Why is uncontrolled use of antibiotics a dangerous thing? What can we do about it?
- Antibiotics are used to treat a wide range of infections, ranging from life threatening conditions to common respiratory tract infections
- They are our only defence against many of these illnesses, but can become ineffective as bacteria have the ability to develop mutations that protect themselves from the drugs
- The more antibiotics are used, the more likely it is that bacteria will develop protection against them. It is therefore important to use them sparingly so that we have effective antibiotics to combat life threatening conditions for as long as possible
- Continued medical research is an essential tool that could create new drugs that bacteria are not resistant to
- Changes to clinical practice, encouraging doctors not to prescribe antibiotics to those who do not necessarily require them, could help
- Public health campaigns could highlight these issues, encouraging patients not to request antibiotics when they have the common cold, for example
- Saying that we need to stop giving away antibiotics to every patient who requests them because patients need to understand that it is the doctor’s decision whether to provide these drugs
- Belittling patients who want antibiotics or doctors who prescribe them too quicky. For example, saying that prescribing antibiotics are an easy way of keeping a patient happy
What role do public health campaigns like anti-smoking TV adverts have in the NHS, and why is this a good way to spend NHS resources?
- Pay close attention to health campaigns. These are used a lot and are seen as a significant weapon against disease and a way of safeguarding the NHS
- Although healthcare professionals are well equipped to deal with a huge range of medical conditions, they are overstretched and under-funded. Prevention of disease is a major way that this burden can be, to a degree, alleviated
- Through education, it is possible to make people aware what causes certain diseases, and therefore to encourage them to cut down on such practices. This can both improve the quality of their lives and ensure NHS resources are well used on other patients
- However, it is important to note that not all diseases are preventable through education. Cancer, for example. So this is not a catch all solution
- Think also from a scientific and analytical perspective: how measurable are the results of these campaigns? Try to look up some statistics online
- Whether this is good or bad is probably too black and white: it ultimately depends on effectiveness, which links to the cost/reward ratio on a campaign basis and requires constant monitoring
- Viewing this kind of campaign as unimportant when set against the serious business of saving lives through medical activity. Saying for instance, that people never really listen to TV adverts and it is a waste of money
- Being closed minded and not seeing all sides of the debate. Instinctively believing that money needs to be spent on hiring more doctors, as they are the ones who actually treat the patients
- Not recognising the power of prevention — an increasing trend, which you need to be aware of
Is mental health an area of concern for the NHS, and if so why?
- Mental health conditions can be a terrible burden for somebody suffering from them, and it is the duty of the NHS to help them
- Modern society is increasingly fraught and stressful for many people, and this can lead to a wide range of mental health problems
- Mental health conditions can also lead to physical problems
- Mental and physical health care are both equally important when considering the health of a whole person, and mental health should therefore be receiving a significant amount of NHS resources
- Recently, this has been a focus for many of the political parties, and the Liberal Democrats focused on mental health as a flagship policy in the 2015 election
- Saying that the NHS is charged with treating serious conditions like trauma and cancer, and mental health should be dealt with by other services
- Believing that depression is not that serious and that psychologists can sort out things like that
Should vaccinations of children against common infectious diseases be compulsory?
- First, as with so many questions of this type, it is important to establish the basic facts before getting into detail
- Despite medical progress, preventable disease continues to affect millions of people, and vaccines for many of these are readily available. Vaccinating children is one way of halting their spread
- The consequences of a parent’s child becoming infected are not just borne by that child, or that parent, but also the local community, who are at risk as well
- However, forcing vaccination on all school children might be seen as overly paternalistic and parents may see this as a loss of their freedom to choose how to care for their child
- In terms of the four pillars, this comes down to a choice between autonomy and non-maleficience — it’s a difficult balancing act
- Taking up a partisan position based on personal opinion
- Even if you have a very strong personal opinion, it is better to walk through the arguments on both sides
A recent study estimated that by 2050 more than half of the UK population could be obese. Is this a cause for concern and if so, why?
- Start by recognising that the issue has been in the news and cite anything you may have read or heard to corroborate this. If you have seen the study, say who it was by to really impress the interviewers
- Move on to the problem itself. Why might obesity cause concern? Well, obesity is associated with a wide range of health problems, including diabetes and osteoarthritis, among others
- These lead to a low quality of life for the person affected. Furthermore, their consequent conditions can cost the NHS. This is already a huge drain of NHS resources, so it is worrying that the trend is going up
- It is therefore the interest of the NHS, and the population as a whole, to try to combat the rise of obesity
- In most cases obesity is preventable and manageable, and can be reduced with exercise and diet advice. So, there is hope that even though the study estimates a spike in obesity numbers, these can be brought down with hard work
- Failure to see all the angles. There are lots of stakeholders in this problem: the patient, the NHS and the population as a whole. Try to see the big picture
- Believing that the NHS shouldn’t be involved in giving lifestyle advice; it should stick to treating illnesses
Do you agree that people should be charged for attending A&E with non-life-threatening ailments?
- Before tackling this controversial issue, you need to establish the context and signal your awareness of what the issue that this question relates to: the crisis in A&E departments across the NHS.
- Since 2004, A&E Departments have been set a target of seeing, treating and discharging (or admitting) patients within 4 hours of attendance. These figures are tracked and reported each quarter – and are the benchmark for A&E performance.
- In October 2015, NHS England had missed this target in 13 out of 14 months in the previous periods. This led Dr Clifford Mann – President of the Royal College of Emergency Medicine – to declare the A&E system at ‘full capacity’ and near-to-breaking-point.
- Pressures on A&E are complex and are driven by a number of intersecting factors: Demographic factors (an aging and more long-term disease affected population); Lack of GP appointments (actually a myth with the real problem being lack of awareness of how to contact out-of-hours GPs); Staff shortages (between 2012-2015 a third of the A&E workforce quit the specialty).
- And of course, increased attendances. When tackling the actual question you need to acknowledge that a proportion of these attendances are most likely non-life-threatening.
- But acknowledge that: It is very difficult to determine which attendances are life-threatening and which aren’t (a headache can be nothing or it could be a subdural haemorrhage). It is unreasonable to expect the lay public to be able to determine what is an emergency and what is not. The NHS Constitution states that access to care at the point of need is a right (would charging remove that access for low-income families?). Would instituting a charge deter sick people from attending and cause an increase in preventable deaths?
- There are an enormous number of For’s and Against’s for this question! Remember to structure your answer in a logical order and use any clinical experience where appropriate.
- Simply agreeing or disagreeing with the statement without any logical reasoning.
- Going down the rabbit hole and speaking continuously without structuring your answer.
What is your opinion on the junior doctors’ contract situation?
- You need to have a basic understanding of the organisations involved in the contract dispute such as the Department of Health and the British Medical Association.
- The proposed contract only affects doctors in England as the health authorities in other UK countries have decided to stick to the previous contract for now.
- Have an understanding of who a junior doctor is.
- Mention how patient care and working conditions are the key areas of concern.
- Comment on how you felt the media coverage portrayed the situation and whether you think it was biased or not.
- Mention how a good contract leads to efficient doctors who are able to provide the best quality care for patients.
- You might want to mention how there is a lack of doctors in the workforce and how this has contributed towards the push for a better contract. A better contract would increase doctor numbers so that safe levels of patient care can be delivered.
- Mention the positive aspects of the dispute, such as how it has united a profession of doctors to stand up for what they believe in.
- As long as you are balanced and not too polarised in your opinion, you will be in safe territory.
- Holding a strong opinion against a certain individual or organisation. It is likely that there are nuances to the situation you are not aware of and in any case, it is good practice to criticise ideas and not the individual.
- Being unrealistic of your assessment of the situation. It is unlikely for a doctors’ contract to provide six figure salaries for all doctors in all specialties.