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Disagreements between peers — fellow medical students, foundation doctors at the same level, or colleagues of equal seniority — are a common SJT theme. Unlike scenarios involving seniors, peer disagreements do not have a clear hierarchy to resolve them. Instead, the SJT tests your ability to communicate, collaborate, and prioritise the patient.
This lesson covers how to handle peer disagreements professionally, including when to compromise, when to stand firm, and when to involve someone more senior.
Peer disagreements test a different set of skills from hierarchical scenarios:
| Skill tested | Why it matters |
|---|---|
| Communication | Can you express your view clearly without being aggressive? |
| Collaboration | Can you work with someone who disagrees with you? |
| Prioritisation | Can you put the patient's needs above your ego? |
| Conflict resolution | Can you resolve the disagreement constructively? |
| Escalation judgement | Do you know when to involve someone more senior? |
Two peers disagree about what is best for a patient.
Example: You and a fellow FY1 disagree about whether a patient needs a blood test repeated. You think the results are borderline and should be rechecked; your colleague thinks it is unnecessary.
Key principle: When two peers disagree about a clinical matter and neither has clear authority, the safest option for the patient should prevail. If in doubt, involve a senior.
One peer feels another is not doing their fair share.
Example: You are both on the same ward rotation, but your colleague frequently leaves early, leaving you to complete tasks alone.
Key principle: Address it directly but privately. Do not let resentment build. If the direct conversation does not resolve it, involve a supervisor.
One peer witnesses another peer doing something unprofessional.
Example: A fellow medical student jokes about a patient's appearance in the canteen.
Key principle: Address the behaviour, not the person. Focus on why it is inappropriate (patient dignity, professionalism) rather than making personal attacks.
Peers disagree about how to manage a shared academic task.
Example: In a group presentation, one member wants to use a particular format and another disagrees.
Key principle: This is lower stakes. Compromise is usually the best answer. The SJT does not expect you to "win" academic disagreements — it expects you to work collaboratively.
Before asserting your view, genuinely listen to your peer's perspective. They may have information or reasoning you have not considered.
| Do | Do not |
|---|---|
| "I hear what you are saying — can you explain your reasoning?" | "You are wrong and here is why" |
| "That is an interesting point — I had not thought of it that way" | "That does not make any sense" |
| "Let me make sure I understand your position" | "I do not care what you think" |
Once you have listened, express your own view using assertive communication.
| Effective | Ineffective |
|---|---|
| "I see it differently because [specific reasoning]" | "Well I think I am right" |
| "My concern is that [specific patient safety issue]" | "You clearly have not read the guidelines" |
| "Based on what I have observed, I think [specific action] would be safer" | "Anyone can see that my approach is better" |
In most peer disagreements, there is an area of agreement. Identify it and build from there.
| Approach | Example |
|---|---|
| Acknowledge the shared goal | "We both want what is best for this patient" |
| Identify where you agree | "We agree that the patient needs monitoring — we just differ on the frequency" |
| Propose a compromise | "How about we check after two hours rather than one or four?" |
If you cannot resolve the disagreement and patient care is affected, involve someone with more experience or authority.
| When to involve a senior | When NOT to involve a senior |
|---|---|
| The disagreement affects patient safety | The disagreement is about personal preferences |
| Neither of you has the expertise to resolve the clinical question | You have not yet tried to discuss it between yourselves |
| The disagreement is escalating and becoming personal | The matter is trivial and does not affect patient care |
| You have tried to resolve it but reached an impasse | You want a senior to "take your side" |
SJT insight: Involving a senior is appropriate when you have genuinely tried to resolve the disagreement and cannot. It is inappropriate if you have not spoken to your peer first — the SJT almost always expects direct communication as the first step.
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