Worked Examples: Delivering Unwelcome News to a Colleague
Not all difficult conversations in healthcare involve patients. Some of the most challenging interactions are with colleagues — particularly when you need to raise a concern about their performance, behaviour, or wellbeing. The UCAT SJT regularly tests whether candidates can handle these interprofessional situations with professionalism, honesty, and sensitivity.
This lesson works through scenarios involving peer feedback, raising concerns, and navigating the tension between loyalty and professional duty.
Why Interprofessional Communication Matters for SJT
The GMC's Good Medical Practice states that doctors must:
- Work collaboratively with colleagues
- Treat colleagues fairly and with respect
- Raise concerns if patient safety is at risk
- Be open and honest in professional interactions
In SJT, you are typically placed in the role of a medical student. This means you are junior to almost everyone. The SJT tests whether you understand:
- When to speak up despite being junior
- How to raise concerns appropriately
- The balance between loyalty to colleagues and duty to patients
- When and how to escalate
Worked Example 1: A Fellow Medical Student Has Plagiarised
Scenario: You discover that a fellow medical student, Emma, has submitted a research assignment that contains large sections copied from published papers without attribution. You have clear evidence of this. Emma is a close friend.
Rate the appropriateness of each response:
Response A: "Emma, I've noticed some sections of your assignment that look like they've been taken from published papers without referencing. I think you need to know that this could be considered plagiarism, and if it's discovered, the consequences could be serious. I think you should speak to your tutor about it."
Rating: Very appropriate
Analysis:
- Raises the issue directly with Emma first — this is the appropriate starting point for a peer concern
- Is factual, not accusatory ("look like" rather than "you plagiarised")
- Explains the potential consequences (informing, not threatening)
- Recommends a constructive next step (speaking to the tutor)
- Maintains the friendship while being honest — honesty is more important than comfort
Response B: "It's none of my business what Emma does with her assignments."
Rating: Very inappropriate
Analysis:
- Academic integrity is a core professional value for medical students
- The GMC expects medical students to uphold honesty in all aspects of their work
- A doctor who ignores dishonesty in a colleague is failing in their professional duty
- This mindset — "it's not my problem" — is exactly what the SJT is designed to screen against
Response C: "I'll report Emma anonymously to the academic integrity team without telling her."
Rating: Inappropriate as a first step
Analysis:
- While reporting may ultimately be necessary, going straight to a formal report without speaking to Emma first is disproportionate
- The SJT generally expects you to address concerns at the lowest appropriate level first
- Anonymous reporting has its place (particularly for serious safety concerns) but should not be the first response to a peer issue
- However, if speaking to Emma does not resolve the issue, escalation would then be appropriate
Response D: "I'll help Emma rewrite the sections and no one needs to know."
Rating: Very inappropriate
Analysis:
- This makes you complicit in academic dishonesty
- It undermines the integrity of the assessment process
- It prevents Emma from facing the consequences and learning from the experience
- It violates the GMC's expectation of honesty and integrity
Worked Example 2: A Junior Doctor Appears to Be Under the Influence of Alcohol
Scenario: You are a medical student on a morning ward round. You notice that the FY1 doctor (first-year junior doctor) smells strongly of alcohol, appears unsteady, and is slurring their words slightly. They are about to review patients.
Rate the appropriateness of each response:
Response A: "I'm concerned about you this morning — I've noticed you seem unwell. I think we need to let the registrar know before the ward round continues."
Rating: Very appropriate
Analysis:
- Frames the concern as welfare ("seem unwell") rather than accusation ("you're drunk")
- Takes immediate action — patient safety is the overriding priority
- Escalates to the appropriate senior person (registrar)
- Does not allow the ward round to continue while there is a risk to patients
- Compassionate but firm
Response B: "Everyone has a rough night sometimes. I'll cover for you — just stand back and let me do the talking."
Rating: Very inappropriate
Analysis:
- Covering for an impaired colleague puts patients at direct risk
- The FY1 may need to make clinical decisions, prescribe medication, or perform procedures — intoxication makes all of these dangerous
- You are a medical student — you cannot "cover" for a doctor
- This response prioritises loyalty over patient safety, which is the wrong way round in every SJT scenario
Response C: "I'll speak to the FY1 privately after the ward round and suggest they seek help."
Rating: Inappropriate
Analysis:
- Patient safety cannot wait until after the ward round
- While speaking privately shows consideration for the colleague, the priority must be preventing harm to patients NOW
- Delaying action when you have identified a patient safety risk is a serious professional failing
Response D: "I need to speak to the registrar urgently about a patient safety concern."
Rating: Very appropriate
Analysis:
- Takes immediate action to protect patients
- Escalates to the correct person
- Uses appropriate language ("patient safety concern")
- As a medical student, you are not expected to confront a doctor directly — escalation is the right approach
- Does not make a diagnosis ("drunk") — reports observations and lets the senior clinician make the judgement
Worked Example 3: A Colleague Makes a Discriminatory Comment
Scenario: You are a medical student in the hospital cafeteria. A fellow medical student, Tom, makes a derogatory comment about a patient's weight, saying, "No wonder she's ill — look at the size of her. People like that are a waste of NHS resources."
Rate the appropriateness of each response:
Response A: "Tom, I don't think that's fair. Every patient deserves the same quality of care regardless of their weight. Comments like that could also be overheard and would reflect badly on all of us."
Rating: Very appropriate