Before we start
This guide is educational. It is not medical or legal advice, and it is not guidance for any real situation. The law on capacity and consent differs between the four UK nations, and the GMC says each jurisdiction has its own mental capacity legislation. At interview, nobody expects you to quote statutes. They want to see fair, careful thinking.
We use the GMC's professional standards because they apply to doctors across the UK and are written in plain language. Reading a little of them is a good way to prepare.
A framework that works for most stations
Ethics stations reward a calm, step-by-step approach. Try this order, and say it out loud as you go.
- Facts: what do we know, and what would we want to find out?
- People: who is affected, and what might each of them be feeling?
- Principles: respect for the person's choices, acting in their interests, avoiding harm and fairness.
- Guidance: what would professional guidance expect? It is fine to say you would check it or ask a senior.
- Plan: what would you actually do first, and who would you involve?
Capacity: who decides?
The GMC's guidance Decision making and consent came into effect on 9 November 2020. One of its seven principles is that adults are presumed to have capacity to make decisions about their own care. The guidance says capacity is about a specific decision at a specific time, and that a doctor must not assume someone lacks capacity just because they choose an option the doctor considers unwise.
In England and Wales, the Mental Capacity Act 2005 sets out a test. The NHS explains that a person is unable to make a decision if they cannot understand the relevant information, retain it long enough, use or weigh it up, or communicate their decision. The NHS also explains that an adult with capacity can refuse treatment even if refusing would result in their death.
Try this with Mock 2, Station 2 (Q08). An adult with a serious infection refuses antibiotics, appears to understand, and the family asks the doctor to treat anyway. A strong answer recognises the family's distress with real compassion. It explores why the patient is refusing, checks they have the information they need, and considers whether capacity has been properly assessed. If the patient has capacity, it accepts that their decision stands, while keeping the door open and continuing to offer support.
Confidentiality: important, not absolute
The GMC's confidentiality guidance describes confidentiality as an important duty but not an absolute one. It sets out situations where disclosure can be justified, including when the patient consents, when the law requires it, and when it is in the public interest, for example to protect others from a risk of death or serious harm. Even then, the guidance says to share only the minimum necessary and to record the reasons.
Mock 3, Station 2 (Q09) is a classic example. A patient with recent seizures has been told not to drive and to inform the licensing authority. The GMC has specific guidance on this. It says the driver is legally responsible for telling the DVLA or DVA, and that the doctor should make every reasonable effort to persuade them to stop driving. If the patient continues to drive and others are at risk of death or serious harm, the doctor should contact the DVLA or DVA medical adviser promptly. The guidance says to try to tell the patient before disclosing, and to tell them in writing afterwards.
Notice the order. Persuasion and honesty come first. Disclosure is a careful last step, not a first reaction.
Consent and young people
Mock 5, Station 2 (Q10) describes a 15-year-old who asks their GP for contraception and asks that their parents are not told. The GMC's guidance 0-18 years covers this directly. Based on the Gillick case, it lists conditions a doctor should consider before giving advice or treatment without parental knowledge. These include whether the young person understands the advice and its implications, whether they can be persuaded to involve a parent, and whether treatment is in their best interests.
The same guidance asks doctors to think about safeguarding, including signs of exploitation or abuse, and notes that concern about confidentiality is the biggest deterrent to young people seeking sexual health advice. It also says the consultation should stay confidential even if the doctor decides not to provide treatment, unless there is a reason to share information to protect the young person or others.
So a balanced answer respects the young person, encourages but does not force parental involvement, assesses their understanding, stays alert to safeguarding concerns and explains when confidentiality might have to be broken.
When something goes wrong
Mock 4, Station 2 (Q12) asks what you would do as a medical student if you saw a junior doctor give a larger dose than prescribed. Here, two pieces of guidance help.
First, the GMC and NMC's joint guidance on the professional duty of candour says health and care professionals must be open and honest when something goes wrong, tell the person affected, apologise and explain what happens next. It also says professionals should support each other to be open and not stop anyone from raising concerns.
Second, the GMC's guidance on undergraduate clinical placements says patient safety should be the primary concern of medical schools, placement providers and students, and that students should know when to ask for support. A good answer puts the patient's safety first, raises the concern promptly and respectfully with the doctor or a senior, and avoids blame or gossip. It also recognises that you may not have the full picture.
Common mistakes
- Jumping to a decision in the first sentence. Explore first.
- Treating relatives as decision-makers for an adult who has capacity.
- Breaking confidentiality as a first step, rather than a carefully justified last one.
- Forgetting feelings. Every ethics station involves real people under stress.
- Pretending to be certain. It is a strength to say you would seek advice from a senior colleague or guidance.
Practise, then review
Work through Q08, Q09, Q10 and Q12 in our complimentary mocks, timed, then read the model points. For more on resource decisions, try Mock 6, Station 2 (Q11). Some schools include more ethics than others, so check your school's guide via our interview dates page.
If ethics is your weak spot, the Interview Handbook (£249) has a full ethics section, and a one-to-one mock MMI (£180) lets you practise under pressure with feedback. Neither is medical or legal advice, and neither can guarantee an offer.