Sunday, May 30, 2010

Preparing for the MCAT – Not Your Father’s Exam

Remember the MCAT (Medical College Admission Test)?  This is the examination that determines if pre-med students will become actual physicians. This is an extensive examination covering an expansive amount of information that is not clearly related to the practice of medicine.   It reminds me of the government and insurance industry’s emerging quality initiatives.   Like the MCATs, these programs measure what is easy to count; but what really counts, can’t be easily measured. 

If I were asked to submit MCAT questions, as a practicing physician, I would bring a real world flavor to the examination. 

Whistleblower MCAT 2.0 Sample Questions!

Test Your Knowledge! Amaze Your Friends!

Let the Games Begin!

Medical Knowledge Section

You are in the hospital recovering from ankle surgery after a fracture. After pain medication is prescribed, you develop some constipation and abdominal discomfort. The orthopedist’s physician assistant orders a CAT scan of the abdomen to evaluate the new symptom.

The biggest risk that you face from this recommendation is:

Choose the best answer.

(1) Radiation from the scan
(2) Injury to the ankle during transport to the radiology department
(3) Worsening constipation from the oral contrast. This could lead to a stampede of scope-wagging gastroenterologists into your hospital room resulting in physical and emotional trauma
(4) Finding an incidental 3 mm lower lung nodule, which will initiate a medical cascade of testing that will torture you for 2 years.
(5) The radiology tech confiding that the your orthopedist is quietly known as Defendant of the Year.

Whistleblower Note: Are you wondering why a laxative wasn’t recommended instead of a CAT scan?
If so, then you need to travel to Washington, D.C. to testify before Congress as a medical expert STAT!

Medicolegal Section

Disclaimer: Nothing in this exam purports to offer any legal advice to any examinee, or to their relatives or pets. The question is hypothetical only. Any attempt to use test materials, either purloined or memorized, to further one’s legal advantage is strictly prohibited.  Lucky for us, there is no federal tort reform legislation so can sue at whim.

Which of the following statements about the medical liability system is true?

Choose the best answer.

(1) The current medical liability system reduces medical malpractice.
(2) Democrats receive substantial financial support from trial lawyers, but this does not influence the legislators’ hostility toward tort reform.
(3) If physicians were more careful, conscientious and communicative, then they would never be sued.
(4) Tort reform is a political straw man, another example of a vast right wing conspiracy.
(5) The current system targets many more innocent physicians than negligent practitioners.
(6) If a baby is born imperfect, then something must have gone wrong.
(7) Depositions are fun and physicians should learn to enjoy them.

Doctor-Patient Communication Section

Which of the following behaviors contribute to a successful therapeutic partnership?

There are two correct answers.

(1) Patients asking for a treatment, not a diagnosis. “I need an antibiotic, doctor.”
(2) Physicians who practice TIER medicine, aka Texting In Exam Room.
(3) Patients who call for medication refills after office hours and on weekends.
(4) Patients who call for test results 2 days before their office appointment.
(5) Patients who say thanks.
(6) Physicians who start questioning about ‘stress issues’ after  the CAT scan and laboratory results are normal.
(7) Physicians who call patients a few days after appointments to check on their progress.

Please record your MCAT answers in the comment section below, along with your own sample test questions. Humor, sarcasm and bone dry wit are encouraged.

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