As a junior doctor, what is the most appropriate response?

• ARespect patient confidentiality and say nothing to the GP
• BImmediately break confidentiality and tell the GP
• CExplore the patient's concerns about side effects and explain the importance of discussing this with their GP✓
• DDischarge the patient as they are non-compliant

Answer: The best approach addresses the patient's concerns while encouraging open communication with their GP. Immediately breaking confidentiality or ignoring the issue are not appropriate first responses.

During your first week as a foundation doctor, you are asked by a nurse to prescribe a medication you are unfamiliar with. What is the most appropriate action?

• APrescribe the medication as the nurse must know best
• BRefuse to prescribe any medication you haven't seen before
• CLook up the medication, consult relevant guidelines, and seek senior advice if uncertain before prescribing✓
• DAsk the nurse to get a more experienced doctor to prescribe it

Answer: Safe prescribing requires understanding what you are prescribing. Seeking information and senior guidance before prescribing demonstrates appropriate professional behaviour and prioritises patient safety.

You discover that a friend who is a medical student has been sharing patient details on social media, claiming they are anonymised, but some details are potentially identifiable. What should you do?

• AIgnore it as they probably know the rules
• BConfront them publicly on social media
• CSpeak to your friend privately about your concerns and the potential breach✓
• DReport them immediately to the medical school without speaking to them first

Answer: Speaking to the friend privately first is the most proportionate initial response. This allows them the opportunity to understand and correct their behaviour, which may be the result of poor judgement rather than malice.

A patient becomes aggressive and verbally abusive towards you during a consultation. How should you respond?

• ATerminate the consultation and call security immediately
• BRemain calm, acknowledge their distress, try to de-escalate, and if necessary end the consultation safely✓
• CMatch their tone to assert authority
• DApologise and give them what they are asking for to calm them down

Answer: The priority is to de-escalate the situation calmly and safely. Ending the consultation is an option if necessary, but should not be the first step. Matching their aggression or giving in to demands is inappropriate.

You notice that a fellow medical student consistently arrives late to clinical placements and misses learning opportunities. This has been going on for three weeks. What is the most appropriate course of action?

• AReport them to the dean without speaking to them
• BSay nothing as it is not your business
• CSpeak to them privately and express your concerns about their attendance✓
• DTell other students and let the rumour reach staff naturally

Answer: Approaching the student privately is the most proportionate and supportive first step. It allows them to explain their situation and may resolve the issue without formal escalation.

A patient with capacity refuses a blood transfusion on religious grounds, despite doctors believing it is necessary to save their life. What is the ethically correct response?

• AOverride the refusal as saving life is the highest priority
• BRespect the refusal and document it, exploring all alternative treatments✓
• CSeek a court order to force the transfusion
• DContact the patient's family to get permission instead

Answer: A competent adult has the absolute right to refuse treatment, even life-saving treatment. This must be respected, documented, and alternative options explored.

You are on a night shift and are exhausted after 12 hours. A patient needs a complex procedure that you have limited experience with. What should you do?

• AAttempt the procedure to avoid disturbing your senior colleague
• BDelay the procedure until morning regardless of the patient's condition
• CAssess the urgency and contact your senior for guidance or assistance✓
• DAsk a nurse to assist you with the procedure

Answer: Patient safety requires honest assessment of your competence. Contacting a senior for guidance or assistance is the correct approach, balancing patient need with safe practice.

During a ward round, your consultant makes a clinical decision you believe is incorrect based on your learning. What is the most appropriate action?

• ACorrect the consultant publicly in front of patients and staff
• BSay nothing as you are junior and likely wrong
• CPolitely raise your concern with the consultant at an appropriate moment, privately if possible✓
• DGo directly to the medical director to raise the concern

Answer: Raising concerns through appropriate channels and in a respectful, private manner is professional. This allows for open discussion without undermining the team dynamic, while still prioritising patient safety.

A terminally ill patient asks you directly: 'How long do I have to live?' You are a junior doctor and do not know the answer. What is the most appropriate response?

• AGive a confident estimate to reassure them
• BTell them it is not something doctors can predict at all
• CAcknowledge their question, express empathy, and arrange for their senior team to have this conversation✓
• DChange the subject to avoid causing distress

Answer: Honesty and compassion are both important. As a junior, referring this sensitive conversation to the appropriate senior while acknowledging the patient's question is the most appropriate response.

You are working in a team and one colleague is not completing their fair share of work. This is affecting patient care. What is the most appropriate first step?

• AComplete their work for them without saying anything
• BComplain about them to other team members
• CRaise your concern with the colleague directly and professionally✓
• DReport them to management immediately

Answer: The first step is direct, professional communication with the colleague. This may resolve the issue without formal escalation and is consistent with professional standards.

A patient asks you not to share information about their drug use with their partner, who is present in the consultation. You believe the drug use does not pose an immediate risk to others. What should you do?

• ATell the partner anyway as they have a right to know
• BRespect patient confidentiality and do not disclose to the partner✓
• CLie to the partner and say nothing significant was discussed
• DRefuse to treat the patient unless they agree to disclosure

Answer: Patient confidentiality must be maintained unless there is a serious, imminent risk to others. The information concerns the patient's own health and there is no such risk described.