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By The Next Step

Medical SJT: The answers

the-next-step
doctor
FY1
3 min
Young female professional smiling

See the solutions below to find out how you performed in the medical SJT mock questions.

Answer to question 1: BCDAE

Understanding Mr West’s living situation is the most important issue here. It is the patient’s decision where they decide to live as long as they have the capacity to make that decision, so discussing with the patient directly is most appropriate. Asking his son may highlight some further issues and therefore would be the next most appropriate action to take. D may lead to a conflict between Mr West and his son and could potentially cause some distress, however, it is a better action to take than ignoring the situation as this is a passive action. A is ranked last as this would be unethical and without valid consent from the patient.

Answer to question 2: ABCED

As her physician, you should first look at the patient’s medication and see if any adjustment or additions can be made to help manage her diabetes better. Entering a conversation around the patient’s thoughts and attitudes will be key to achieving behaviour change. The dietetics service will be able to provide personalised and detailed nutritional advice for the patient to help improve her diet. Whilst providing some information on physical activity will be beneficial, this alone won’t address the issues the patient is facing, but is more appropriate than option D, which is unprofessional and may make the patient feel uncomfortable or upset.

Answer to question 3: AEDBC

Reading up on the drug will build good rapport and trust with your patient, and you can then go back to them with a more informed approach on why they should not use the supplement. Providing information and evidence on current approved treatments will provide the patient with safer options. Refusing to prescribe the medication is not ideal but it is less patronising and rude than telling the patient it’s not going to work when you don’t know anything about the drug. C is ranked last as it is potentially putting the patient at risk.

Answer to question 4: EDCBA

In such a situation, you want to make sure your colleague is not seeing patients when they will most likely still be under the influence of alcohol. E, D and C are all actions that will prevent your colleague from seeing any patients. E is most appropriate as you are ensuring your colleague gets home okay and will not be attending work. Getting in extra sleep is not the issue here, but advising your colleague to go home is still better than ignoring the issue.

Answer to question 5: DBCAE

Finding a senior colleague who can review the patient and discharge them is the most appropriate action to take here, as they will have the authority and be familiar with the patient. An FY1 should never discharge a patient without the supervision or sign-off of a senior colleague and is therefore ranked last. If senior supervision is not available, then it is acceptable to gain verbal approval from a senior colleague and therefore B is ranked second. The patient should be informed of their right to self-discharge but must be informed of the potential risks of doing this.

Practice questions and answers correct at time of publication.