In an MMI interview, the Moral & Ethical Situation prompts are the ones that terrify applicants. They feel so high stakes. For example: Decide which of these two patients gets an organ transplant. Geez Louise.
Many MMI questions—especially the ones about morals and ethics—may omit details you might've considered when contemplating your answer. Fill in those blanks and consider them still because your answer could be conditional from an ethical or legal standpoint. "Conditional" does not mean wishy-washy but rather "If X factor is present, then my answer is Y."
Think about how you would answer this ethical question: A minor teenage patient asks you for a prescription for birth control pills—and doesn't want their parents to know about it. How would you handle this request?
You might reflexively have an answer to this—but pause and consider potential conditional factors, even if you ultimately dismiss them. Beyond answering your patient's request, what else might you discuss with your patient? You might ponder these questions:
Are there legal matters to consider?
Are there health risks to consider?
Is your patient sexually active already or considering becoming sexually active?
Is your patient 13 or 17?
Will your patient be using a second form of protection to prevent STIs?
Are they being pressured into a sexual relationship?
Is there anything you should know about their partner/partners—like how old they are?
If those things were not factors in your decision-making, why not?
Here's an example of a response to this question:
"If there are neither state laws limiting my ability nor significant health risks present, I would give my teenage patient a prescription for birth control without their parents’ knowledge. I would not tell their parents because the teen is my patient and deserves doctor-patient confidentiality. But there are things I would want to discuss before providing this prescription.
I would first provide my patient with information on all their birth control options. I'd advise my patient to use condoms as a secondary form of contraception to prevent STIs and ask them what they know about STIs.
Next, I'd want to establish that they want to have sex and that this isn't a case of a partner pressuring them to have sex. If the latter is true, it wouldn't determine whether I'd prescribe birth control, but it would influence our conversation, as I'd want to take care of my patient's mental health as well as their physical health. I'd also ask about their partner's (or partners’) age. Many age of consent laws have a close-in-age exemption, but some do not. I’d inform my patient if that was the case in our state, just so they’re aware of certain risks. If my patient revealed that they were already sexually active with a partner who was older than 18, I'd refer to my state's age of consent. I am required by law to report any suspected child abuse. I would also direct my patient to information on predatory behaviors.
If their partner was their same age, I likely would not weigh in on a 16- or 17-year-old’s choices beyond asking the aforementioned questions and providing helpful resources. But I might respectfully discourage a younger patient from having sex in the same way that I'd encourage a young patient to take care of their still maturing body and mind in other ways. (I know I'd advise my 14-year-old cousin or niece to consider waiting to have sex.) But again, I would still give a prescription to any patient that I legally can prescribe to, whether I was a family doctor or practicing at a sexual health center."
This is not a gut reaction—it's thoughtful, it's careful. This response considers legality—that's important. It involves a thorough conversation between doctor and patient. Wanting to connect shows empathy and asking the patient questions and providing answers to questions that they have or haven’t asked shows strong communication skills. The answer also expresses the respondent's personal beliefs; they would advise a 14-year-old relative to think more before having sex at such a young age. You might think this info has no place in the answer, but the interviewer wants to hear your internal monologue, not only what you'd say aloud to the patient. What matters most is that your resulting action is based on facts and that you showed your patient respect, not harsh judgment. You may not agree with this sample answer—but you should understand why it's a strong one.
Related:
The Med School’s MMI Interview: Healthcare Policy Questions
The Med School’s MMI Interview: Role Playing Scenarios
The Med School’s MMI Interview: Teamwork Activities
The Med School’s MMI Interview: Writing and Picture Stations