Practice Set 4: Professional Integrity Scenarios

Professional integrity means being honest, transparent, and accountable — even when it is difficult. The GMC's Good Medical Practice framework makes clear that doctors must act with integrity at all times, and the SJT tests this principle extensively. These scenarios are often the most challenging because they pit personal consequences against doing the right thing.

Integrity questions in the SJT might involve admitting a mistake, reporting a colleague, refusing to cover up an error, or being transparent with a patient when something has gone wrong. The correct answer is almost always the honest and transparent one, even if it is personally uncomfortable or socially awkward.

The duty of candour is a legal and ethical obligation requiring healthcare professionals to be open and honest with patients when things go wrong. In SJT terms, this means that concealing an error — even a minor one — is always rated as inappropriate. Admitting the error, apologising, and explaining what will be done to prevent recurrence is the expected standard.

Partial credit scoring means you should still rank honest responses above dishonest ones, even if you are unsure which honest response is best. The SJT penalises concealment and deception far more heavily than it penalises a slightly suboptimal but honest course of action.

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Quick-Reference Decision Framework

Situation	Best Response	Why
You make a minor clinical error	Report it immediately to your supervisor and inform the patient	Duty of candour; honest reporting enables learning
A colleague asks you to sign something you did not witness	Refuse and explain why	Falsifying records is a serious professional offence
You discover a colleague has been dishonest on their CV	Raise the concern through appropriate channels	Dishonesty undermines trust in the profession
A patient asks you a question you do not know the answer to	Admit you do not know and offer to find out	Honesty about limitations is valued over bluffing
You are offered a gift by a grateful patient	Follow your institution's policy on gifts	Transparency prevents conflicts of interest

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Focus for This Practice Set