CASPer Practice Test #3 - Master Student

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Master Student

CASPer Practice Test #3

A nanny comes into your emergency department with three kids aged 4, 8 and 10. She is babysitting her clients’ kids today but has come in to see you because of an urgent gynecological issue. You enter the examination room and see the 3 kids are with her. You are an emergency doctor who needs to take a detailed sexual history and perform a gynecological physical exam. You begin to wonder about the appropriateness of the situation.

1. With the children currently in the room, how would you proceed to take the sexual history and perform the sensitive physical exam?

2. Do you think the children’s parents should be notified of this incident? What would be your plan?

3. Imagine you were the nanny in this situation. How would you handle it?

A doctor in your ward is on duty and you notice that he is probably under the influence of alcohol as he is unable to walk upright, his eyes are bloodshot red, and he is stuttering his words. You have worked with him for a few years and know that he is a really good man who would not do this if not because of the recent loss of his wife of 15 years. It is not a busy night and you probably will not need him to stay much longer.

1. What is going through your mind?

2. What would you do?

3. If nothing bad has happened yet, should he be punished for his actions?

“Sin taxes” exist on goods and services such as tobacco, alcohol, fatty foods and snacks, and gambling at casinos.

1. Are these taxes fair?

2. Do you believe these taxes are effective at changing behaviour?

3. Should the proceeds go to healthcare?

You are a physician on duty at the local ER. A 'scruffy' looking middle aged man, dressed in sweat pants and an old sweater walks in complaining of severe back pain. While taking the history, the man kept insisting that the only thing that helps his pain is a very strong painkiller. A nurse quietly tells you that this gentleman frequently visits the hospital and gets prescribed painkillers.

1. What is going through your mind right now?

2. What should you do in this situation?

3. How would you handle the patient if he kept insisting on getting prescribed painkillers?

Scholar/Medical expert.

1. Describe a situation in your education where you had to be an “expert” in your chosen field.

2. What learning methods did you use to achieve competency at your training or program of education?

3. Compare and contrast what you expect in medical school with your previous university education. What new learning methods will you need to employ in your medical training?

You are a family physician working at a student health care clinic on the university campus. It is very close to exam time and you wonder why you have been receiving a higher than normal patient load. It is understandable that students can be stressed out by exams and it appears the patient you are currently seeing, Jonathan, is feigning illness to receive a medical note.

1. How would you approach the situation? What would you say to Jonathan?

2. What are the negative implications of writing a sick note for Jonathan?

3. How could you reduce the incidence of students faking illnesses before exams?

There is a local bully, Thomas, who has been taunting children as they walk home from school and has been known to create a fearful environment for other children in the neighbourhood. One day as he is troubling a group of innocent girls, Willy, a fellow classmate was fed up and punched the bully repeatedly. The bully was badly harmed and taken to hospital to get stitches, his parents are now asking who did this to him.

1. What should you do?

2. Is it acceptable for someone to do bad things for a good reason?

3. What are your thoughts on the philosophy, “one needs to have a taste of your own medicine”?

You are a medical student doing a clinical observership with a cardiologist, Dr.Pepper. He is very knowledgeable, caring of patients, and enthusiastic to teach you. One of his patients, Mr.Jones, presents to the clinic with moderate chest pain and wonders whether it is a warning sign of heart failure. After careful clinical examination, Dr.Pepper reassures Mr.Jones that there is nothing to worry about, saying, “Your boss,Mr.Smith, came in last week with similar symptoms and it turned out to be merely acid reflux”.

1. Was Dr.Pepper’s comment appropriate? Why or why not?

2. As a medical student, how would you address the situation?

3. What are the potential negative impacts of Dr.Pepper’s comment?

You are the executive director of a law firm. You find out that your articling student has accidentally destroyed an important piece of evidence that would have cleared a wrongfully accused person. If you reveal this to the authorities, your student will not only lose her job, but will face jail time for destroying court evidence.

1. What will you do in this situation?

2. What if you had information that the accused person is indeed guilty of other unrelated but more serious crimes for which you do not have any evidence that would hold up in the court?

You are a medical oncologist who has just been told your 24 year old patient has colon cancer. The patient's sister begs you not to say anything, citing that the patient has threatened to kill himself if he finds out he has cancer. You have not heard the patient express such wishes previously, but these ideas deeply concern you.

1. Under what circumstances is it acceptable to not share information with a patient?

2. Is it acceptable in this instance to follow the sister's wishes? Why or why not?

3. What would be your plan for your very next meeting with the patient?

You are a member of a study group and you observe members of your group having a heated conversation. Mike and John are confronting Sarah about her inconsistent contribution to the study group. Mike and John are upset that Sarah did not contribute to the study session today and accuse her of not being prepared. Sarah defends herself by saying that she has been busy writing an important paper. Mike and John inform her that they also had the same paper due and, despite that, were able to show up prepared for the session. They then accuse her of regularly coming to tutorials unprepared, suggesting that she’s only learning from the information that they have provided during the study sessions. Sarah informs them that she has been under a lot of stress and that they are not being fair to her. She prepares to leave due to their “negativity”.

1. You are a member of the study group and have not participated in the interaction so far, but now the group is looking to you. How would you diffuse this situation?

2. Do you agree with the two students who are upset with Sarah? Why or why not?

3. What suggestions can you make to help the group function better going forward?

Consider the following quote: “To say nothing is to say something.” – Germany Kent

1. What do you do?

2. What are the ethical, legal, and psychological implications of your decision?

3. Would your answer change if you were told this was the only time the mother did this?

You are a nephrologist at a major kidney transplant centre in Canada. Because of the long wait list for a kidney transplant in Canada, a wealthy patient of yours is contemplating going to India to pay for one. He comes into your office today seeking your opinion.

1. How would you counsel the patient on whether he should seek a kidney transplant outside Canada?

2. What concerns, both ethical and medical, would you have about a kidney transplant done outside Canada?

3. Currently there are no policies against patients seeking treatments, such as transplants, outside Canada. Should such policies exist? Why or why not?

Physicians are expected to be Medical Experts — competent at diagnosing and treating various illnesses and conditions.

1. Describe a situation in your education where you had to be an “expert” in your chosen field.

2. What learning methods did you use to achieve competency at your training or program of education?

3. Compare and contrast what you expect in medical school with your previous university education. What new learning methods will you need to employ in your medical training?

A woman arrives home with a ticket/fine issued for running a red light, captured by a red light camera. She expresses frustration/exasperation with the $325 fine to her friend, who tells her that while it sucks to pay the fine, the red light cameras are there to reduce accidents. The woman expresses frustration with the fine, because stopping would have been difficult, and anyhow, her running the light did not cause an accident; shouldn’t we focus on punishing people who are committing real violations like not wearing seatbelts?

1. What is your opinion on red light cameras? Do they work?

2. Is $325 a fair fine? Why/why not?

3. Some people have expressed concerns that red light cameras are a “violation of their privacy”; do you agree with this argument? Why/why not?

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