FMProC practice questions for Canadian family medicine applicants

Dr. Amara Okoye, a first-year Family Medicine resident on a General Internal Medicine ward rotation, is caring for Mr. Stein, a fully competent 68-year-old man recently diagnosed with locally advanced pancreatic cancer. During morning rounds, Mr. Stein's adult children, David and Sarah, intercept Dr. Okoye in the hallway and insist that their father must not be told the diagnosis directly. They explain that hearing such devastating news from a stranger would destroy him, asking that the clinical team allow them to disclose it gradually at home in their own way. When Dr. Okoye raises this with the attending physician, Dr. Vance, the attending remarks that the family knows the patient best and seems content to let them manage the information. Mr. Stein is scheduled for a discharge planning conference this afternoon and has just rung his call bell to ask for an update on his scan results.

Dr. Priya Sundaram is a family medicine resident at an urban community clinic. She is currently seeing Joy, a 17-year-old patient who attended the consultation alone under the clinic's mature minor youth confidentiality protocol. While discussing her tension headaches, Joy becomes visibly distressed, begins to weep, and discloses that she is attracted to girls. Joy suddenly grabs Dr. Sundaram's sleeve and whispers, 'Please don't tell them, please,' expressing acute terror that her parents waiting in the parking lot will find out. Moments later, the clinic medical office assistant sends an urgent instant message stating that Joy's parents have texted requesting a written summary of the visit before driving home. Dr. Sundaram must determine how to handle Joy's immediate distress alongside the parents' request.

You are Dr. Yusuf Ahmed, a PGY2 family medicine resident on a community medicine rotation. You are conducting a home visit with Rina Kowalski, an experienced public health nurse who has worked in this community for fourteen years. As you explain your proposed insulin titration schedule, Rina states flatly across the kitchen table that your plan completely ignores what was agreed upon at the prior care conference. This conference took place two weeks before your rotation began and utilized a different clinical protocol that you were not briefed on. Mr. Doiron looks visibly anxious and glances back and forth between you and Rina, waiting for guidance on what to do next. You must address Rina's concern while maintaining Mr. Doiron's trust and psychological safety in the moment.