194 CHAPTER 13 Working effectively as part of a team
to enforce this (largely unwritten) code of behaviour informally. In this
case, the transgression is relatively minor and so calls for a measured
approach. (B) is the best answer as it raises the issue discreetly in a way
that would allow your SHO to modify his behaviour without embarrass-
ment. There may actually be a problem (e.g. an emergency at home) and
he might elect to leave the ward round. (A) is ranked lower than (B) as
it is more direct and could lead to defensiveness in some colleagues.
(C) ranks lower than (A) for the same reason, i.e. it is excessively direct.
(D) and (E) are incorrect as they are not measured responses to a rela-
tively minor problem. (E) is particularly excessive and is unlikely to gar-
ner much support from other members of your clinical team.
37. E, D, C, B, A
In any difficult situation involving colleagues, it is important to establish
the facts early on. For this reason, (E) is the best answer. You might be
willing to help out your SHO if there is a temporary problem with child-
care, but she will be working normal hours in the near future. However,
it might become necessary to confront the SHO and make it clear that
you are unwilling to accept the current arrangement (D) which risks
patient safety and your own well-being. (D) is ranked lower as (E) is
more likely to resolve the issue to everyone’s satisfaction without caus-
ing unnecessary ill feeling. (C) may become necessary later on but is a
worse initial response than (D). If the matter cannot be resolved through
discussion, it must be escalated to your consultant. (B) is the first wrong
answer. Although time might be made up elsewhere, working through
lunch is not an optimal long-term strategy and should not be imposed on
the SHO, particularly by the FY1 doctor. The worst answer is (A) as it
leaves only one doctor on site for 1.5 hours every day.
38. B, E, G
The immediate goal should be to de-escalate what could become an
inflammatory situation if an argument was to develop. Your best move
would be to steer the ward round back to its original business of review-
ing patients (B). However, you should also let the registrar know after-
wards that his behaviour raised concerns (E). If this is unsuccessful, the
matter should be raised with your consultant (G).
You should avoid becoming embroiled in controversial discussions
when these are likely to cause offence in the workplace. This includes
agreeing (D) or disagreeing (C) with the registrar.
It would be an overreaction to leave the ward round (F) or apologize
on your registrar’s behalf (A), although he might wish to approach the
patient after you have brought the issue to his attention. Similarly, you
should not usually solicit complaints from patients about colleagues (H).
39. E, B, A, C, D
Dishonest removal of hospital equipment constitutes theft with its
attendant legal and professional consequences. The situation would
ANSWERS 195
be much different if he had asked an appropriate person (e.g. theatre
coordinator) and been given equipment with which to practise. The
best answer is (E) as you should give your colleague an opportunity to
recognize his actions were incorrect (he might not have thought through
the consequences thoroughly) and return any remaining equipment.
(B) is correct but would be unnecessarily confrontational as an initial
response.
You might wish to let the theatre manager know that property is going
missing (A) so that items can be appropriately secured and warnings
distributed to staff. However, (A) is not as good as (E) or (B) as it does
not directly address the person responsible.
Reporting your colleague outright (C) under these circumstances
seems excessive as it is likely he has not thought through the conse-
quences and does not view his behaviour as stealing. If he had stolen
something more obvious (e.g. a hospital computer), you would clearly
have to involve the hospital authorities early on.
The worst answer is (D). Although a surgical registrar could perhaps
argue that the Trust should make reasonable allowances for practice,
this argument is rather less convincing for an FY1 doctor. Instead, he
is forcing his employer to subsidize his further professional education
without their agreement.
40. C, E, F
Attending a set number of teaching sessions is a mandatory require-
ment for completion of FY1. If you identify difficulties attending sessions,
these must be raised early on so that you do not find yourself in difficulty
towards the end of the year.
You could certainly speak with the SHO to emphasize the importance
of sufficient cover so that you can attend teaching (E). However, the
issue should be escalated swiftly if it persists. Your Clinical Supervisor
(C) is a good place to start, followed by your Educational Supervisor if
issues are still not resolved. It would also be polite to inform the teaching
coordinator as well by way of apology for not arriving (F).
You should not leave the clinic without cover, particularly if you doubt
that your SHO will arrive on time (A). Similarly, you should not del-
egate to another healthcare professional (G) unless this has been agreed
locally. The secretaries are unlikely to be able to manipulate the clinic
volume without impacting on the elective operating list (H). Involving a
senior doctor for the simple task of reminding your SHO is unlikely to
be received well (B). Asking a colleague to sign you in to teaching casts
doubt on both your own and your colleague’s probity (D).
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Section 3
Practice test
