Section 1
You have just started a job as a medical F2 in a new hospital. Your wife has a chest infection, and is not yet registered with a GP and has asked you to prescribe antibiotics. Rank the following options 1-5, 1 being the most effective / best option, 5 being the least effective / worst option:
Answers:
1. B. Tell her to register with a GP locally.
The GMC Good Medical Practice guidance states that “Wherever possible, you should avoid providing medical care to anyone with whom you have a close personal relationship.” This is because it may be difficult to remain objective and so compromise your judgement. Your wife could be seen as a temporary resident and register with a local GP.
2. A. Prescribe the medication as a private prescription, and arrange for her to register with a GP the following week.
The GMC guidance does allow for you to prescribe for those close to you if absolutely necessary, or in an emergency, but your wife still needs to register with a GP for her future care. As this is not an emergency, this is not as good an option as option B.
3. C. Prescribe the medication on a hospital take home prescription with her details on it.
Take home prescriptions are for patients being seen in the hospital only. You should not abuse your position of responsibility - this option shows a lack of professional integrity.
4. E. Ask one of your work colleagues to write a prescription on a hospital take home script without seeing your wife.
Do not implicate a work colleague in the situation when they are not responsible for the patient or their follow-up. This is unfair to your colleague – he has not seen the patient, yet he would be responsible for any adverse events.
5. D. Prescribe the medication on a hospital take home prescription with one of your patient's details on it. Collect the medication from the hospital pharmacy.
This is fraudulent, and dishonest. This could lead to you losing your job, and potentially your GMC registration.
Further reading: Good Medical Practice
Section 2
You are an FY2 doctor working in General Medicine. The son of a patient who was recently admitted asks to see you privately on the ward. He expresses his gratitude for the care given to his mother. He gives you an envelope with thirty pounds cash in it. Choose the three most appropriate actions to take in this situation.
Answers: Choose the THREE most appropriate actions to take in this situation.
A. Thank him for his gesture, saying it is very kind of him.
D. Suggest that he donate the money to the ward, as everyone helped care for his mother.
G. Inform the ward staff about his gratitude for the care received.
By thanking the relative, you are recognising that he is trying to do something nice. It does NOT mean that you have accepted the money - it is easy to make this assumption, but you have to ONLY use the information given. Suggesting he donate the money to the ward allows all the staff to benefit. Letting all the staff know that the care received was good will improve team and individual morale. It is important to note that in Section 2 questions, you need to consider all the options together as a single response (A + D + G).
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