General Surgery Board Review Professional Standards & Competencies 2 — Questions and Answers
Question 1: A surgical resident repeatedly arrives late to morning rounds but performs technically well in the OR. Which competency domain is most deficient?
- Patient Care
- Professionalism (Correct answer)
- Medical Knowledge
- Systems-Based Practice
Correct answer: Professionalism
Professionalism encompasses reliability, punctuality, and accountability to the team and patients.
Question 2: Under HIPAA, which of the following disclosures of protected health information is permissible WITHOUT patient authorization?
- Sharing operative photos at a public marketing event
- Reporting a gunshot wound to law enforcement (Correct answer)
- Disclosing records to the patient's employer
- Posting de-identified images on social media with institution name
Correct answer: Reporting a gunshot wound to law enforcement
HIPAA permits disclosure without authorization for mandatory public health reporting such as gunshot wounds.
Question 3: A surgeon is asked to perform a procedure outside their current scope of privileges. The best course of action is to:
- Proceed if confident in the technique
- Decline and refer to a credentialed colleague (Correct answer)
- Perform the procedure with a resident assisting
- Request retrospective privilege approval after the case
Correct answer: Decline and refer to a credentialed colleague
Performing procedures outside one's granted privileges violates credentialing standards and risks patient safety.
Question 4: Which principle of the ACS Code of Professional Conduct is best illustrated by a surgeon who discloses a financial conflict of interest before recommending a specific surgical implant?
- Beneficence
- Justice
- Transparency and honesty (Correct answer)
- Autonomy
Correct answer: Transparency and honesty
Disclosing conflicts of interest exemplifies transparency and honesty, a core ACS professional conduct principle.
Question 5: During a morbidity and mortality (M&M) conference, the primary purpose of case review is to:
- Assign blame to the responsible surgeon
- Generate medicolegal documentation
- Identify system and process improvements to prevent recurrence (Correct answer)
- Satisfy Joint Commission reporting requirements
Correct answer: Identify system and process improvements to prevent recurrence
M&M conferences are protected educational forums aimed at quality improvement and error prevention, not blame assignment.
Question 6: A patient with capacity refuses a blood transfusion on religious grounds before an elective high-risk operation. The ethically appropriate response is to:
- Proceed without transfusion and document the refusal (Correct answer)
- Seek a court order to override the decision
- Postpone surgery until the patient changes their mind
- Consult psychiatry to assess decision-making capacity
Correct answer: Proceed without transfusion and document the refusal
Competent adults have the right to refuse treatment; the surgeon must respect this and document the informed refusal.
Question 7: The 'duty to report' an impaired colleague to the appropriate authority is primarily grounded in which ethical obligation?
- Fidelity to the profession
- Non-maleficence toward patients (Correct answer)
- Respect for colleague autonomy
- Distributive justice
Correct answer: Non-maleficence toward patients
Reporting an impaired colleague is driven by the duty of non-maleficence — protecting patients from harm.
General Surgery Board Review Professional Standards & Competencies 2
A surgical resident repeatedly arrives late to morning rounds but performs technically well in the OR.
Which competency domain is most deficient?