FREE Comprehensive MSRA Questions and Answers
As a Foundation (F2) physician, you are employed in a crowded medical ward. Mr. Davies, a patient, has complained to you about two occasions when the registrar* spoke to him in an abrupt and icy manner. It is well known that the registrar treats patients with extreme kindness and gentleness.
Choose the 3 most appropriate actions to take in this situation.
Please select 3 correct answers
Correct Answer: CDG
This scenario revolves around professional integrity, specifically within the General Medical Council's (GMC) guidelines on Communication, Partnership, Teamwork, and Working in Partnership with Patients. Addressing Mr. Davies's concerns with empathy and respect is crucial. Apologizing for his feelings (Option D) aligns with GMC's emphasis on treating patients politely and considering their concerns.
Acknowledging the importance of teamwork, asking Mr. Davies to explain further (Option C) demonstrates active listening and a commitment to understanding the situation before making decisions. Similarly, offering Mr. Davies the choice of how to proceed (Option G) respects his autonomy and aligns with both teamwork and partnership principles.
However, suggesting that the registrar is a good doctor (Option B) is inappropriate, as it may dismiss the patient's concerns. Explaining the registrar's workload (Option F) is irrelevant to Mr. Davies's feelings and should be avoided. Advising him to discuss the matter with the consultant (Option A) is premature unless he wishes to escalate the issue.
Importantly, bringing up the formal complaints procedure (Option E) is deemed inappropriate at this stage as the patient has not expressed interest in pursuing this course of action. The focus should be on understanding Mr. Davies's perspective and addressing his immediate concerns.
While on a medical ward round, the consultant instructs Emily, one of your Foundation (F2) medical colleagues, to tap Mr. Lucas's pleura. Emily informs the consultant that she is capable of performing the surgery. But Emily informed you a few days ago that she had never done this procedure before. You've carried out this process multiple times.
Choose the 3 most appropriate actions to take in this situation.
Please select 3 correct answers
Correct Answer: BCH
This scenario revolves around professional integrity and ensuring patient safety. The primary concern is the competency of the colleague, Emily, who is tasked with performing a procedure on the patient, Mr. Lucas. To address this, it is initially appropriate to speak directly to Emily about the concerns (Option A), allowing her the opportunity to address the issue and provide support if needed. Jumping to seniors or discussing the matter in a teaching session (Option G) is deemed inappropriate at this stage, as the immediate focus should be on patient care
Emphasizing teamwork, encouraging Emily to discuss the situation with her consultant (Option H) is more suitable than bypassing her and directly informing the consultant (Option D). It is not appropriate to involve the patient in this situation (Option E) as it may undermine the doctor-patient relationship and erode trust.
Seeking support and offering guidance aligns with the GMC's professional requirements. Suggesting to help Emily perform the procedure (Option C) provides a learning opportunity with support, ensuring patient safety. Insisting on performing the procedure oneself (Option B) is inappropriate, as the consultant has assigned the task to the colleague.
Due to some of your coworkers' recent leaves of absence, you have been extremely busy at work. You are having a lot of personal problems right now. You haven't been getting enough sleep. You know you're not working as well as you usually do, and you frequently don't finish your tasks by the end of the shift. You've exhibited irritability toward coworkers.
Choose the 3 most appropriate actions to take in this situation.
Please select 3 correct answers
Correct Answer: BDE
This scenario emphasizes professional integrity and the importance of practicing within one's scope of competence. Recognizing personal limitations and seeking help when feeling overwhelmed is crucial for patient safety. Escalating the situation to a senior colleague for advice (Option E) is appropriate, ensuring proper management of workload and personal well-being. Taking a break to recuperate (Option D) and seeking advice from a GP or occupational health physician (Option B) are also suitable actions to address personal issues affecting work performance.
However, focusing solely on work and neglecting personal issues (Option F) is deemed inappropriate, as it disregards the impact on patient care. Complaining to hospital management (Option G) is not suitable in this context, as the issue stems from tiredness rather than an excessive workload. Visiting a pharmacy for a sleep remedy (Option H) is considered inappropriate as it does not address the underlying personal issues causing sleep problems.
Booking a course on time management (Option C) could be beneficial for time management concerns, but in this scenario, where lack of sleep and personal issues are affecting general health, it may not be the most effective solution.
Arriving an hour early each day to complete unfinished tasks (Option A) is deemed inappropriate, as it compromises rest periods essential for well-being and increases the risk of mistakes. The focus should be on addressing personal issues and seeking support for better overall health and job performance.
As a Foundation (F2) physician, you are employed in an emergency room. You have the right to protected study leave as part of your training, during which you can schedule a meeting with your educational supervisor*. You had scheduled a meeting with him for last week, but you had to postpone it because of a staffing shortage, which required the consultant to ask you to stay in the department at short notice. We have rescheduled your meeting for today. The consultant asks to stay a little while longer because the department is very busy as you are about to end your shift and head out for your meeting.
Choose the 3 most appropriate actions to take in this situation.
Please select 3 correct answers
Correct Answer: AFG
This scenario revolves around managing pressure and fulfilling professional responsibilities. The GMC emphasizes doctors' engagement in Continuous Professional Development (CPD) and attending essential supervision meetings. To ensure attendance at a scheduled meeting, finding a colleague for departmental support (Option A) is appropriate, maintaining cover and allowing you to attend the meeting.
Contacting the educational supervisor directly (Option H) is deemed inappropriate, as it is your responsibility to communicate with the consultant and arrange suitable cover. Staying longer in the department (Option C) is also inappropriate due to the importance of adhering to allocated working hours and the potential impact on the scheduled meeting. Rearranging the meeting (Option D) is not recommended, especially after a previous cancellation, as it may reflect poorly on your professional progression.
Contacting the LETB for advice (Option E) is premature at this stage, and it's more appropriate to address issues locally before escalating. Reminding the consultant of the missed meeting last week (Option F) is appropriate to make them aware of the consequences of repeated requests to stay longer.
Offering immediate support to the consultant (Option G) and notifying the educational supervisor about potential lateness is a suitable course of action, demonstrating a commitment to urgent tasks while prioritizing the scheduled meeting. Insisting on protected study leave (Option B) is considered inappropriate as it overlooks the impact on patient care and the importance of considering the broader multidisciplinary team.
You cover the cardiac care unit as part of your job in acute medicine. You have theater tickets and it's your partner's birthday. In order to make it home on time, you must finish quickly. Dr. Orr, who is going to take over, calls shortly before the end of the shift to say he is stuck in traffic and will be an hour late.
Choose the 3 most appropriate actions to take in this situation.
Please select 3 correct answers
Correct Answer: CDG
This scenario focuses on handling pressure in a medical setting. The General Medical Council (GMC) underscores patient safety and the doctor's responsibility to ensure appropriate workload coverage. Balancing personal commitments while prioritizing patient needs is crucial. Options such as asking a senior colleague or another Foundation doctor for cover (Options D and G) are appropriate, demonstrating responsibility and proactive problem-solving without passing the duty to others.
Delaying the cancellation of personal plans and telephoning a partner to arrange a meeting at the theatre (Option C) is a reasonable approach to finding alternative solutions without immediately canceling pre-arranged commitments.
However, leaving the hospital to get home on time (Option A) is deemed inappropriate and unprofessional, as patient needs should take precedence in emergency situations. Asking nursing staff to contact Dr. Orr or telephoning medical staffing for cover (Options E and F) are also inappropriate for a Foundation doctor, as these decisions fall under the purview of higher-ranking medical professionals.
As a Foundation (F2) physician, you treat out-patient gastroenterology patients. You examine Helen, a 30-year-old patient who has had three appointments for irritable bowel syndrome (IBS). Helen breaks down in tears and says her life has been ruined by the severity of her symptoms. She says that your consultant, renowned gastroenterologist Professor Khan, doesn't care about her because he told her that there are far worse diagnoses and that she should just try to accept it.
Choose the 3 most appropriate actions to take in this situation.
Please select 3 correct answers
Correct Answer: CEH
In this scenario, Helen expresses dissatisfaction with the professor's comments regarding her condition. As a responsible doctor, addressing Helen's concerns is crucial, aligning with the General Medical Council's (GMC) principles, specifically in the Communication, Partnership, and Teamwork domain. Apologizing to Helen for the impact of the professor's comments and acknowledging her feelings (Option C) demonstrates respect for her autonomy.
The GMC emphasizes working in partnership with patients, which involves listening to and responding to their concerns (Option E). Understanding Helen's perspective on how her symptoms affect her life is essential. Providing information about her condition (Option H) aligns with the principle of offering information in a manner that patients can comprehend, empowering them to make informed decisions.
However, suggesting that IBS is hard to treat (Option B) is inappropriate, as it may cause unnecessary distress, and effective symptom management is possible. Recommending a second opinion (Option A) is also inappropriate in this context, as Helen's concerns are related to the professor's comments rather than the diagnosis itself.
However, suggesting that IBS is hard to treat (Option B) is inappropriate, as it may cause unnecessary distress, and effective symptom management is possible. Recommending a second opinion (Option A) is also inappropriate in this context, as Helen's concerns are related to the professor's comments rather than the diagnosis itself.
Reassuring Helen about the professor's intentions without having all the facts (Option F) and asking a nurse to comfort her (Option D) are inadequate responses, as they do not address the patient's specific concerns. Similarly, informing Professor Khan about Helen's dissatisfaction (Option G) is premature, as the immediate focus should be on supporting the patient.
In summary, acknowledging Helen's feelings, understanding her perspective, and providing relevant information are key actions that align with GMC principles in this scenario.
You are a general surgery physician employed by the Foundation (F2). The end of your night shift is almost here. Following a traffic accident, Sarah, the F2 who will take over for you, informs you that her mother is critically ill. Sarah says she doesn't want time off ""on her record"" and has shown up for work as usual in spite of this.
Choose the 3 most appropriate actions to take in this situation.
Please select 3 correct answers
Correct Answer: BEF
This scenario revolves around empathy, sensitivity, and professional responsibilities in a medical setting. Doctors are expected to provide peer support within a Multi-Disciplinary Team (MDT). Offering support to Sarah to discuss her situation (Option B) aligns with teamwork principles, allowing her to share her concerns.
Additionally, considering patient safety as a priority, explaining to Sarah the potential impact on patient safety if she remains at work (Option E) is a responsible action. Enquiring with medical staffing about alternative coverage (Option F) demonstrates a proactive approach to address the situation while ensuring patient safety.
Covering Sarah's duties (Option C) is deemed inappropriate as it falls outside the scope of practice and poses potential risks to patient safety. Advising Sarah to book an appointment with occupational health (Option A), informing the consultant about Sarah's mother (Option G), and involving her educational supervisor (Option H) are considered inappropriate at this stage since Sarah has not sought advice or raised specific concerns that necessitate such actions.