UCAT Situational Judgement 4 — Questions and Answers
Question 1: During a procedure, a patient says 'I'm not sure about this — stop.' The most appropriate immediate action is:
- Stop the procedure immediately and address the patient's concerns (Correct answer)
- Carry on as they consented earlier
- Stop only if physically possible without causing harm
- Assume they are anxious and continue
Correct answer: Stop the procedure immediately and address the patient's concerns
A patient may withdraw consent at any point during a procedure. 'Stop' is an unambiguous withdrawal of consent and must be respected immediately.
Question 2: A hospital manager asks a doctor to discharge patients faster to free beds, even if the doctor believes they are not ready. The most appropriate response is:
- Explain clinical concerns clearly, document them, and seek support from senior medical staff if pressured further (Correct answer)
- Discharge patients immediately to comply
- Ignore the request and say nothing
- Resign from the post
Correct answer: Explain clinical concerns clearly, document them, and seek support from senior medical staff if pressured further
Patient safety must not be compromised by operational pressures. The doctor should document concerns and escalate through clinical leadership rather than comply with unsafe instructions.
Question 3: A patient with capacity refuses to tell their sexual partner they have a sexually transmitted infection. The most appropriate response is:
- Strongly encourage disclosure, explain risks to the partner, and follow public health guidance — only breach confidentiality if a serious identifiable risk cannot otherwise be managed (Correct answer)
- Immediately breach confidentiality and contact the partner yourself
- Do nothing — it is entirely the patient's decision
- Refuse to treat the patient unless they disclose
Correct answer: Strongly encourage disclosure, explain risks to the partner, and follow public health guidance — only breach confidentiality if a serious identifiable risk cannot otherwise be managed
Most STI guidance advises encouraging disclosure, contact tracing, and only breaching confidentiality as a last resort where there is serious, identifiable, preventable harm — GMC guidance supports this nuanced approach.
Question 4: You are running a clinic and realise you haven't eaten or drunk anything for 8 hours. You are beginning to feel unfit to practise. The most appropriate action is:
- Inform your supervisor, arrange cover if needed, and take a break to recover (Correct answer)
- Carry on until the clinic is over
- Cancel all appointments without informing anyone
- Prescribe yourself medication to stay alert
Correct answer: Inform your supervisor, arrange cover if needed, and take a break to recover
Being unfit to practise — even temporarily — creates a patient safety risk. Doctors have a duty to recognise their own limitations and seek support. Informing a supervisor and obtaining cover is the safe, responsible action.
Question 5: A medical student is offered payment by a patient to 'bump them up the waiting list'. The most appropriate response is:
- Decline the offer, explain that treatment is allocated on clinical need, and report the offer (Correct answer)
- Accept it — the student needs money
- Decline but don't report it
- Ask a consultant if it is permissible
Correct answer: Decline the offer, explain that treatment is allocated on clinical need, and report the offer
Accepting payment for preferential access is corrupt and illegal. Even declining without reporting fails to protect the integrity of the system. The offer must be reported.
Question 6: A patient asks a medical student for their personal mobile number 'in case they have questions after the appointment'. The most appropriate response is:
- Politely decline, explain professional boundaries, and advise the patient to contact the surgery or NHS 111 (Correct answer)
- Give the number to be helpful
- Give a colleague's number instead
- Ask the consultant for advice before responding
Correct answer: Politely decline, explain professional boundaries, and advise the patient to contact the surgery or NHS 111
Maintaining professional boundaries is essential. Personal contact details should not be shared with patients. Redirecting to appropriate contact channels is the correct approach.
UCAT Situational Judgement 4
During a procedure, a patient says 'I'm not sure about this — stop.' The most appropriate immediate action is: