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My “memorable patient” story

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39218.580613.DE (Published 02 August 2007) Cite this as: BMJ 2007;335:257
  1. Deborah Bird, specialist registrar in paediatrics, Darent Valley Hospital, Dartford
  1. deborahbird{at}doctors.org.uk

    When it comes to medical interviews, there are a few classic questions, including “Tell me about a memorable patient.” I used to hate this question. As a senior house officer, I took “memorable” to mean the complex, clever medical diagnosis or the difficult case that required clever handling. Most people I knew, myself included, would make up impressive sounding cases tailored to fit the interview. Occasionally, I would use a real patient, as long as there was something about their case that demonstrated my skills or my ability to improve myself. As I was generally successful at interviews, I assumed this was a good approach.

    One evening on call, I was idly chatting with the consultant. He mentioned that “Tell me about a memorable patient” was his favourite question. He felt that the type of patient the candidate deemed memorable was far more important than the details of the case, and that this choice of patient told him more about the candidate than any other question. I paid little attention at the time, but, two years later, I still remember this remark.

    As I've progressed through my training, my attitudes and opinions have changed. Memorable no longer means challenging or complex. Of course, I've not been asked the question since, but I wish someone would. If you asked me today, I would not tell you about the clever diagnoses I have made or the newborns I have successfully resuscitated; I would tell you about just one child—my favourite patient. I'd tell you about this boy who was happy, well adjusted, and polite despite debilitating chronic disease. I'd tell you how he never minded any examination or test and how he had the wonderful gift of making everyone around him feel happy and relaxed, myself included.

    With so many of my colleagues anxiously preparing for interviews for specialist training posts, I am constantly being asked for advice. While I try to help them formulate answers, I remember my conversation with the consultant and my memorable patient. I tell my colleagues that interviews are not just about you the doctor; they're also about you the person. Tell the interviewers about the silliest, funniest, nastiest, or nicest children or parents you have ever met: this reflection on your personality is just as valid as, and probably more interesting than, a medical diagnosis. And incidentally, although I remember the child's name, face, and personality perfectly, I can't remember his diagnosis.

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